How Childhood Experiences Influence Substance Use Later in Life

Childhood experiences play a crucial role in shaping an individual's behavior and choices later in life, particularly regarding substance use. The connection between early life experiences and substance use disorders has been extensively documented through decades of research, revealing complex pathways that link childhood adversity, family dynamics, peer relationships, and socioeconomic factors to addiction risk. Understanding this connection can help educators, parents, healthcare professionals, and policymakers create supportive environments that promote healthy development and prevent substance use disorders before they begin.

The Profound Impact of Early Experiences on Lifelong Health

Research consistently demonstrates that various childhood experiences can significantly influence the likelihood of substance use during adolescence and adulthood. Toxic stress from adverse childhood experiences can negatively affect children's brain development, immune system, and stress-response systems, affecting their attention, decision-making, and learning. These neurobiological changes create vulnerabilities that can persist throughout the lifespan, making individuals more susceptible to substance use as a coping mechanism.

Childhood maltreatment affects trajectories of brain development that are involved in threat detection, emotional regulation, and reward anticipation. This disruption in normal brain development helps explain why individuals who experience childhood adversity often turn to substances as a way to manage emotions and stress. Exposure to traumatic experiences during childhood has been shown to predict cortisol dysregulation, leading to heightened threat sensitivity, and impacts brain structures including the prefrontal cortex and amygdala, which are involved in behavioral inhibition, self-control, and impulsivity.

The scope of this issue is substantial. Three in four high school students reported experiencing one or more adverse childhood experiences, and one in five experienced four or more. These experiences can be categorized into several key areas that each contribute uniquely to substance use risk: family environment, peer influences, socioeconomic status, and trauma or adverse childhood experiences.

Understanding Adverse Childhood Experiences (ACEs)

Adverse childhood experiences are potentially traumatic events that occur in childhood (0-17 years), including experiencing violence, abuse, or neglect, witnessing violence in the home or community, and having a family member attempt or die by suicide. Aspects of the child's environment that can undermine their sense of safety, stability, and bonding include growing up in a household with substance use problems, mental health problems, instability due to parental separation, and instability due to household members being in jail or prison.

The relationship between ACEs and substance use disorders is both strong and well-documented. Adults with any history of ACEs have a 4.3-fold higher likelihood of developing a substance use disorder. This risk varies by gender and substance type, with female adults having a 5.9-fold higher likelihood of developing an alcohol use disorder and male adults having a 5.0-fold higher likelihood of developing an illicit drug use disorder.

Survivors of childhood trauma are 15 times more likely to attempt suicide, four times more likely to develop an alcohol-related disorder, and 2.5 times more likely to smoke cigarettes. These statistics underscore the critical importance of early identification and intervention for children experiencing adversity.

The Cumulative Effect of Multiple ACEs

Research shows that the number of adverse experiences matters significantly. Individuals with ACEs were more likely to use or abuse alcohol or other substances during early adulthood, and this association was pronounced for multiple ACEs. The cumulative nature of ACEs means that each additional adverse experience compounds the risk, creating a dose-response relationship where more trauma leads to greater vulnerability.

An ACE score of one increases the risk of depressive symptoms by 50% and an ACE score of four or more shows a fourfold increase. This relationship between ACEs and mental health problems creates an additional pathway to substance use, as individuals may turn to drugs or alcohol to self-medicate symptoms of depression, anxiety, or post-traumatic stress disorder.

Specific Types of ACEs and Their Impact

Physical abuse, parental divorce and witnessed violence were the strongest individual ACE predictors for substance use disorders. However, all forms of childhood adversity contribute to risk. ACEs that were most common among high school students were emotional abuse, physical abuse, and living in a household affected by poor mental health or substance use.

The mechanisms through which different types of ACEs influence substance use vary. Childhood abuse, childhood neglect, and family dysfunction all significantly affected depression, in turn affecting drug use. This suggests that mental health symptoms serve as an important mediating factor between childhood adversity and later substance use.

Family Environment: The Foundation of Development

The family environment is one of the most significant factors influencing childhood development and subsequent substance use risk. A supportive and nurturing family can foster resilience and serve as a protective factor, while a dysfunctional family environment may increase the risk of substance use substantially. The quality of family relationships, parenting practices, and household stability all play crucial roles in shaping a child's trajectory.

