Beyond Age: Transition Age Adults Have Distinct Identities, Substance Use Patterns Compared With Other Adults in Substance Use Disorder Treatment

OBJECTIVES: Transition age (TA, 18-5 years old) adults experience disproportionately high rates of substance use disorders (SUD) but are less likely than other adults to engage in treatment. To better understand TA adults engaged in SUD treatment, we explored the characteristics of this age group compared with other adults 26 years or older. METHODS: Using New York State administrative data, we compared sociodemographic characteristics and substance use patterns of TA adults and other adults (≥26 years) in SUD treatment in 2023 at the individual level, overall and stratified by specific SUD (alcohol, cannabis, opioid, stimulant, or sedative use disorder). Two-sample proportion tests by age group were conducted, and prevalence ratios (PR) were calculated. Effect size was determined with Cohen's h. RESULTS: TA adults accounted for 8.1% (N = 12,103) of adults engaged in SUD treatment in 2023 (N = 148,611). Compared with other adults, TA adults were significantly more likely to identify as LGBT (11.7% vs 5.6%, p < 0.01, h = 0.22), report criminal legal system involvement (46.2% vs 33.3%, p < 0.01, h = 0.27), and be engaged for cannabis use disorder (32.8% vs 7.4%, p < 0.01, h = 0.67). Compared with other adults, they were significantly less likely to be unstably housed (15.6% vs 24.3% p < 0.01, h = -0.22) and engaged in opioid use disorder (20.0% vs 37.5%, p < 0.01, h = -0.39). CONCLUSIONS: TA adults in SUD treatment have distinct identities and substance use patterns compared with other adults in SUD treatment. These characteristics can inform age-specific treatment programs and guide resource allocation, outreach, and engagement strategies.