Lee Carol A, Bonar Erin E, Ilgen Mark A
University of Michigan Medicine Department of Psychiatry.
University of Michigan Medicine Addiction Center.
Addict Res Theory. 2025;33(1):65-71. doi: 10.1080/16066359.2024.2314049. Epub 2024 Feb 12.
Emerging adulthood (typically ages 18-25) is a developmental period associated with increased likelihood of developing substance use disorders (SUDs) resulting in life-altering negative consequences. While SUD treatment can be effective and diminish substance-related consequences, very few emerging adults with SUDs actually receive treatment and research is needed to identify potential determinants of receiving care. We examined associations between individual factors and social determinants of health (SDOH) with SUD treatment service utilization to inform treatment engagement strategies for emerging adults.
Using pooled cross-sectional data from the 2015-2019 years of the National Survey on Drug Use and Health, we evaluated past-year treatment utilization among emerging adults (i.e., respondents aged 18-25 years-old) with a past-year SUD ( = 12,594). Logistic regression analyses evaluated sex, race, education level, lifetime arrest history and age of alcohol initiation in addition to mental illness, employment, food stamp utilization, poverty status, and frequency of housing relocation.
Past-year mental illness, Non-Hispanic White identity, not having college degree, lifetime arrest history, part-time employment or unemployment, and relocating for housing more than 2 times in the past year were significantly associated with greater likelihood of treatment utilization in adjusted analyses.
Findings from this nationally representative survey of emerging adults highlight the possible contribution of some SDOH associated with social disadvantage and/or criminal justice involvement on SUD treatment utilization. These results may guide providers in tailoring service delivery mode, community organizations to target populations, and implementation strategies that are effective in reducing SUD treatment service utilization inequity.
新兴成年期（通常为18至25岁）是一个发育阶段，在此期间，发展成物质使用障碍（SUDs）并导致改变生活的负面后果的可能性增加。虽然物质使用障碍治疗可能有效并减少与物质相关的后果，但实际上很少有患有物质使用障碍的新兴成年人接受治疗，因此需要开展研究以确定接受治疗的潜在决定因素。我们研究了个体因素和健康的社会决定因素（SDOH）与物质使用障碍治疗服务利用之间的关联，以为新兴成年人的治疗参与策略提供信息。
利用2015 - 2019年全国药物使用和健康调查的汇总横断面数据，我们评估了过去一年有物质使用障碍（n = 12,594）的新兴成年人（即18至25岁的受访者）过去一年的治疗利用率。逻辑回归分析评估了性别、种族、教育水平、终身被捕史和开始饮酒的年龄，此外还评估了精神疾病、就业、食品券使用情况、贫困状况以及住房搬迁频率。
在调整分析中，过去一年的精神疾病、非西班牙裔白人身份、没有大学学位、终身被捕史、兼职工作或失业，以及过去一年因住房问题搬迁超过2次与更高的治疗利用率显著相关。
这项针对新兴成年人的具有全国代表性的调查结果突出了一些与社会劣势和/或刑事司法参与相关的健康的社会决定因素对物质使用障碍治疗利用的可能影响。这些结果可能会指导服务提供者调整服务提供模式；指导社区组织确定目标人群；指导实施有效减少物质使用障碍治疗服务利用不平等的策略。
