ACEs and Their Significance in Substance Use and Addiction
Early childhood experiences are important contributors to health outcomes across the lifespan. Adverse childhood experiences (ACEs), defined as negative, stressful, traumatizing events that occur before age 18, can increase the risk for negative health outcomes, including mental illness and addiction. ACEs are viewed as an important upstream determinant of health, and an awareness of this relationship can strengthen public health approaches to prevention and treatment.
To understand what causes this relationship it is important to understand how the brain develops and how experiences can influence neuro-development to ultimately shape health outcomes. This foundational information is a key knowledge competency for anyone working with people who use substances or are at risk of using substances, as it can inform the development of prevention and treatment programs that are effective and trauma-informed and can help reframe perceptions around substance use as a health issue.
The Brain Story 
The Brain Story is about how early childhood experiences shape our brains to influence lifetime health. Part of that story describes how adverse childhood experiences (ACEs) can influence risk for later physical and mental illness, including addiction. The Alberta Family Wellness Initiative developed an online resource that presents Brain Story science to non-experts, including an in-depth certification course eligible for professional accreditation and continuing medical education. https://www.albertafamilywellness.org/training
- Promoting Brain Story certification to spread foundational knowledge and advance professional development across sectors linked with child and family welfare and substance use; and
- Hosting the Brain Builders Lab, a pair of national events that bring together champions, innovators and agents-of-change to develop initiatives in their communities that incorporate Brain Story learning.
The first event took place in March 2019, and the final event is scheduled for February 2021.
Sixty-five participants were selected from among 150 applicants to participate.
Applicants met the following criteria:
1. Completed the certification course before the March 2019 Brain Builders Lab kick off to ensure a common knowledge base at the event;
- Demonstrated buy-in from their employer through a commitment agreement to ensure the required time and resources would be made available; and
- Prepared a brief summary outlining how they intended to use the Brain Story to ensure a broad range of ideas would be represented at the event and to facilitate assignment to work groups.
Brain Builders Lab participants attending the event had the opportunity to:
- Access expertise, including scientific expertise from leading researchers, as well as practical expertise from Brain Story course alumni successfully implementing projects that apply the science;
- Engage and exchange ideas with like-minded individuals from across the country and sectors;
- Develop project plans for their ideas through facilitated group work, and obtain feedback from national leaders and people with lived experience; and
- Receive implementation support from CCSA over the following two years.
Participants were placed in work groups as follows:
Group 1: Ottawa Advocacy to Invest in Early Childhood
Group 1 aims to spread and embed the Brain Story into the services that support young children (birth to six years old and prenatal) within Ottawa to improve system-wide practice and policy from within. The group consists of members of early learning organizations and networks, including Growing Up Great and Ottawa Public Health.
Group 2: Atlantic Provinces
Group 2 is a cross-sectoral group from the four Atlantic provinces (N.B., N.L., N.S. and P.E.I.), spanning health, education, justice and social services. Their aim is to develop an Atlantic “hub” to leverage connections, tools and successes across the region and across sectors, with a focus on service provider and community education and influencing policy and decision makers.
Group 3: Northern, Rural and Remote
Group 3 works across sectors and across the country to spread and embed the Brain Story into the work and practice of people living in northern, remote and rural communities in order to enhance community wellness. They will adapt the Brain Story to be relevant to their communities and address some of the unique challenges faced by them, with the key message that building resilience is possible.
Group 4: Substance Use
Group 4 is characterized by a common focus on individuals already using substances, with group members including members of local drug strategies, Ontario Provincial Police and peer support/recovery organizations. Their aim is to spread and embed the core elements of the Brain Story into the practices or work of community service providers in order to improve individual and community outcomes.
Group 5: Educating Current and Future Healthcare and Social Service Providers
Group 5 consists of medical and nursing school instructors and members of professional associations including the Canadian Paediatric Society, the Canadian Association of Social Workers and the Canadian Mental Health Association. Their aim is to embed the Brain Story into post-secondary and professional development curricula.
Groups 6 and 7: Promotion and Prevention
Due to the large number of Brain Builders proposing promotion and prevention plans, this group was split into two smaller groups. The groups include members of regional public health units, municipal governments and provincial health service networks. They aim to embed the Brain Story into the practices of health, education and social service providers in order to promote healthy practices in child and youth development, improve professional practices and enhance population health.
Group 8: Services for At-risk Youth and Families
Group 8 is characterized by a common focus on individuals and families facing barriers to social, emotional and academic success, including as a result of potentially traumatic adoption and family law experiences. The group includes organizations such as the Salvation Army and Big Brothers, Big Sisters, and their goal is to spread and embed the Brain Story into the lives of individuals and families and those who support them to improve health, social and educational outcomes.
Reproduced with permission from the Canadian Centre on Substance Use and Addiction, 2020
Source: CCSA Brain Builders Lab, March 4–5, 2019: Meeting Summary Report
Where we are now
The project has passed the half way point, and much has been accomplished. The Covid-19 pandemic and associated States of Emergency and restrictions have had a significant impact on progress however groups remain committed to moving forward if and when possible, with some already taking advantage of virtual platforms to continue to connect and provide ACEs and neuroscience education.
In some cases, staff in partner organizations have had more time over the past 3 months to work on their online Brain Story certification and stats from the Alberta Family Wellness Initiative tracking registrations and completion are encouraging.
For more information about the Brain Builders Lab:
https://www.ccsa.ca/adverse-childhood-experiences
Contact: BrainStory@ccsa.ca / HistoireDuCerveau@ccsa.ca
Comments (0)