Exploring Pathways from Childhood Adversity to Substance Use in Young Adults

Adverse childhood experiences (ACEs) are recognized risk factors for later substance use. Yet, data remain scarce—particularly regarding the differentiated effects of specific types of ACEs and their distinct associations with various psychoactive substances. The current study is one of the first in Lithuania to explore the associations between specific ACEs and psychoactive substance use in young adulthood (ages 18–29). This cross-sectional study included a total of 709 participants who completed an online survey. ACEs were measured using a combination of adapted ACEs items and the MACE questionnaire. Substance use was assessed using self-reported instruments: CUDIT-R (cannabis), AUDIT (alcohol), ASSIST (heavy psychoactive substances), and nicotine use. Structural equation modeling (SEM) was chosen to examine predictive relationships. Results revealed that experiences of sexual abuse and physical maltreatment in childhood predicted higher levels of alcohol use in young adulthood. Sexual abuse was positively associated with nicotine, cannabis, and heavy psychoactive substance use, while witnessing interpersonal violence was only associated with higher nicotine use. However, verbal abuse showed significant negative associations across several substance categories. No significant associations were found between family addiction history and substance use. The absence of an important relationship between family history of addiction and substance use indicates that genetic factors may be less decisive than environmental or psychosocial conditions. The main findings of this study are that ACEs are not qualitatively equivalent to one another, so it is worth examining them separately, rather than summing them. Furthermore, based on the negative associations with verbal abuse and the generally statistically negative associations, we can assume that ACEs may not be the most important factors increasing substance use. Further studies should look for other factors that influence substance use.