Impact of social determinants of health and individual characteristics on substance use disorder treatment utilization among emerging adults aged 18-25

Abstract

Background

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.

Methods

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 (N = 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.

Results

Past-year mental illness, Non-Hispanic White identity, not having a 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.

Conclusions

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.

Keywords:

• Addiction
• substance use disorder
• alcohol use disorder
• social determinants of health
• treatment utilization
• young adults

Disclosure statement

The authors do not have any personal financial interests related to this manuscript.

Additional information

Funding

Carol Lee’s effort on this project was funded by a grant from the National institutes of health (NIAAA) #007477. Mark Ilgen’s effort on this project was supported by RCS 19-333.