PUBLIC HEALTH ADVISORY CONCERNING FENTANYL AND FENTANYL-LACED SUBSTANCES

Adverse Childhood Experiences

The early years of life matter to lifelong health and prosperity. The basic architecture of the human brain is constructed through an ongoing process that begins before birth and continues into adulthood. Like the construction of a home, the building process begins with laying the foundation, framing the rooms and wiring the electrical system in a predictable sequence. Early experiences literally shape how the brain gets built, establishing either a sturdy or a fragile foundation for all of the development and behavior that follows. A strong foundation in the early years increases the probability of positive outcomes. A weak foundation increases the odds of later difficulties, and getting things right the first time is easier than trying to fix them later.

Science points us to pay attention to factors that can disrupt the developmental periods that are times of intense brain construction, because when this activity is derailed, it can lead to lifelong difficulties in learning, memory and cognitive function. Stress is an important factor to consider. Everyday challenges, like learning to get along with new people or in new environments, set off a temporary stress response that helps children be more alert while learning new skills. But truly adverse childhood experiences – severely negative experiences such as the loss of a parent through illness, death or incarceration; abuse or neglect; or witnessing violence or substance abuse – can lead to a toxic stress response in which the body’s stress systems go on “high alert” and stay there. This haywire stress response releases harmful chemicals into the brain that impair cell growth and make it harder for neurons to form healthy connections, damage the brain’s developing architecture and increase the probability of poor outcomes. This exaggerated stress response also affects health, and is linked to chronic physical diseases such as heart disease and diabetes.

Science  tells us that many children’s futures are undermined when stress damages the early brain architecture.  But the good news is that potentially toxic stressors can be made tolerable if children have access to stable, responsive adults – home visitors, child care providers, teachers, coaches, mentors. The factors children are exposed to affect how well they progress, and communities play a big role. A child’s wellbeing is like a scale with two sides; one end can get loaded with positive things, while the other end can get loaded with negative things. Supportive relationships with adults, sound nutrition and quality early learning are all stacked on the positive side. Stressors such as witnessing violence, neglect or other forms of toxic stress are stacked on the other. This dynamic system shows us two ways we can achieve positive child outcomes: to tip to the positive side, we can pile on the positive experiences, or we can offload weights from the negative side. Children who have experienced several ACEs are carrying a heavy negative load, and to tip these children toward the positive, innovative states and communities have been able to design high-quality programs for children to prevent Adverse Childhood Experiences whenever possible, and respond to them with strong, nurturing supports to ameliorate their impact when they can’t be prevented. These programs have solved problems in early childhood development and shown significant long-term improvement for children.