Abstract
<title>Abstract</title> <p>Background Adverse childhood experiences (ACEs) are increasingly recognized as an important driver of the global substance use disorder (SUD) issue. However, current literature regarding this topic contains limited knowledge from Asia-Pacific countries and hardly any research from Thailand. Therefore, this study sought to examine the prevalence and impact of ACEs among people with SUD in Thailand. Methods A total of 249 individuals with SUD recruited from Thanyarak Chiang Mai Hospital’s In-Patient Department completed the ACE Questionnaire (Thai-version) and the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). The prevalence of high ACE scores (≥ 4) and of each individual ACE category were calculated, with 95% confidence intervals estimated using the Wald method. Binary logistic regression was used to explore the relationship between ACEs and high-risk substance use. Results The prevalence of high ACE scores in this group was 23.7% [18.4%, 29.0%]. High prevalence was also observed across every single ACE category. High ACE scores were associated with high-risk polysubstance use (AOR = 1.89, 95%CI 1.02–3.50, p = 0.044), high-risk depressant use (AOR = 1.86, 95%CI 1.01–3.46, p = 0.048), and high-risk cannabis use (AOR = 2.73, 95%CI 1.16–6.39, p = 0.021) after adjusting for age, gender, and level of education. However, no statistically significant association was found between high ACE scores and high-risk stimulant use. Conclusions Among individuals with SUD in Thailand, ACEs are highly prevalent and significantly associated with high-risk substance use. These findings underscore the necessity for trauma-informed drug policies and the value of ACEs-SUD research in understudied countries.</p>