Substance Use Factors in Young Adult Psychiatric Hospitalization

Background and Purpose: Young adults aged 18 to 25 have the highest rates of co-occurring mental health and substance use disorders in the United States. Nearly 14% struggle with both a substance use disorder and a mental illness. In 2022, approximately half of the young adult population sought mental health treatment, including psychiatric hospitalization. This age group also has the highest prevalence of major depression, with a rate of 18.6%. Cannabis and cocaine are among the most used substances in this population. The purpose of this study was to understand the impact of marijuana and cocaine use on the likelihood of inpatient psychiatric hospitalization among young adults with a history of depression.

Methods: This study was a secondary data analysis of the 2014 National Survey on Drug Use and Health, looking at the subsample of 18- to 25-year-olds who reported ever having depression in their lifetime (N = 1.662). The dependent variable was psychiatric hospitalization (yes/no) in the last year. The independent variables examined in this study included marijuana use and cocaine use measured in two ways: those who reported using at some point in life (yes/no), and frequency of use within the past 12 months. Chi-Square tests examined the prevalence of using marijuana and cocaine for subjects who had and had not been hospitalized. Mann-Whitney U tests examined differences in the frequency of cocaine and marijuana use in the past year between subjects who did or did not stay in a psychiatric hospital. Finally, a binary logistic regression analysis evaluated the impact of marijuana use on psychiatric hospitalization while controlling for gender and age.

Results: Subjects ranged from 18 to 25 years old, and were mostly female (69.6%) and white (71.4%). Chi-square tests found a significant association between marijuana use and psychiatric hospitalization (χ²(1, N = 1,660) = 5.86, p < .05), but determined there was no significant relationship between cocaine use and hospitalization (χ²(1, N = 1,660) = 2.74, p = 0.098). A binary logistic regression analysis that included age, gender, and marijuana use revealed that marijuana use did have a statistically significant impact on psychiatric hospital stay (OR = 2.148, p < .01). The binary logistic regression analysis also found that younger adults were significantly more likely to stay in a psychiatric hospital compared to older adults within the subsample (OR = .828, p < .01).

Conclusions and Implications: The results suggest that psychiatric hospitalization is significantly related to marijuana use and younger age in a subsample of young adults with histories of depression. With this, there needs to be greater availability of mental health support centers and systems for young adults such as community clinics or support groups across college campuses. Education on different substances and their interactions with clients’ predispositions will be essential for social workers serving this population. More research is needed in the future to focus directly on young adult populations and how marijuana use may be associated with specific mental health symptoms found in individuals who are hospitalized in psychiatric units.