Injury Center Priorities

ACEs prevention

Experiencing adversity in childhood can change the way the brain develops and functions. This can increase the risk of chronic diseases, such as diabetes, cancer, and stroke; substance use; suicide; and other injury and violence-related outcomes.

• About Adverse Childhood Experiences
• Policy Approaches to Preventing Adverse Childhood Experience

Overdose prevention

More than 92,000 drug overdose deaths occurred in the United States in 2020 alone. The adverse childhood experience of having a parent with substance use disorder or die from an overdose has profound impacts on the next generation.

• Overdose Prevention
• Policy Approaches to Preventing Drug Overdose
• Opioid Overdose Prevention in Tribal Communities

Suicide prevention

People who have attempted suicide or had suicidal thoughts may suffer long-term mental and physical health consequences including anger, guilt, and physical impairment. Similarly, survivors of a loved one’s suicide may experience ongoing pain and suffering, including grief, stigma, depression, anxiety, post-traumatic stress disorder, and increased risk of suicide or suicidal thoughts.

• Suicide Prevention

ACEs, suicide, and overdose are related

• ACEs increase the risk of opioid misuse and overdose and suicide later in life. ACEs are associated with younger age of opioid initiation, injection drug use, and likelihood of experiencing overdose.1
• A CDC study examined the association between experiencing ACEs and recent opioid misuse. Study findings showed that the odds of opioid misuse increased as the number of adverse childhood experiences increased. Students experiencing five or more ACEs were 15 times more likely to report opioid misuse than those experiencing no ACEs.2
• Losing a loved one to overdose or suicide during childhood is an ACE that can increase the risk of overdose or suicide.
• ACEs are associated with lower educational attainment, unemployment, and poverty. These are risk factors for ACEs, suicide, and substance use that can impact future generations as well.3
• Experiencing trauma before age 18 is associated with increased odds of opioid misuse; the odds of opioid misuse are approximately three times higher among adults with four or more different experiences of trauma.4
• Having any ACE is associated with an increased risk for suicide. The odds of ever attempting suicide are 30 times higher for adults with four or more ACEs compared to adults with no ACEs.5

Effective ways to prevent all three issues

CDC is working with partners to reduce the impact of ACEs, suicide, and overdose by:

1. Generating understanding of the connection between ACEs, overdose, and suicide to inform more holistic, comprehensive, and effective policy and programs. Use shared, evidence-based, and easy-to-understand messages that create urgency.
2. Engaging people as champions for prevention and agents for change in their own communities, including those with personal experience with these issues, decision-makers, champions across sectors, and others.
3. Employing a comprehensive public health approach to prevent harm in the first place
4. Investing in research and evaluation to develop, test, implement, and translate evidence-based strategies to prevent ACEs, opioid overdose, and suicide and to address the connection between them.