Aleksanyan Josh, Maria Zobaida, Renteria Diego, Fawole Adetayo, Jordan Ashly E, Drury Vanessa, Kowala Sam, Del Rosario Jamie, Lincourt Patricia, Morris-Grove Maria L, Hong Sueun, Choi Sugy, Neighbors Charles J
Department of Population Health, New York University Grossman School of Medicine, NY, New York, United States.
New York State Office of Addiction Services and Supports, Albany, New York, United States.
J Subst Use Addict Treat. 2025 Jul;174:209704. doi: 10.1016/j.josat.2025.209704. Epub 2025 Apr 28.
Transition-age (TA) adults, aged 18-25, have the highest prevalence of substance use disorder (SUD) among all age groups yet they are less likely to seek treatment and more likely to discontinue it than older adults, making them a high-priority treatment population. While structural barriers and varying expectations of recovery may affect treatment initiation, insights from providers working with TA adults can reveal what further impels and impedes treatment engagement.
We conducted two focus groups with 14 front-line treatment providers, representing urban and rural outpatient, residential, and inpatient SUD care settings across New York State. Providers were selected through stratified sampling using restricted-access treatment registry data. A semi-structured interview guide facilitated discussions, and transcripts were analyzed to identify key themes.
Providers report that TA adults prefer briefer, innovative treatment approaches over traditional modalities like A.A./12-step recovery, driven by a desire to rebuild their lives through education and career. Post-pandemic social disruptions were cited as exacerbating engagement challenges and increasing the need for integrating mental health support. Providers highlighted the potential of technology to enhance treatment engagement, though expressed concerns regarding social isolation and the fraying of childhood safety nets and support systems (e.g., housing) undermining successful treatment outcomes and transitions to adulthood more broadly.
Providers report and perceive various challenges-unmet mental health needs, social alienation, and housing insecurity-that impede TA adults from successful SUD treatment. Understanding providers' perceptions of the needs of young adults can inform patient and clinical decision-making, lead to the development of innovative treatment approaches tailored to TA adults and contribute to improved health outcomes over the life course.
18至25岁的转型期成年人在所有年龄组中物质使用障碍（SUD）的患病率最高，但与年长成年人相比，他们寻求治疗的可能性较小，且更有可能中断治疗，这使他们成为高度优先的治疗人群。虽然结构障碍和对康复的不同期望可能会影响治疗的开始，但与转型期成年人合作的提供者的见解可以揭示进一步推动和阻碍治疗参与的因素。
我们与14名一线治疗提供者进行了两个焦点小组讨论，这些提供者代表了纽约州城乡门诊、住院和住院SUD护理环境。通过使用受限访问治疗登记数据进行分层抽样来选择提供者。一份半结构化访谈指南促进了讨论，并对访谈记录进行了分析以确定关键主题。
提供者报告说，转型期成年人更喜欢比戒酒互助会/12步康复等传统方式更简短、创新的治疗方法，这是出于通过教育和职业重建生活的愿望。大流行后的社会干扰被认为加剧了参与挑战，并增加了整合心理健康支持的需求。提供者强调了技术在增强治疗参与方面的潜力，尽管对社会隔离以及童年安全网和支持系统（如住房）的破裂表示担忧，这些会更广泛地破坏成功的治疗结果和向成年期的过渡。
提供者报告并认识到各种挑战——未满足的心理健康需求、社会疏离和住房不安全——这些阻碍了转型期成年人成功进行SUD治疗。了解提供者对年轻人需求的看法可以为患者和临床决策提供信息，促成开发适合转型期成年人的创新治疗方法，并有助于在整个生命过程中改善健康结果。
