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Establishing Principles of Care for Young Adults with Substance Use Disorders

New provider principles lay out how to treat patients according to their age-specific needs — and elevate national discussions on systemic changes.
Taryn Johnson

One of the age groups most heavily impacted by substance use disorders are young adults between the ages of 18 and 25. According to a Substance Abuse and Mental Health Administration report in 2016, 23% of young adults reported using illicit drugs, most commonly marijuana and prescription drugs, while 2 of 3 adults in treatment for opioid use disorder report that they first tried drugs before age 25. Yet, studies have shown that very few young adults identified as needing treatment for a substance use disorder (SUD) receive it — 1 in 13 — and of those few in treatment, they are less likely to remain engaged in treatment than older adults.

A national group of pediatric addiction medicine experts have released newly established principles of care for young adults with SUD. Led by the Grayken Center for Addiction at Boston Medical Center (BMC), the experts aimed to guide providers on how to treat young adults with SUD given their age-specific needs, as well as elevate national discussions on addressing these challenges more systematically.

A supplement published in Pediatrics breaks down the most important principles necessary to address when caring for this unique population of patients.

“There are significant cognitive and developmental changes taking place during young adulthood that need to be considered when determining how best to address substance use disorder in this unique patient population,” said Scott Hadland, MD, MPH, MS, pediatric addiction specialist at the Grayken Center who served as first and co-author on several of the papers. “We must incorporate, at every opportunity, a way to reduce harm and consequences of use, and address any compounding health conditions that factor into their ability to realize recovery.”

Consensus was reached that each of the six overall principles of care “convey a commitment to compassion, therapeutic optimism, and social justice.”

6 Principles of Care for Young Adults with SUDs

Experts determined six key principles of care: evidence-based treatment, integrative addiction and psychiatric illness treatment, harm reduction, criminal justice system reform, family engagement in care, and recovery support services. HealthCity worked with many of the pediatric and addiction medicine experts involved in the supplement to create six articles that explain each of these principles of care as well as detail specific models of care they encompass.

“Our goal is to bring attention to the unique needs and challenges faced by this age group and highlight the opportunities to best address these needs in order to lead to improved outcomes,” said Michael Silverstein, MD, associate chief medical officer for research and population health at BMC who served as first and co-author on several papers in the supplement and played a key role in the convening. “We hope that this will start the much-needed dialogue within the medical community about young adult addiction medicine and lead to the development of recommendations and treatment guidelines specific to the needs of these patients.” 

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