An International Systematic Review of Drug Utilization Patterns and Risk Factors Among Young Adults

Background:

Increasing drug use among young adults is a growing concern worldwide. The unique challenges of early adulthood—graduation, employment, etc.—and the underdeveloped brain regions responsible for rational judgement and emotional regulation can be attributed to this increase. Therefore, it is crucial to understand their unique drug utilization in the context of rapidly evolving drug trends and COVID-19 effects to prepare effective intervention and prevention. This paper focuses on the most recent one-year period to systematically review international studies of young adults’ drug use patterns and related risk factors.

Methods:

Five databases were examined for studies from October 1, 2022 to October 1, 2023, employing keywords such as 1) drug, substance, cocaine, marijuana, opioid, and methamphetamine, 2) risk factor, and 3) young adult, college student, and university student. Utilizing PRISMA guidelines, 1,209 articles were imported through the Covidence program. After screening, 79 studies meeting the inclusion criteria were selected for the final analysis. Seven reviewers participated in the individual rating and coding of the articles, employing coding components including country/state, legalization of drug use, study type, data source, sample characteristics, measurement tools, drug use prevalence, and risk factors.

Results:

Regarding the country where the studies were conducted, the majority (72.15%) was in the United States and 25.32% was in other countries. The average age of the samples calculated to 23, while the average percentage of male participants was 43.26%, and females, 56.87%. Among the 79 studies examined, 79.75% focused on marijuana/cannabis use, followed by opioid/opiate (32.91%), cocaine (26.58%), other illicit drugs (25.32%), meth/amphetamine (20.25%), and prescription medicine misuse (18.99%). Prevalence varied greatly by timeframes and drug type. For example, during the 30-day timeframe, marijuana use ranged from 0.1% to 74.3%; opioid use ranged from 0.3% to 42.6%; cocaine use ranged from 0.04% to 5.8%; illicit drug use ranged from 4% to 32%; and methamphetamine use was 0.1%. Risk factors were categorized by sociodemographic characteristics (e.g. gender, n = 24), individual level (e.g. mental health issues, n = 29), family level (e.g. substance-using family members, n = 11), peer/school level (e.g. friends’ substance use, n = 10), and community level (e.g. COVID-19 pandemic, n = 2).

Conclusion/Implication:

The current study is notable in that it offers a comprehensive understanding of international drug use rates and relevant risk factors of young adults. By highlighting the disproportionate focus on certain regions and drug types, it underscores the need for greater attention to understudied populations and substances. Moreover, the research reveals a highly diverse range of drug usage rates, prompting recommendations for more precise and consistent methods in measuring drug use in the future. Also, the examination of risk factors indicates the need for a comprehensive approach, emphasizing multicomponent interventions. Mental health issues were the most prominent risk factor, aligning with previous research suggesting drug use as a coping strategy for those with mental health problems. Thus, it is essential to prioritize a focus on these factors when developing preventive measures, self-evaluation, and international resources for young adults.