Longitudinal within- and between-person associations of substance use, social influences, and loneliness among adolescents and emerging adults who use drugs

Today’s emerging adults belong to one of the most diverse generations in the United States and show the highest rates of alcohol and illicit drug misuse, facing significant health risks. Thus it is critical to develop effective interventions to reduce alcohol and illicit substance misuse and its related harms among this diverse group. This chapter examines the current literature on the development and effectiveness of existing culturally relevant substance use disorder treatments and makes recommendations for future research and best practices. We argue that given their unique needs, the severity of their substance use, and the low rates of treatment engagement among this population, it is critical that treatment efforts focus on increasing effective treatment access to all emerging adults. We further encourage substance use disorder treatment researchers and practitioners to move beyond addressing culture-bound intervention targets focused on specific cultural groups. The chapter advocates for the development, testing, and adoption of interventions that are responsive to cultural contexts and that (1) target social determinants of health, (2) are equally effective with privileged and marginalized emerging adults, and (3) prepare therapists to effectively deliver interventions to diverse groups and demonstrate cultural competence.

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What Is the State of the Art in Preventing and Treating Substance Use Disorders among Emerging Adults?

Emerging Adults and Substance Use Disorder Treatment ◽

10.1093/med-psych/9780190490782.003.0004 ◽

2017 ◽

pp. 71-95

Author(s):

Douglas C. Smith ◽

Clayton Neighbors ◽

Jordanna Lembo

Keyword(s):

College Students ◽

Substance Use ◽

Emerging Adults ◽

State Of The Art ◽

Empirical Support ◽

Future Research ◽

Substance Use Prevention ◽

Behavioral Therapies ◽

Cognitive Behavioral Therapies ◽

Electronic Interventions

This chapter reviews state-of-the-art substance use prevention and treatment models available for college-attending and non-college-attending emerging adults. Findings on the widely researched Brief Alcohol Screening and Intervention for College Students (BASICS) model are summarized, as well as those for community-level prevention efforts for college students. For non-college attending emerging adults, motivational interviewing, twelve step facilitation treatment, and cognitive-behavioral therapies have the most empirical support. Few studies are available on the use of primary care–based interventions for emerging adults, which are needed if integrated care is to be realized. There is also new evidence suggesting personalized feedback is less effective than other treatments for emerging adults in non-college settings. Finally, the chapter discusses the mixed findings on electronic interventions and provides recommendations for future research.

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Screening, Assessment, and Diagnosis of Substance Use Disorders among Emerging Adults

Emerging Adults and Substance Use Disorder Treatment ◽

10.1093/med-psych/9780190490782.003.0003 ◽

2017 ◽

pp. 38-70 ◽

Cited By ~ 1

Author(s):

Douglas C. Smith ◽

Kyle M. Bennett ◽

Michael L. Dennis ◽

Rodney Funk

Keyword(s):

Substance Use ◽

Emerging Adults ◽

Substance Use Disorders ◽

Emerging Adult ◽

Assessment Instruments ◽

Specific Research ◽

Dsm 5 ◽

Administration Time ◽

Symptom Patterns ◽

Using Data

Several challenges may hinder accurate screening for and assessment of substance use disorders among emerging adults ages 18–29. This chapter discusses emerging adult–specific research on diagnosing substance use disorders and several empirically supported screeners and assessments that may be useful to those working with emerging adults. First, emerging adult–specific research supporting changes to the most recent version of the Diagnostic and Statistical Manual for Mental Disorders, the DSM-5, is reviewed, and nuances in using the DSM-5 with emerging adults are discussed. The chapter highlights idiosyncrasies in emerging adult symptom patterns using data from large national surveys. Finally, a practice-friendly review of screening and assessment instruments commonly used with emerging adults is provided. For screening instruments, administration time, the instrument’s ability to discern which emerging adults exhibit substance use problems, and emerging adult–specific cutoff points in the literature are addressed. For assessment tools, comprehensiveness of the instrument, administration time, and contexts in which the instrument has been used with emerging adults are discussed.

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Why Should We Focus on Emerging Adults with Substance Use Disorders?

Emerging Adults and Substance Use Disorder Treatment ◽

10.1093/med-psych/9780190490782.003.0001 ◽

2017 ◽

pp. 1-15

Keyword(s):

Substance Use ◽

Emerging Adulthood ◽

Emerging Adults ◽

Substance Use Disorders ◽

First Language ◽

Developmentally Appropriate ◽

Age Groups ◽

Treatment Access ◽

Problematic Substance Use ◽

Problematic Substance

Emerging adulthood (roughly ages 18–29) is the lifespan period when the peak prevalence of substance use disorders (SUD) and substance use occurs. Opportunities for prevention and intervention abound during these years. This chapter provides a brief introduction to the concept of emerging adulthood, as well as a laundry list of terms used to describe problematic substance use. The chapter argues that we must be mindful of using person-first language and, based on available stigma research, advocates for use of the term substance use disorder. The chapter then presents a strong rationale for creating more developmentally appropriate treatments for emerging adults. This rationale is based on three pillars: (1) emerging adults’ current underrepresentation in large outcome studies, (2) existing disparities in treatment outcomes between emerging adults and individuals in other age groups, and (3) the possibility of expanded substance use treatment access under healthcare reform.

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