Substance Use and Exposure to Adverse Childhood Experiences in Undergraduate and Graduate Nursing Students

BACKGROUND: Substance misuse remains a public health crisis and contributor to morbidity and mortality. The nursing workforce is not immune to the impacts of substance misuse as rates are thought to mirror those of the general population. Additionally, as substance misuse often begins in adolescence or early adulthood, prevalence of misuse among practicing nurses highlights the fact that students are also at risk. OBJECTIVES: The purpose of this study was to examine rates and patterns of substance use and adverse childhood experience (ACE) exposure among nursing students while also examining associations between substance use and ACE exposure. METHOD: This study utilizes a cross-sectional and descriptive design through the provision of email surveys to nursing students. Email surveys consisting of the Alcohol Use Disorders Identification Test, the Drug Abuse Screening Tool 10-item survey, the ACE Questionnaire, and a demographic inquiry were distributed via Qualtrics survey software. RESULTS: A total of 662 individuals participated in the survey, the majority of whom self-identified as female, were undergraduate students, and were between 18 and 21 years. Moderate- to high-risk alcohol use was identified in 20% of students, while moderate- to high-risk drug use was identified in 3.6% of students. More than half of students endorsed exposure to at least one ACE. Significant associations were found between the Drug Abuse Screening Tool 10-item survey and the ACE Questionnaire. CONCLUSIONS: The results of this study have significant implications for nursing educators and must inform groundwork for the development of policies and interventions that are evidence based, nonpunitive, and trauma informed.