Adverse Childhood Experiences (ACEs)

Adverse Childhood Experiences (ACEs) are traumatic events experienced during childhood and remembered as an adult. Examples of ACEs include:

  • physical, sexual, and emotional abuse, 
  • household substance use, 
  • suicide of a loved-one,
  • violence,
  • and poverty.

 Minnesota Department of Health has a more complete list of ACEs

Though the long-lasting effects of ACEs differ based on people’s support systems and how they cope, these events often shape how people perceive and interact with the world, even as adults. ACEs are also related to long-term poor physical health. People with ACEs are more likely to have diseases like diabetes, cancer or heart disease.

ACE scores

The effect of ACEs is usually measured as an “ACE score”. The more adverse experiences people have, the higher their ACE scores. A higher ACE score is associated with a greater risk of anxiety, depression, chronic stress, substance use and suicide. 

ACEs have also played a significant role in opioid addiction and the opioid overdose crisis. According to the CDC, a higher ACE score will increase the odds of opioid misuse. The loss of a friend or family member to overdose or suicide is an ACE that makes it more likely for an individual to overdose or attempt suicide. 

Opioid overprescription can fuel this cycle. Tolerance, when the brain adapts to an opioid and more is required to stop pain, can build up relatively quickly. As people are prescribed more opioids to prevent pain, overdose risk increases. Though opioid prescription has decreased since 2012, the amount prescribed per person remains greater than in 1999, when the opioid epidemic began. 

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Generations of trauma

The relationship between historical and intergenerational trauma, ACE scores and suicide is clear. In American Indian communities, historical and intergenerational trauma is tied to a cycle of ACEs. This cycle continues as the experiences of one generation make it more likely members of the next generation will also experience trauma. American Indian and Alaskan Native communities have a higher suicide rate than other racial and ethnic groups.

Preventing ACEs and subsequent substance use and suicide can be approached on the individual and community level. According to the CDC, changes on the community level that could prevent ACEs include the following:

  • Creating a community that supports “positive parenting.”
  • Helping community members develop parenting skills.
  • Providing economic support.
  • Offering educational opportunities.
  • Becoming involved in situations where ACEs may occur.
  • Providing childcare.

For people who have already experienced an ACE or multiple ACEs, especially kids in school, it may be helpful to use a trauma-informed approach. In other words, when schools try to address problematic behavior with students, they must understand and consider the root causes instead of simply punishing the behavior. 

The results of the Minnesota Student Survey can provide an idea about how common ACEs are in your community. The survey results can also provide a launching point for community change by showing what puts students most at risk and how to protect them from further harms.

Host an ACEs program

If you are interested in hosting a program about ACEs, please reach out to Jennifer Garbow of the American Indian Resource and Resiliency Team by email [email protected] or 218-281-8683. 

Related resources

If you are interested in learning more about the role pharmaceutical companies and providers played in the opioid epidemic, check out these articles: “Drug Companies’ Liability for the Opioid Epidemic” and “Opioid Manufacturer Purdue Pharma Pleads Guilty…”.

Read “The Power of Protective Factors for Minnesota Youth” to find out more.

The death of a loved one from an overdose is an ACE, and it is a time where children may have lots of thoughts and feeling. Use these tips on how to talk to kids when there is a death from an overdose. A shorter and simpler version is also available to print and share.   

The suicide of a loved one is considered an ACE, and the support of a caring adult through that difficult time is important. Kids will need help grieving and processing such a traumatic experience, and this resource for talking to kids about suicide could help. There is also a shorter and simpler version that could be printed and shared in community and learning spaces.  

Listen to the “Remembering Resilience” podcast, on the podcast webpage or on other streaming services, to hear from Indigenous community leaders about how cultural connection helps support healing and build resilience in American Indian communities.