Addressing substance use disorders among young adults

The pandemic has had a profound impact on substance use in the United States, with a major increase in drug and alcohol misuse and overdose deaths. Opioid addiction, for example, has become a national crisis as drug overdose deaths topped 100,000 in the past year; in fact, opioid overdose is now the leading cause of accidental death in the United States, surpassing even motor vehicle accidents.

Leading up to the pandemic, alcohol misuse was on the rise, with a JAMA Network Open study revealing that 1 in 5 deaths of U.S. adults 20 to 49 were attributed to excessive drinking. During the pandemic, a CDC report found alcohol-induced deaths jumped 26% between 2019 and 2020, killing more than 49,000 people during the first year of the pandemic.

While substance use disorders (SUDs) impact all age groups, they have a particularly negative effect on a more vulnerable subgroup of the population: young adults between the ages of 18 and 25.

Young adults have some of the highest rates of substance misuse and dependence. For example:

• In 2018, about 35% of people aged 18 to 25 binge drank, meaning women had four or more drinks and men had five or more drinks in a two-hour period.

• People aged 18 to 25 comprised the largest percentage of cigarette smokers. In addition, the use of e-cigarettes among young adults has increased, with about 13% of young adults using them in 2014 and 23% using them in 2016.

In addition to having higher rates of alcohol, cigarette and e-cigarette use, young adults are also more likely than any other age group to use illicit substances. The National Institute on Drug Abuse (NIDA) reported that young adults were the biggest users of prescription pain relievers, ADHD stimulants and anti-anxiety drugs. And, with more than one-third of all young adults having used marijuana in the past year, its use is at a historic high among college-aged adults.

A 2019 NIDA Monitoring the Future national survey tapped college students and people from ages 19 to 60 to determine drug use trends. They found that the use of illicit drugs (e.g. marijuana, amphetamines, cocaine, hallucinogens and ecstasy/MDMA) is highest among people in their early twenties.

Habits formed in their youth follow people into adulthood. Using data from the Monitoring the Future survey, McCabe et al. recently reported that people who had severe SUDs in high school still had two or more SUD symptoms in midlife — an association that held for baseline alcohol, cannabis, and other SUDS — and adolescents with the highest SUD symptom severity at age 18 had the highest risk of prescription drug use and misuse in adulthood.

There’s no doubt that the support of family and friends plays a key role in the treatment and recovery of young adults suffering from SUDs. But it is employers who have been tasked with managing a public health crisis that has grown exponentially in recent years, particularly among the young-adult subgroup — whether they are employees or dependents of employees.

The impact that employers can have in the current substance misuse crisis is significant. Addiction directly and indirectly affects the health, productivity and safety of the workforce. But these crises also have major financial implications, such as the management of an organization’s overall health care costs.

Whether they recognize it or not, every company in America in some way bears the burden of addiction as well as the opportunity to make a difference. Opioid misuse alone costs employers $21,281 per affected individual per year. And the prevalence of these issues among today’s young adults affects not only the current workforce but influences generations to come.

The good news is, employers have the power to bring meaningful change to how SUDs are treated through better coverage, improved access via digital care, and by reducing the stigma associated with addiction. The workplace also presents a prime opportunity to address addiction challenges among workers and their families, including young adults. In fact, research shows that employer-initiated treatment is more successful than treatment initiated by family members or friends.

There also is an important role employers can play in education. Although younger workers are more open to mental health treatment, they were also found to be the least knowledgeable about available benefits and resources, perhaps because they are relatively new to the workforce. For example, in one recent study only 37% of Generation Z workers said they felt comfortable seeking employer help compared to 47% of Millennials and 42% of boomers. Making employees aware of the options available — for both them and their dependents — is crucial in getting people the help they desperately need.

Workplace solutions for young adults should include:

• Going beyond traditional Employee Assistance Programs (EAPs) for a more accessible, holistic focus on employee health and wellness.
• Providing access to virtual mental health and SUD programs and services.
• Promoting apps for stress reduction, mindfulness, cognitive behavioral therapy and other wellness benefits.

Read more: High cost of substance use disorder can be offset by employer sponsored insurance

Understanding the long-term implications today’s young adult substance misuse can have on corporate America and the country overall is a powerful motivation for employers to assume a leadership role in addressing SUD among young adults. Now is the time for employers to take the next step forward in supporting employees and their dependent children on the path to securing the health and future of their workforce.

Yusuf Sherwani, M.D., Co-Founder and CEO, Quit Genius