Understanding Risk and Resilience: Adverse Childhood Experiences and Substance Use among Racial and Ethnically Diverse Adolescents

Purpose of review: This narrative review synthesizes literature linking adverse childhood experiences (ACEs) and substance use among Latino, Black, Asian American, and American Indian/Alaska Native adolescents. A total of 31 peer-reviewed studies, published between 2020 and 2025, were included that included at least 50% minoritized adolescents (≤ 18 y/o). Recent findings: Across studies and groups, a dose-response relation emerged between ACEs and substance use. Latinos were the most researched, with several factors (e.g., acculturation) influencing this association. Black, Asian, and Native American/Alaska Native adolescents were substantially less researched, with few studies evaluating moderating factors, revealing critical gaps. Across all groups, relational/community-based ties emerged as protective elements. Implications and future directions are discussed. Summary: Reducing the ACEs-substance use association among minoritized adolescents requires culturally embedded frameworks. Researchers must understand the historical and structural contexts shaping risk and resilience while harnessing relationally grounded strategies already in place within these communities.