Background We examined associations between childhood trauma and adulthood prescription pain reliever misuse (PPRM) and injection drug use (IDU) in a nationally-representative U.S. sample to further understanding of factors associated with these epidemics. Methods National Longitudinal Study of Adolescent to Adult Health data (N=12,288) yielded nine childhood traumas: neglect; emotional, physical, sexual abuse; parental incarceration and binge drinking; witnessed, threatened with, and experienced violence. We estimated adjusted odds ratios (AOR) and 95% confidence intervals for the association of each trauma and cumulative trauma and drug initiation in emerging and later adulthood. Results Outcome prevalences were 20% (PPRM) and 1% (IDU) in emerging adulthood and 10% PPRM in adulthood. We observed dose-response relationships that varied across outcomes. Cumulative trauma (referent=none) was associated with 34–79% greater odds of PPRM (emerging adulthood) across one to five+ trauma categories. The gradient was most consistent and associations strongest for adulthood PPRM: one trauma AOR=1.46(1.12, 1.91); two AOR=1.71(1.23, 2.36); three AOR=2.16(1.43, 2.36); four AOR=2.70(1.42, 5.62); five+ AOR=3.09(1.52, 6.30). Dose-response was less consistent for IDU, but 4 and 5+ traumas were associated with approximately seven and five times the odds of IDU. Neglect, emotional abuse, and parental incarceration and binge drinking were associated with 25–55% increased odds of PPRM. Sexual abuse and witnessed violence were associated with nearly 3 and 5 times the odds of IDU. Conclusions Associations between childhood trauma and PPRM/IDU highlight the need for trauma-informed interventions for drug users and early trauma screening and treatment for prevention of drug misuse over the life course.

Background: While previous research has documented the impact of violence on substance use, none has looked longitudinally across the lifespan to measure independent effects of direct and indirect violence exposure. Objective: To examine independent associations between adolescent experiences of violence and subsequent substance use in adolescence and adulthood in the United States. Method: Using the National Longitudinal Study of Adolescent to Adult Health (N=12,288), we examined being shot or stabbed (“experienced”), being threatened with a knife or gun (“threatened”), and seeing someone either shot or stabbed (“witnessed”) during adolescence (Wave I) as correlates of substance use in adolescence and adulthood (Wave IV) via logistic regression. Results: Violence exposure was a significant correlate of drug use in adolescence and several associations remained significant in adulthood. Witnessing violence had the highest point estimates in the adjusted models in adolescence for each substance use outcome (e.g., Cocaine-Adjusted Odds Ratios [AOR]=2.59, 95% confidence interval [CI]=1.21, 5.54). However, the point estimates for threatened with violence or experienced violence were highest in three out of the four drug outcomes in adulthood (e.g., Threatened with violence: Binge drinking-AOR=1.41, 95% CI=1.08, 1.83). Conclusion/Importance: Adolescent exposure to witnessing violence had stronger effects on substance use in adolescence, while experiencing and being threatened with violence in adolescence had stronger effects on substance use in adulthood. Violence prevention efforts targeted toward adolescents may lead to a reduction in substance use throughout the life-course, and clinicians and policy makers should be aware of the downstream effects of violence experienced in adolescence.

The University of Michigan School for Environment and Sustainability (SEAS) seeks to transform sustainability learning through new curricular tools that incorporate multimedia sources, build both scientific and professional skills, and nurture partnerships with practitioners for extended engaged learning beyond the classroom. The Michigan Sustainability Cases (MSCs) bring case-based teaching to the sustainability field and redefine cases by making them more immersive and multimodal, for traction with diverse kinds of learners. MSCs are hosted on an open access, interactive platform called Gala that makes case studies accessible both for individual use and to enhance face-to-face experiential learning. This article analyzes one MSC case about urban farming in Detroit, Michigan, as it embodies principles of cocreation, integration into multiple curricula, and digital innovation for enhanced experiential learning. Specifically, we describe how it was collaboratively produced, deployed and iteratively improved in successive SEAS classrooms, incorporated field learning in Detroit for strong user experiences from students, but also for faculty and practitioners. We further note its impact on the lead author’s development projects within Detroit’s landscape, suggesting cases as catalysts for more ethical, efficient, and inclusive sustainability science and policy in practice.