Parental Supervision and Monitoring

High levels of parental supervision and monitoring can significantly reduce the likelihood of substance use. Positive parent/child relationship, parental supervision/monitoring, and consistent discipline, and parental communications of nondrug use expectations and family values are the major reasons youth do not use drugs or engage in other adolescent behavioral problems.

Effective parental monitoring involves knowing where children are, who they are with, and what activities they are engaged in. This doesn't mean intrusive or controlling behavior, but rather maintaining appropriate awareness and involvement in children's lives. Parents who maintain open communication channels and demonstrate genuine interest in their children's activities create an environment where risky behaviors are less likely to develop.

Parenting Styles and Their Influence

The style of parenting employed has a profound impact on substance use risk. Parental involvement, restriction of mature-rated content, parental monitoring, authoritative parenting styles, and parental support and knowledge can help in the prevention of adolescent substance use. Authoritative parenting, characterized by warmth combined with clear expectations and boundaries, appears to be most protective.

In contrast, poor parent-child bonding, overprotection, permissive parenting, parental frustrations, authoritarian and harsh parenting styles promoted adolescent substance use disorders. Authoritarian parenting, which emphasizes strict control without warmth, can create a stressful home environment that drives children toward substance use as an escape or act of rebellion.

Permissive parenting, which lacks clear boundaries and expectations, leaves children without the structure and guidance they need to make healthy choices. This parenting style may fail to communicate the serious risks associated with substance use or provide insufficient consequences for risky behaviors.

Parental Attitudes and Communication

Parents who openly discuss the dangers of substance use and clearly communicate their expectations can significantly influence their children's choices. These conversations should begin early and continue throughout childhood and adolescence, adapting to the child's developmental level and understanding.

Effective communication about substance use involves more than just warnings about dangers. It includes helping children develop critical thinking skills, teaching them how to resist peer pressure, and providing them with healthy coping strategies for stress and difficult emotions. Parents who model healthy behaviors and demonstrate effective stress management provide powerful examples for their children to follow.

Substance Use in the Home

Exposure to substance use by family members can normalize these behaviors and significantly increase risk. Children with a parent who has a substance use disorder are more likely than children who do not have a parent with a substance use disorder to have lower socioeconomic status and increased difficulties in academic and social settings and family functioning.

About 1 in 8 children in the United States aged 17 or younger were residing in homes with at least one parent who had a substance use disorder, and this rate was consistent across four age groups ranging from younger than 3 years to adolescents aged 12 to 17. This widespread exposure highlights the intergenerational nature of substance use disorders and the importance of family-based interventions.

Impaired parenting and dysfunctional family dynamics are primary contributors to ineffective parenting, with parental substance use linked to an increased likelihood of adolescent substance use, higher levels of conflict, anger, criticism, harsh parenting, and hostility, as well as reduced levels of cohesion, support, and warmth.

The Role of Family Stability

Family stability provides children with a sense of security and predictability that supports healthy development. Instability due to parental separation, divorce, frequent moves, or household members being incarcerated can disrupt this foundation and increase vulnerability to substance use.

However, it's important to note that family structure alone doesn't determine outcomes. A single-parent household with strong parenting practices and stable routines can be far more protective than a two-parent household characterized by conflict, abuse, or neglect. The quality of relationships and parenting practices matters more than family configuration.

Peer Influences: The Growing Impact During Adolescence

As children grow and develop, peer relationships become increasingly important and influential. Friends can have a profound impact on behavior, including substance use. During adolescence, when identity formation and social belonging are central developmental tasks, peer influence reaches its peak.

The Power of Peer Pressure

Friends who use substances can pressure others to join in, either through direct encouragement or more subtle social dynamics. Peer pressure doesn't always involve explicit coercion; often it operates through the desire to fit in, be accepted, or maintain friendships. Adolescents who lack strong family connections or have low self-esteem may be particularly vulnerable to peer pressure.

Proximal risk factors like peer influence, previous use of other substances, and risky behaviours had more effect than just parenting styles. This finding underscores the importance of addressing multiple risk factors simultaneously rather than focusing solely on family interventions.

Social Norms and Perceived Acceptance

The perceived acceptance of substance use within a peer group can significantly influence individual choices. When adolescents believe that "everyone is doing it," they are more likely to engage in substance use themselves, even if the actual prevalence is lower than perceived. This highlights the importance of accurate education about substance use rates and the development of critical thinking skills.

