Individual and Criminal Justice Involvement Factors Affecting Alcohol and Substance Use Treatment Utilization Among Young Adults Age 18-25

Background and Purpose: Young adults' heightened propensity for risky alcohol and substance use (ASU) corresponds with their disproportionate representation in the criminal justice system. Previous research shows that following release from incarceration, many individuals resume high levels of ASU after a period of abstinence. It is critical that our society systemically recognize young adults as a group with distinct developmental characteristics and align any ASU treatment engagement strategies to better address the needs of justice-involved young adults' ASU. The present study aimed to examine the justice involvement factors in addition to individual factors as they relate to ASU treatment utilization among US young adults (age 18-25), using nationally representative data from the National Survey on Drug Use and Health (NSDUH).

Method: Using data from the 2015-2019 NSDUH, the analytic sample was limited to the 12,594 young adult respondents (ages 18-25) with ASU dependence or disorder. The percentages of individuals who received substance use treatment in the past year by demographic characteristics and criminal justice involvement were examined. Multivariate logistic regression model was fit with past year ASU treatment utilization as the binary outcome measure. The analysis specifically examined the relationship between individual factors (i.e., mental illness, education, age of first alcohol use, sex, and race) and justice involvement factors (i.e., arrest history, frequency of arrest past year, and probation history) with the outcome measure.

Results: It was found that, holding all individual covariates included in the model constant, the odds of utilizing ASU treatment was 2.738 (95% CI [2.269, 3.304]) times higher for those who have any lifetime arrest history, 2.218 (95% CI [1.809, 2.702]) times higher for those who have been arrested one time in the past year, 2.635 (05% CI [1.955, 3.551]) times higher for those who have been arrested two times in the past year, and 2.213 (95% CI [1.513, 3.236]) times higher for those who have been arrested three times or more in the past year with statistical significance of less than .001. Similarly, the utilization was 2.740 (95% CI [2.258, 3.324]) times higher for those who were on probation at any time past year (p < .001). It was also found that, controlling for justice involvement, those who are non-Hispanic Black African American (OR 0.569, 95% CI: 0.441 – 0.735, p < .001), Hispanic (OR 0.710, 95% CI: 0.589 – 0.857, p < .001), and have some college education (OR 0.762, 95% CI: 0.660 – 0.880, p < .001) were slightly less likely to utilize ASU treatment.

Conclusions and Implications: The findings from the current study using nationally representative young adult sample were consistent with existing general adult literature in that justice involved young adults are utilizing ASU treatment at higher rates than those without criminal justice involvement. However, this particular study underscores the need to increase ASU treatment engagement effort for specific historically marginalized racial/ethnic groups.