Adverse childhood events and substance use history or recent opioid use among women with chronic pelvic pain

Abstract

Introduction: We aimed describe the association of adverse childhood events (ACEs) with a history of substance use disorder and recent opioid use among women with chronic pelvic pain (CPP). Methods: This cohort study investigated two data sets of women presenting to subspecialty gynecologic and pelvic floor disorder clinics where questionnaires querying substance use disorder, opioid use in the last 3 months, and ACEs (BRFSS-ACE questionnaire) were obtained. We compared the recent opioid use, morphine milligram equivalents (MMEs) per dose, pills used per month, and minimum MMEs reported per month between women with high (⩾4) or low (<4) reported ACEs. Results: Patients completing the BRFSS-ACE (n = 113) were older, more likely to be Hispanic/Latina, had higher levels of education, a higher prevalence of pain syndromes, and a greater degree of bother from pelvic floor disorders than those not completing the BRFSS-ACE. Women reporting a high number of (⩾4) ACEs (n = 56) were younger, less likely to identify as Hispanic, had higher co-occurrence of fibromyalgia and IBS, and a higher prevalence of a history of substance use disorder (18% vs 2%, p < 0.01) than women with low (<4) ACEs (n = 57). High ACEs were not significantly associated with recent opioid use (43% vs 39%, p = 0.83), opioid pills used per month, MMEs per dose, or the minimum MMEs used per month. Conclusion: Women with CPP reporting higher numbers of ACEs are more likely to report a history of substance use disorder but were not more likely to have used opioids in the last 3 months.