Social norms operate at multiple levels, including immediate friend groups, school culture, and broader community attitudes. Interventions that address social norms can help correct misperceptions and create environments where substance-free choices are supported and valued.

Friendship Quality as a Protective Factor

Strong, positive friendships can serve as a protective factor against substance use. Friends who share healthy values, engage in prosocial activities, and support each other's wellbeing create a social environment that discourages risky behaviors. These friendships provide emotional support, positive role models, and alternatives to substance use.

Helping children and adolescents develop strong social skills and form healthy friendships is an important prevention strategy. Programs that facilitate positive peer connections and teach relationship skills can build this protective factor.

Socioeconomic Status and Environmental Context

Socioeconomic status (SES) can significantly affect childhood experiences and opportunities, creating additional layers of risk or protection. Children from lower SES backgrounds may face more challenges and stressors, potentially increasing the risk of substance use. However, the relationship between SES and substance use is complex and mediated by multiple factors.

Access to Resources and Opportunities

Limited access to educational and recreational resources can lead to higher risk behaviors. Children who lack access to quality schools, after-school programs, sports teams, arts activities, and other enrichment opportunities may have fewer positive outlets for their energy and fewer pathways to success and achievement.

Communities with limited resources may also have fewer prevention programs, mental health services, and support systems available to families. This lack of infrastructure can leave vulnerable children without the interventions and support they need to overcome adversity and avoid substance use.

Economic Stress and Household Instability

Economic stress can create an unstable home environment, contributing to substance use risk through multiple pathways. Financial strain increases parental stress, which can negatively impact parenting quality, family relationships, and household stability. Parents struggling with economic hardship may have less time and energy available for supervision and involvement in their children's lives.

Economic instability can also lead to frequent moves, changes in schools, and disruptions in social networks, all of which can increase stress and reduce protective factors. The chronic stress associated with poverty can have direct effects on child development, including impacts on brain development and stress response systems.

Community Environment and Neighborhood Factors

Neighborhoods with high crime rates, limited support systems, and easy access to substances can increase vulnerability to substance use. Community-level factors such as the availability of alcohol and drugs, the presence of drug dealing, and community norms around substance use all influence individual risk.

ACEs and community factors such as living in under-resourced neighborhoods can cause toxic stress, and toxic stress from ACEs can negatively affect children's brain development, immune system, and stress-response systems. This interaction between individual experiences and environmental context highlights the need for multi-level interventions that address both individual and community factors.

However, communities can also provide important protective factors. Neighborhoods with strong social cohesion, positive role models, quality schools, and accessible support services can buffer against risk and promote resilience even in the face of economic challenges.

The Neurobiological Impact of Childhood Trauma

Understanding how childhood experiences physically change the developing brain helps explain the strong connection between early adversity and later substance use. The brain undergoes rapid development during childhood and adolescence, and experiences during this period have lasting effects on brain structure and function.

ACEs can lead to insecure attachments in children and interfere with the neurobiological development of the brain. These changes affect multiple brain systems involved in emotion regulation, stress response, reward processing, and impulse control—all of which play important roles in substance use vulnerability.

The impairment in executive functioning resulting from exposure to ACEs leads to increased substance use or dependence starting in adolescence and continuing into adulthood. Executive functions include abilities such as planning, decision-making, impulse control, and emotional regulation. When these capacities are compromised by childhood adversity, individuals have greater difficulty resisting immediate temptations and making choices aligned with long-term goals.

Emotional Regulation and Coping Mechanisms

Substance use can have a role in emotional regulation. For individuals who experienced childhood trauma, substances may serve as a way to manage overwhelming emotions, numb psychological pain, or escape from distressing memories and thoughts. Research shows a propensity to self-medicate with substances to escape or numb negative thoughts and feelings.

Exposure to traumatic experiences contributed to emotional dysregulation, inducing poor coping that facilitated substance use. This stepwise process helps explain how childhood adversity translates into substance use: trauma disrupts normal emotional development, leading to difficulties managing emotions, which in turn leads to maladaptive coping strategies including substance use.

The Role of Depression and Mental Health

Mental health problems serve as an important mediating factor between childhood adversity and substance use. ACEs significantly affected depression, which increased the likelihood of drug use. The relationship between ACEs, mental health, and substance use creates a complex web where each factor influences the others.

