Non-medical use of drugs and adverse childhood experiences in a community sample

The misuse of addictive drugs is increasing worldwide and has become a major public health concern. Recent trends indicate a growing reliance on prescription medications with misuse potential, raising concerns about their non-medical use in community settings.

This study aimed to investigate the current status of addictive drug use in a regional community and analyze the severity of drug misuse and mental health-related indicators among drug users, thereby providing foundational data for preventing drug addiction problems in the community.

From June to August 2024, data were collected through an online survey using a structured questionnaire from 1,000 residents aged 19 to 65 years in Gangwon State, South Korea. Along with sociodemographic characteristics, the prevalence and types of addictive drugs used were investigated. Participants were categorised into three groups based on drug use within the past year: past user (no use within the past year), medical user (medical user within the past year), and non-medical user (non-medical user within the past year). For those who used addictive drugs within the past year, the severity of drug misuse was assessed using the Drug Abuse Screening Test (Korean version). Depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), adverse childhood experiences (Adverse Childhood Experiences), and life satisfaction (Satisfaction With Life Scale) were also measured. Group differences were analysed using analysis of variance, including Welch’s ANOVA when assumptions were violated, followed by appropriate post-hoc tests. The survey sample was proportionally stratified by age, sex, and region to enhance representativeness of the general population.

The lifetime and 1-year prevalence of addictive drug use were 13.2% and 7.1%, respectively. The most commonly used substances were medically prescribed sedatives, hypnotics, and opioids. No significant sociodemographic differences were observed among the past, medical, and non-medical user groups. Among those who used drugs within the past year, the non-medical user group showed significantly higher severity of drug misuse than the medical user group (2.35±2.41 vs. 0.76±1.26, t = -2.794, p = .010). Notably, the non-medical user group reported significantly higher scores for adverse childhood experiences than the past user group (7.60±6.15 vs. 3.57±3.54, p = .027). No significant differences were found in depression, anxiety, and life satisfaction among the three groups.

In the Gangwon State community, drug misuse is primarily centred on the non-medical use of prescription drugs, including sedatives, hypnotics, and opioids. Exposure to adverse childhood experiences may be associated with an increased risk of addictive drug use in adulthood. These findings suggest the importance of considering early-life adversity in understanding vulnerability to drug misuse. This pattern may reflect underlying vulnerability mechanisms related to stress regulation and maladaptive coping. This is consistent with previous evidence linking early-life adversity to increased vulnerability to substance misuse and highlights the importance of further research into early identification and prevention of high-risk groups. These findings may have implications for community-based strategies to prevent drug misuse.

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