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. 2025 Jul:174:209704.
doi: 10.1016/j.josat.2025.209704. Epub 2025 Apr 28.

Perspectives of treatment providers overseeing substance use disorder treatment among transition-age adults, aged 18-25 years

Josh Aleksanyan  1 , Zobaida Maria  1 , Diego Renteria  1 , Adetayo Fawole  1 , Ashly E Jordan  2 , Vanessa Drury  2 , Sam Kowala  2 , Jamie Del Rosario  2 , Patricia Lincourt  2 , Maria L Morris-Grove  2 , Sueun Hong  1 , Sugy Choi  1 , Charles J Neighbors  3
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Perspectives of treatment providers overseeing substance use disorder treatment among transition-age adults, aged 18-25 years

Josh Aleksanyan et al. J Subst Use Addict Treat. 2025 Jul.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Mental health; Social development; Substance use disorder (SUD); Transition-age adults; Treatment engagement.

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Conflict of interest statement

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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