ACEs have been associated with several mental health issues such as depression, anxiety and post-traumatic stress disorder. These mental health conditions increase substance use risk both through biological mechanisms (such as altered brain chemistry and stress response) and behavioral pathways (such as self-medication and impaired decision-making).

Resilience: A Critical Protective Factor

While childhood adversity increases risk, not all children who experience trauma develop substance use disorders. Resilience—the ability to adapt successfully despite adversity—serves as a crucial protective factor that can buffer against risk and promote positive outcomes even in challenging circumstances.

ACEs were positively correlated with depression, and resilience was negatively correlated with ACEs and depression, and ACEs not only affected drug addiction through resilience or depression alone but also through the combined action of resilience and depression, indicating that depression led to drug addiction while resilience weakened the effect of ACEs on depression and drug addiction.

Resilience can be fostered through multiple pathways, including supportive relationships with caring adults, development of coping skills, opportunities for success and mastery, and connection to community resources. Programs that build resilience focus on strengthening protective factors rather than simply reducing risk factors.

The Importance of Supportive Relationships

Even one stable, supportive relationship with a caring adult can make a significant difference for children experiencing adversity. This relationship might be with a parent, grandparent, teacher, coach, mentor, or other trusted adult who provides consistent support, encouragement, and guidance.

These relationships help children develop secure attachments, learn healthy coping strategies, and build self-esteem. They provide a safe space for children to process difficult experiences and develop a sense of hope and possibility for the future.

Gender Differences in Risk and Response

Research reveals important gender differences in how childhood experiences influence substance use risk. This study reinforces the association between ACEs and substance use disorders and exposes a gender-specific pattern. Understanding these differences can help tailor prevention and intervention efforts to be more effective.

Males and females may experience different types of ACEs at different rates, respond to adversity through different coping mechanisms, and face different social pressures around substance use. These gender-specific patterns suggest the need for prevention programs that address the unique needs and experiences of boys and girls.

The Public Health Impact of ACEs

The widespread prevalence of ACEs and their strong association with substance use disorders represent a significant public health challenge. Population-attributable fractions associated with experiencing ACEs were highest for suicide attempts (89.4%), seriously considering attempting suicide (85.4%), and prescription opioid misuse (84.3%).

Preventing ACEs could reduce suicide attempts among high school students by as much as 89%, prescription pain medication misuse by as much as 84%, and persistent feelings of sadness and hopelessness by as much as 66%. These statistics demonstrate the enormous potential impact of effective ACE prevention efforts.

Beyond substance use, preventing ACEs could reduce cases of heart disease by 22% and depression by 78% for adults. This broad impact across multiple health outcomes underscores the importance of addressing childhood adversity as a fundamental public health priority.

Preventive Measures and Interventions

Recognizing the impact of childhood experiences on substance use is essential for developing effective preventive measures. A comprehensive approach that addresses multiple risk factors and strengthens protective factors offers the best chance of preventing substance use disorders before they develop.

Family-Based Prevention Programs

Standardized family-based interventions are the most effective way of preventing or treating adolescent substance abuse and delinquency. These programs work by strengthening family relationships, improving parenting skills, and enhancing family communication.

Culturally tailored family-based intervention strategies such as "Preventive Parenting", "Parent Training", and "Parent Involvement", with focus on "Technology Assisted Intervention", particularly "SMART" (Substance Misuse among Adolescents in Residential Treatment) are found as effective family-based intervention strategies to mitigate substance use in youth.

Effective family programs teach parents specific skills such as active listening, clear communication of expectations, appropriate monitoring, consistent discipline, and positive reinforcement. They also help families strengthen emotional bonds and create supportive home environments where children feel valued and connected.

Education and Awareness Programs

Programs that educate parents and children about the risks of substance use can be beneficial when they go beyond simple scare tactics to provide accurate information, build critical thinking skills, and teach effective coping strategies. Evidence-based prevention curricula delivered in schools can reach large numbers of youth with consistent messages about substance use risks.

Parent education programs can help caregivers understand child development, recognize warning signs of substance use, and learn effective communication strategies. These programs are most effective when they are accessible, culturally appropriate, and provide practical skills that parents can immediately apply.

Support Services for Families

Providing access to counseling and support services for families can help address underlying issues that contribute to substance use risk. Mental health services, trauma-informed care, and family therapy can help families heal from past adversity and develop healthier patterns of interaction.

