A growing body of research suggests exposure to adverse childhood experiences is linked to negative health outcomes in adulthood. Substance abuse is one of the most common health outcomes associated with childhood adversity, and poses a significant public health threat to the United States, affecting the lives of millions of Americans. To date, most studies examining the relationship between adverse childhood experiences and substance abuse have used data gathered from clinical populations. The present study assessed the relationship between exposure to multiple types of adverse childhood experiences and lifetime diagnosis of a substance use disorder using data from a nationally representative sample of adolescents followed into adulthood. Data from Waves I, III and IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were analyzed to determine if exposure to multiple types of adverse childhood experiences predicted the development of an alcohol use, cannabis use, or other drug use disorder in adulthood, while controlling for prior substance use and other demographic variables that have shown associations with substance use. Three types of adverse childhood experiences were considered; physical, emotional and sexual abuse. An additive index was created to determine if lifetime risk for substance use disorders increased in a linear fashion as exposure to multiple types of adverse childhood experiences increased. Logistic regression revealed the likelihood of developing an alcohol use, cannabis use or other drug use disorder later in life increased as the score on the adverse childhood experience index increased. Additionally, religiosity was investigated as a possible protective mechanism against substance abuse in those who experienced early life adversity. A religiosity index was created using information about attendance at religious services and activities. This index was used to determine if religiosity moderates the impact of adverse childhood experiences on the likelihood of developing a substance use disorder. While religiosity did significantly reduce the risk of developing a substance use disorder, no moderating effects were observed. This study underscores the long-term consequences of exposure to childhood adversity, and provides information that can be used to improve prevention and treatment programming.