Providing Effective Support to Transition Age Adults A Unique Substance Use Disorder Treatment Population
Young adults aged 18 to 25, or transition age (TA) adults, face a range of behavioral health challenges as they move into adulthood. To foster understanding and support, we offer the following information about TA adults in substance use disorder (SUD) treatment. This information is designed to guide those who want to provide compassionate harm reduction, prevention, treatment, and recovery services to this group. Your support can make a significant difference in their lives.
Making the Transition from Adolescence to Adulthood
Understanding the Unique Challenges
Change is Hard
During this period of transformation, this group experiences changes in relationships and responsibilities and encounters new educational and vocational opportunities.1
Higher Rates of Substance Use
Nationally, the prevalence of substance use disorder (SUD) is consistently higher among adults aged 18 to 25 compared to adults aged 26 and older.2
Less Likely to Seek Treatment
This group is less likely to be engaged in SUD treatment than older adults, so little is known about this population in treatment.
Unique Individuals Served in the OASAS-Overseen SUD Treatment System in 2023
Overview of TA Adults in Treatment
TA Adults in Treatment
13,830 unique TA adults were engaged in SUD treatment. The median age was 22.6 (range 18-25).
Race, Ethnicity and Sex at Birth
Of TA adults engaged in treatment, 65.3% and 34.5% identified as males and females, respectively. More white female TA adults were engaged in treatment, compared to non-white female TA adults.
Sexual Orientation and Gender Identity
A larger percentage of TA adults and those 17 years of age and younger identified as LGBT than individuals aged 26 and older.
Figure 1. TA Adults by Race, Ethnicity and Sex at Birth
Program Type Engagement
In 2023, the majority of TA adults were engaged in outpatient substance use disorder (SUD) treatment at 81.3%.
Engagement in other treatment programs is as follows:
• 11.3% of TA adults engaged in inpatient treatment
• 11.2% of TA adults utilized medically managed withdrawal (MMW)
• 6.7% of TA adults enrolled in residential treatment
• 5.3% of TA adults participated in opioid treatment programs (OTP)
Engagement in other treatment programs is as follows:
• 11.3% of TA adults engaged in inpatient treatment
• 11.2% of TA adults utilized medically managed withdrawal (MMW)
• 6.7% of TA adults enrolled in residential treatment
• 5.3% of TA adults participated in opioid treatment programs (OTP)
2023 Admissions to the OASAS-Overseen SUD Treatment System TA Adults Accounted for 12,902 Admissions in 2023
Admission data provides a helpful overview of service utilization trends. Assessing why and where transition age (TA) adults 18-25 years old are admitted to substance use disorder (SUD) treatment in New York State can help better understand this age group’s treatment needs.
Prevalence of Alcohol, Cannabis, and Opioids in Treatment Substance Use at Admission
Alcohol was the most common primary substance reported at SUD treatment admission among TA adults (32.9%). Opioids were the primary substance for more than one quarter (27.5%) of TA adult admissions. The next most common primary substances at admission were cannabis (22.9%) and stimulants (12.1%).
Considering all substances of use reported at admission, over half of all TA admissions (56.6%) were associated with any cannabis use. Polysubstance use (use of at least two substances) was reported at 65.0% of all TA adult admissions (data not shown).
Figure 2. Primary Substance Among TA Adult Admissions
TA Admissions Across New York State
Regions Most Impacted
Finger Lakes
The highest rate of transition-age adult admissions was by residents of the Finger Lakes (9.5 admissions per 1,000).
Long Island
The second highest rate of transition-age adult admissions was by residents of Long Island (8.8 admissions per 1,000).
Central Region
The third highest rate of transition-age adult admissions was by residents of the Central Region (8.5 admissions per 1,000).
Understanding Referrals Higher Criminal Legal System Referrals for TA Adults
More Criminal Legal System (CLS) referrals were among TA adult admissions compared to admissions among adults aged 26 and older. The gap was particularly wide for Non-Hispanic Black and Hispanic populations. Among Non-Hispanic Black TA adults, over one-third (37.3%) of admissions were CLS referrals, compared for 14.6% for Non-Hispanic Black adults aged 26 and older. Similarly, among Hispanic TA adults 33.1% of admissions were associated with a CLS referral, compared to 17.5% of Hispanic adults aged 26 and older.
Figure 3. CLS Referrals by Race, Ethnicity and Age Group
Research Information
Methods and Definitions
Data Source: OASAS Client Data System, 2023; 2019, US Centers for Disease Control and Prevention National Vital Statistics System.
Individuals: A unique ID variable is created for all records from personal information. This variable allows for counts of unique individuals who may be admitted several times during a given time period. Individual counts provide a better representation of the sociodemographic characteristics of the SUD treatment population compared to admission counts. Individuals who did not report sex at birth are not shown in Figure 1 due to small size (n, 28, 0.2%) but are included in the race and ethnicity totals.
Admissions: Only admissions were counted, which excluded transfers and administrative admissions.
Regional admission rates: Rates were calculated using 2019 population estimates of TA residents in NYS counties. County estimates were then grouped into the ten New York State Economic Development Regions to determine admission rates by region.
Abbreviations: SUD, substance use disorder; TA, transition age; 18-25 years old; LGBT, lesbian, gay, bisexual, (pansexual) and/or transgender; NH, non-Hispanic; OTP, opioid treatment program; MMW, Medically Managed Withdrawal. CLS, criminal legal system.
References
1 Fosbenner. Stephanie, & Al-Mateen, Cheryl (2019, June 10). Challenges faced by transitional-age youth with mental health concerns. American Psychiatric Association.
2 Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health (HHS Publication No. PEP24-07-021, NSDUH Series H-59). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.