The annual average of 8.7 million children aged 17 or younger living in U.S. households with at least one parent who had a substance use disorder highlights the potential breadth of substance use prevention and treatment needs for the whole family, and as substance use and SUDs among parents often occur in households that face other challenges (e.g., mental illness, poverty, domestic violence), the recovery process may need to extend beyond substance use treatment to produce the changes in a family that are necessary to ensure a healthy family environment for a child.

Integrated services that address multiple family needs simultaneously—such as substance abuse treatment, mental health care, parenting support, and economic assistance—are more effective than fragmented services that address only one issue at a time.

Community-Based Programs and Activities

Engaging children in positive community activities can reduce the likelihood of substance use by providing structured time, positive peer connections, skill development opportunities, and relationships with caring adults. After-school programs, sports teams, arts activities, youth groups, and mentoring programs all serve as protective factors.

These programs are most effective when they are accessible to all children regardless of family income, provide consistent and sustained engagement rather than brief interventions, and actively work to build youth competencies and connections.

School-Based Interventions

Schools provide an important setting for prevention efforts because they reach nearly all children and adolescents. Comprehensive school-based prevention includes evidence-based curricula, policies that create safe and supportive school climates, early identification of at-risk students, and connections to support services.

Social-emotional learning programs that teach skills such as emotion regulation, problem-solving, and relationship building can address some of the developmental deficits associated with childhood adversity. These universal programs benefit all students while providing particular support to those who have experienced trauma.

Trauma-Informed Approaches

Trauma-informed care recognizes the widespread impact of trauma and integrates knowledge about trauma into policies, procedures, and practices. This approach involves understanding how trauma affects development and behavior, recognizing signs of trauma in children and families, and responding in ways that avoid re-traumatization and promote healing.

Healthcare providers, educators, social service workers, and others who work with children can benefit from training in trauma-informed approaches. This training helps professionals understand behavior in context, respond with empathy rather than punishment, and connect families to appropriate services.

Early Intervention Services

Prevention and early intervention services can examine frequency, severity and duration of both the trauma experience and the addiction. Identifying children who have experienced adversity and providing early support can prevent the development of substance use disorders and other negative outcomes.

Early intervention requires systems for screening and assessment, trained professionals who can provide appropriate services, and coordination across multiple systems including healthcare, education, and child welfare. The earlier that intervention occurs, the greater the potential to alter developmental trajectories and prevent long-term problems.

Policy Implications and System-Level Changes

Addressing the connection between childhood experiences and substance use requires changes at the policy and systems level, not just individual interventions. Creating environments that support healthy child development and prevent ACEs requires coordinated action across multiple sectors.

Economic Support for Families

Policies that reduce economic stress on families can help prevent ACEs and create more stable environments for children. This includes living wage policies, affordable housing, access to quality childcare, paid family leave, and other supports that help families meet basic needs and reduce chronic stress.

Economic security allows parents to be more present and engaged with their children, reduces family conflict, and provides resources for enrichment activities and opportunities. Investing in family economic stability is an investment in child wellbeing and substance use prevention.

Healthcare System Integration

Integrating substance use prevention into routine healthcare can help identify at-risk children and families earlier and connect them to appropriate services. Screening for ACEs in pediatric settings, providing anticipatory guidance about substance use prevention, and offering family-based interventions in healthcare settings can all contribute to prevention efforts.

Healthcare systems can also play a role in addressing parental substance use disorders, which directly impact children's risk. Ensuring that parents have access to effective treatment and that treatment programs address parenting and family functioning can benefit both parents and children.

Cross-System Collaboration

Effective prevention requires collaboration across systems including healthcare, education, child welfare, juvenile justice, and community organizations. No single system can address all the factors that contribute to substance use risk; coordinated efforts that leverage the strengths of multiple systems are needed.

This collaboration requires shared goals, common language and understanding, mechanisms for communication and coordination, and policies that support rather than hinder cross-system work. Communities that successfully implement collaborative approaches see better outcomes for children and families.

The Role of Cultural Context

Cultural factors influence how childhood experiences affect substance use risk and how prevention efforts should be designed and implemented. Cultural values, beliefs, practices, and community structures all shape child development and family functioning.

Effective prevention programs must be culturally appropriate and responsive to the communities they serve. This means involving community members in program design, adapting interventions to align with cultural values and practices, and ensuring that programs are delivered in culturally competent ways.

Different cultural groups may experience different types and rates of ACEs, have different protective factors available, and respond differently to various intervention approaches. Understanding and respecting these differences is essential for effective prevention.

