Adults with substance use disorders: the long-term impact of adverse childhood experiences in a socioeconomically disadvantaged South African community
1
Division of Public Health Medicine, School of Public Health, University of Cape Town, Cape Town, South Africa
2
Department of Health and Wellness, Western Cape Government, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2602
ABSTRACT
INTRODUCTION:
Substance use represents a major public health concern in Mitchell’s Plain, Cape Town, South Africa. Despite evidence linking numerous socioeconomic factors to adult substance use, there remains limited local evidence on the role of adverse childhood experiences (ACEs) in shaping long-term vulnerability to substance use disorders (SUDs). This study aimed to determine the association between ACEs and SUDs among adults.
METHODS:
A cross‑sectional folder review was conducted using consecutive sampling at Lentegeur Hospital, Mitchell’s Plain. Clinical records of adults (≥18 years) residing in Mitchell’s Plain and admitted between 1 January 2015 and 1 January 2025 were reviewed. Data was collected between September 2025 and November 2025. SUDs and ACEs were identified based on the DSM-5 and the World Health Organisation ACE International Questionnaire, respectively. Descriptive statistics and bivariate analyses were performed.
RESULTS:
A total of 83 records were analysed. Of these, 69.6% of participants were male, with half of all participants aged between 30-40 years (50%). Most participants were single (78.3%), had not matriculated (69.6%), and experienced unemployment (91.9%). Cannabis (76.1%) and methamphetamine (52.2%) were the most commonly reported substances, including polysubstance use. Over half of the participants (55.4%) had a diagnosed SUD. SUDs were more prevalent among ACE-exposed individuals (58.7%) compared to those without ACE-exposure (35.1%). Participants with ACE exposure were 2.62 times more likely to have a SUD diagnosis than non-exposed individuals. Unemployment was also significantly more common amongst ACE-exposed participants in the SUD-diagnosed group (96.3%) compared to those without ACE exposure (73.7%).
CONCLUSIONS:
Adults with substance use disorders in Mitchell’s Plain experience substantial exposure to adverse childhood experiences, which may contribute to ongoing socioeconomic vulnerability and increased risk of SUDs in adulthood. These findings highlight a need for trauma‑informed, context‑specific substance use interventions that integrate psychosocial support and address early life adversity.
Substance use represents a major public health concern in Mitchell’s Plain, Cape Town, South Africa. Despite evidence linking numerous socioeconomic factors to adult substance use, there remains limited local evidence on the role of adverse childhood experiences (ACEs) in shaping long-term vulnerability to substance use disorders (SUDs). This study aimed to determine the association between ACEs and SUDs among adults.
METHODS:
A cross‑sectional folder review was conducted using consecutive sampling at Lentegeur Hospital, Mitchell’s Plain. Clinical records of adults (≥18 years) residing in Mitchell’s Plain and admitted between 1 January 2015 and 1 January 2025 were reviewed. Data was collected between September 2025 and November 2025. SUDs and ACEs were identified based on the DSM-5 and the World Health Organisation ACE International Questionnaire, respectively. Descriptive statistics and bivariate analyses were performed.
RESULTS:
A total of 83 records were analysed. Of these, 69.6% of participants were male, with half of all participants aged between 30-40 years (50%). Most participants were single (78.3%), had not matriculated (69.6%), and experienced unemployment (91.9%). Cannabis (76.1%) and methamphetamine (52.2%) were the most commonly reported substances, including polysubstance use. Over half of the participants (55.4%) had a diagnosed SUD. SUDs were more prevalent among ACE-exposed individuals (58.7%) compared to those without ACE-exposure (35.1%). Participants with ACE exposure were 2.62 times more likely to have a SUD diagnosis than non-exposed individuals. Unemployment was also significantly more common amongst ACE-exposed participants in the SUD-diagnosed group (96.3%) compared to those without ACE exposure (73.7%).
CONCLUSIONS:
Adults with substance use disorders in Mitchell’s Plain experience substantial exposure to adverse childhood experiences, which may contribute to ongoing socioeconomic vulnerability and increased risk of SUDs in adulthood. These findings highlight a need for trauma‑informed, context‑specific substance use interventions that integrate psychosocial support and address early life adversity.
| eISSN: | 2654-1459 |
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