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Substance abuse cause and effect

Uintah Basin Standard - 8/2/2017

This article is part one in a five part column on recovery, mental health and substance abuse.

I'm reading another application. I don't cry easily, but I feel the tears coming. The woman writes:

"My name is Zulema Salazar. I was broken beyond repair. I come from an abusive and highly unstable childhood, both of my parents were heroin addicts and my father died of a heroin overdose when I was four. I was in and out of foster care. I began to form the belief that something was wrong with me and I was defective. I started using drugs and alcohol, and that became my solution to everything. I got pregnant at the age of 18, lost custody of my children when they were six months old. I didn't have the slightest clue how to be a mother. Soon after, I was sent to prison for the first time. The recidivism continued for the next 12 years. Here I was 32 years old and had absolutely no idea how to live life."

Broken homes - broken adults - broken children. Why?

I was brought up in the 1960s with middle-class values. High standards, get an education and job, get married. People who didn't do that were immoral and lazy.

By the time I was in my 50s and starting graduate school in social work, I thought I'd become a more enlightened person. But, funny how a prejudice is something you never know you have, until you don't have it anymore. On the first day of class, we learned about the ACE Study.

17,000 well-educated, middle-class adults, insured through a major HMO, were asked if they had experienced any of 10 Adverse Childhood Experiences (ACEs) that correlate with chronic disease in adulthood. The results were shocking.

Household substance abuse ? 27 percent; parental separation or divorce ? 23 percent; household mental illness ? 17 percent; battered mother ? 13 percent; incarcerated household member ? 6 percent; physical abuse ? 28 percent; sexual abuse ? 21 percent; emotional abuse ? 11 percent; emotional neglect ? 15 percent; and, physical neglect 10 percent. No ACEs- 36 percent.

A person's "ACE score" was found by adding up the total number of types of ACEs. Higher ACE scores significantly increase the odds of an adult having a substance use disorder, chronic depression, suicide, anxiety disorders, incarceration, extreme obesity, poor educational and employment outcomes, and chronic physical diseases. If a child had four or more ACEs (and where there's one, there are usually more), the risk was up to 12 times greater.

ACEs were first seen as risk factors for chronic disease in adulthood. They've now also identified with negative consequences in childhood. Epigenetics-the study of how social and other environments turn our genes on and off-shows that stress from these experiences can actually alter our gene expression and cause long-term changes in our bodies and brains.

These experiences can cause disrupted neuro-development, causing social, emotional and cognitive impairment. These can lead to behaviors such as teen substance abuse, risky sexual behaviors and loss of interest in school, which can lead to disability, disease, social problems and early death.

Not everyone with ACEs will meet this fate. Children with resilience may weather the storm. While some people are naturally resilient, children and adults can learn ways of thinking that boost resilience. The brain has the ability to grow, adapt, reorganize and form new connections throughout life. ACEs are not destiny; the brain can be hurt, but it can also heal.

And Zulema? She now gives others the hope to heal.

Susan Mansfield, MSW, CSW, is the director, Utah State University CPSS Training Program, Utah State University - Uintah Basin.