As opioid use-related behaviors continue at epidemic proportions, identifying the root causes of these behaviors is critical. Adverse childhood experiences (ACEs) are shown to be an important predictor of opioid initiation, opioid dependence, and lifetime opioid overdose. The purpose of this systematic review is to examine the association between ACEs and opioid use-related behaviors later in life and to discuss implications for policy, practice, and research regarding ACEs and opioids. Five databases (PubMed, PsycINFO, CINAHL, Medline, and Scopus) were used to identify studies investigating the association between ACEs and opioid use-related behaviors. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 20 studies out of the initial 428 met the inclusion criteria for this review. Among the included 20 studies, 15 focused on the relationship between ACEs and lifetime opioid use-related behaviors, and five focused on current opioid use-related behaviors. All studies found statistical associations between ACEs and lifetime or current opioid use-related behaviors. Five studies found a significant gradient effect; that is, as the number of ACEs increased, the risk of opioid use-related behaviors also increased. A significant dose-response relationship exists between ACEs and opioid use-related behaviors. Hence, it is essential for clinicians to screen for ACEs before prescribing opioid medications, for opioid treatment to incorporate trauma-informed methods, and for messaging around opioid use interventions to include information about ACEs. The current review points to a critical need to implement standardized ACE screening instruments in clinical and research settings.

中文翻译：

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不良童年经历与阿片类药物使用相关行为之间的关联：系统评价。

由于阿片类药物使用相关行为持续流行，找出这些行为的根本原因至关重要。不良童年经历（ACE）被证明是阿片类药物开始使用、阿片类药物依赖和终生阿片类药物过量的重要预测因素。本系统综述的目的是研究 ACE 与晚年阿片类药物使用相关行为之间的关联，并讨论对 ACE 和阿片类药物的政策、实践和研究的影响。五个数据库（PubMed、PsycINFO、CINAHL、Medline 和 Scopus）用于识别调查 ACE 与阿片类药物使用相关行为之间关联的研究。使用系统评价和荟萃分析指南的首选报告项目，最初 428 项研究中有 20 项符合本次评价的纳入标准。在纳入的 20 项研究中，15 项重点关注 ACE 与终生阿片类药物使用相关行为之间的关系，5 项重点关注当前阿片类药物使用相关行为。所有研究都发现 ACE 与寿命或当前阿片类药物使用相关行为之间存在统计关联。五项研究发现了显着的梯度效应；也就是说，随着 ACE 数量的增加，阿片类药物使用相关行为的风险也随之增加。ACE 与阿片类药物使用相关行为之间存在显着的剂量反应关系。因此，临床医生必须在处方阿片类药物之前筛查 ACE，将阿片类药物治疗纳入创伤知情方法，以及围绕阿片类药物使用干预措施传递信息以包含有关 ACE 的信息。当前的审查指出，迫切需要在临床和研究环境中实施标准化 ACE 筛查仪器。