Looking Forward: Research and Innovation

While substantial research has documented the connection between childhood experiences and substance use, important questions remain. Ongoing research continues to refine our understanding of mechanisms, identify effective interventions, and explore how to best implement and sustain prevention efforts.

Emerging areas of research include the role of epigenetics in transmitting the effects of trauma across generations, the potential for technology-enhanced interventions to increase reach and accessibility, and the identification of specific intervention components that drive positive outcomes.

Innovation in prevention approaches includes the development of more personalized interventions that match specific risk profiles, the use of implementation science to improve the translation of research into practice, and the exploration of how to build resilience and promote positive development rather than simply reducing risk.

Practical Steps for Parents and Caregivers

While systemic changes are important, individual parents and caregivers can take concrete steps to reduce substance use risk and promote healthy development in the children they care for.

Building strong, warm relationships with children provides a foundation for healthy development. This involves spending quality time together, showing affection and appreciation, listening actively to children's thoughts and feelings, and being emotionally available and responsive.

Maintaining appropriate supervision and monitoring helps parents stay aware of children's activities and friendships while respecting growing needs for autonomy. This balance changes as children develop, requiring ongoing adjustment of parenting approaches.

Communicating clearly about expectations and values, including expectations around substance use, helps children understand boundaries and make informed choices. These conversations should be ongoing rather than one-time events, adapting to children's developmental levels and experiences.

Modeling healthy behaviors and coping strategies teaches children by example. Parents who manage stress effectively, maintain healthy relationships, and avoid substance misuse provide powerful models for their children to emulate.

Seeking help when needed demonstrates strength rather than weakness. Parents who are struggling with their own mental health, substance use, or parenting challenges can benefit from professional support, and getting help early can prevent problems from escalating.

The Importance of Hope and Possibility

While the research on childhood experiences and substance use reveals serious risks and challenges, it also points toward hope and possibility. Adverse childhood experiences can be prevented, and when prevention isn't possible, effective interventions can mitigate their impact and promote resilience.

Not all children who experience adversity develop substance use disorders. Many demonstrate remarkable resilience and go on to lead healthy, productive lives. Understanding the factors that promote resilience can help us support all children in developing these capacities.

The science of prevention has advanced significantly, providing evidence-based approaches that can reduce substance use and promote positive development. When these approaches are implemented with fidelity and sustained over time, they produce meaningful improvements in outcomes.

Conclusion

Understanding how childhood experiences influence substance use later in life is crucial for educators, parents, healthcare professionals, and policymakers. The evidence clearly demonstrates that adverse childhood experiences, family dysfunction, peer influences, and socioeconomic challenges all contribute to substance use risk through complex, interconnected pathways.

The neurobiological impact of childhood trauma helps explain why early adversity has such lasting effects, disrupting brain development in ways that increase vulnerability to substance use. Mental health problems, particularly depression, serve as important mediating factors between childhood adversity and substance use.

However, the research also reveals protective factors that can buffer against risk. Strong family relationships, effective parenting practices, positive peer connections, supportive communities, and individual resilience all contribute to positive outcomes even in the face of adversity.

Effective prevention requires a comprehensive approach that addresses multiple levels—from individual and family interventions to community programs and policy changes. Family-based programs have demonstrated particular effectiveness, highlighting the central role that families play in both risk and protection.

By fostering supportive environments, addressing risk factors early, strengthening protective factors, and implementing evidence-based prevention programs, we can help children develop healthier behaviors and choices. This requires sustained commitment, adequate resources, and collaboration across multiple systems and sectors.

The public health impact of preventing ACEs and reducing substance use is enormous, with potential benefits extending far beyond substance use to include improvements in mental health, physical health, educational outcomes, and overall quality of life. Every child deserves to grow up in an environment that supports healthy development and provides the foundation for a successful future.

Continuous research, community engagement, and commitment to evidence-based practice are vital in creating effective prevention strategies that can significantly reduce substance use in future generations. By working together—families, communities, professionals, and policymakers—we can create a society where all children have the opportunity to thrive.

For more information on adverse childhood experiences and prevention strategies, visit the CDC's ACEs Prevention Resource. Additional resources on family-based prevention programs can be found through the Substance Abuse and Mental Health Services Administration. Parents seeking guidance on talking to children about substance use can find helpful information at the National Institute on Drug Abuse.