Adults who faced adversity during childhood were significantly more likely to die from or be hospitalized because of COVID-19. That’s the key finding of my team’s recent study, published in the Journal of Epidemiology and Community Health.

The study of 150,000 adults in the United Kingdom found those reporting the most childhood trauma had a 25% greater likelihood of death associated with COVID-19, as well as a 22% increase in hospitalization after contracting COVID-19. These figures held up even after accounting for demographics and health conditions.

Childhood trauma includes physical, emotional or sexual abuse, neglect, household dysfunction and what many call “toxic stress.”

Our study relied on the UK Biobank, a large biomedical database with more than 500,000 volunteers ages 40 to 69 throughout the United Kingdom. Close to one-third of those volunteers provided information about their childhood. Our team took that data and then searched medical records for participants who died or were hospitalized because of COVID-19. Though more research is needed, these initial results highlight the lasting impacts of childhood stress and the need to provide psychological support early on to mitigate lifelong health risks.

Why it matters

COVID-19 had killed nearly 7 million people worldwide as of November 2023. This underscores the importance of understanding all of the risk factors leading to pandemic-related hospitalization and death.

Prior research has examined the demographic risk factors for COVID-19, including age, race, ethnicity, income and education. But this is the first study to link childhood experiences to adult COVID-19 outcomes.

The striking findings of the study suggest that early childhood trauma should be added to the list of risk factors for illness – not only for COVID-19 but perhaps for other diseases as well.

The study also suggests that communities disproportionately affected by adversity and trauma may be particularly vulnerable to negative health outcomes. This includes communities where there are high levels of neighborhood violence, stress and poverty.

What other research is being done

Our research was prompted by a growing body of work that has found an association between adverse childhood experiences and health problems in adulthood. Adults experiencing significant childhood abuse have an increased risk for chronic conditions, including heart disease, lung disease, cancer and premature death.

Researchers are still trying to understand how childhood adversity contributes to negative health outcomes in adulthood. It could be primarily biological in nature. For instance, adversity has been linked to excess inflammation. Inflammation is normally a protective response from the body, triggered by harmful stimuli such as pathogens, damaged cells or toxins. However, excessive inflammation is related to strokes, heart attacks and other health conditions and can lead to more negative COVID-19 outcomes.

In contrast, the links between early adversity and poorer health could be behavioral in nature. Adversity is associated with having less money or education as an adult. These factors could, in turn, be associated with less access to and subpar medical care. Studies have shown that people with lower incomes and lower-paying jobs were exposed to COVID-19 in the workplace more often. Adversity is also associated with depression and challenges to emotion regulation. This in turn could result in downstream changes in biology and behavior.

What’s next

Our team plans to continue investigating large population studies – that is, at least 30,000 to 50,000 participants – to determine whether adverse childhood experiences relate to other health outcomes, like long COVID.

It’s becoming increasingly clear that learning more about how childhood trauma becomes embedded in the body could inform our understanding of possible interventions and long-term health outcomes, including those potentially connected to COVID-19.

The Research Brief is a short take on interesting academic work.

Jamie Hanson, Assistant Professor of Psychology, University of Pittsburgh

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Drug overdose deaths in the United States continue to rise.

Overdoses claimed more than 112,000 American lives from May 2022 to May 2023, according to the Centers for Disease Control and Prevention, a 37% increase compared with the 12-month period ending in May 2020.

The vast majority of those who died were adults. But drug overdoses are killing young Americans in unprecedented numbers: The monthly total rose from 31 in July 2019 to 87 in May 2021, the period with the most recent data.

As a scholar of substance use who focuses on patterns that vary between age groups, I’m struck by how adolescents’ overdose deaths differ from adults’ in terms of gender, race and ethnicity and the drugs causing these fatalities.

These differences mean that the groups considered to be at high risk and the strategies needed to prevent overdoses in adolescents should not be the same as for adults.

Who is dying?

When the CDC examined data for Americans 10 to 19 years old, it found that, as is the case for adults, most adolescents dying from drug overdoes are male. However, the share of girls among these fatalities is larger than the share of women.

More than twice as many boys who are tweens or teens are dying of a drug overdose for every girl in that age group.

Among adults, three men die of a drug overdose for every two women.

The share of fatal overdoses of white, non-Hispanic adolescents is vastly greater than for their nonwhite peers – more so than for adults.

Fentanyl’s often to blame

Another difference is what’s causing these fatal overdoses.

Among adults, those who use more than one drug are more likely to die from an overdose than those who use a single drug. The most common combinations are fentanyl with another opioid, like a prescription medication, and fentanyl with a stimulant, like cocaine or methamphetamine.

Fentanyl on its own is the key culprit in adolescent overdoses. For teens, 84% of fatal overdoses involved fentanyl, and 56% of all overdoses involved only fentanyl.

This is consistent with my team’s research indicating that rates of prescription opioid misuse fell from 2015 to 2019 in both adolescents and young adults. It also squares with other data that shows deaths from heroin-involved overdoses have declined in recent years.

Fentanyl is among the most potent opioids available. It’s estimated to be roughly 100 times more potent than morphine – a very strong opioid typically used in hospital settings. Teens and tweens usually have little tolerance to opioids because they often have not been exposed to them before, and fentanyl’s high potency makes them more likely to overdose.

Many adolescents accidentally take fentanyl when they ingest counterfeit pills that they believe are prescription opioids or stimulants, or other illicit drugs that are laced with the drug.

This unintentional use can make an overdose even more likely, because people who are unaware they are taking fentanyl are less likely to have the overdose-reversal medication naloxone or fentanyl test strips on hand.

In 67% of adolescent overdose deaths, a bystander was present who could have intervened. Naloxone was administered in less than half of cases where a bystander was present.

Little to no prior drug history

Only 1 in 10 teens and tweens who died from a drug overdose had a history of treatment for a substance use problem, and only 1 in 7 had ever experienced a prior nonfatal overdose. Adolescents who fatally overdose do not necessarily show the warning signs generally expected beforehand, such as problems with alcohol or other drugs or prior substance use treatment.

This pattern underscores the importance that all parents proactively talk with their children about substance use by the time they are 12 years old.

Parents who express their disapproval of substance use tend to prevent or delay it in their kids. Having children who never use substances may be an unnecessary and unrealistic goal – after all, most adults drink alcohol at least occasionally.

However, parents can emphasize that their child’s brain is changing rapidly and significantly and that not using drugs or alcohol while young helps promote healthy development.

What parents can do

Having naloxone available can also be important. It prevents fentanyl and other opioids from causing an overdose by blocking access to opioid receptors in the brain. This potentially lifesaving drug is easy to use, but the cost of the over-the-counter version, which can exceed $50 for two doses, makes it out of reach for some of the people who need it most.

Think of naloxone like car insurance: You don’t want to use it, but it’s important to have in case something goes wrong.

Even if your child never tries an illicit drug, they may be able to intervene and save a friend who overdoses. Everyone should know the signs of an opioid overdose – they include shallow or no breathing, problems staying conscious, and cold, clammy skin – and be ready to intervene when they see someone of any age who appears to be experiencing one.

Finally, more than 4 in 10 adolescents who died from an overdose had a history of mental health conditions. That’s consistent with research from my colleagues and me linking poorer mental health and opioid misuse in adolescents.

There’s also a strong link between mental health conditions and drug overdoses among adults.

For this reason and many others, such as the rising rates of adolescent depression, I recommend that all adults – whether caregivers or other people in an adolescent’s life – check in on their mental health regularly and recommend or seek treatment for any concerns as early as possible.

Ty Schepis, Professor of Psychology, Texas State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.