Iterative Development and Clinical Outcomes of an Outpatient Young Adult Substance Use Program

Objective: Substance use problems peak in emerging adulthood and often co-occur with other psychiatric disorders. Developmentally tailored services are critical to reduce harms, promote recovery, and prevent persistence or exacerbation. The Young Adult Substance Use Program is an evidence-informed outpatient program for 17- to 25-year-olds that aligns with recent frameworks and principles for the treatment of substance use disorders among youth. This article provides (1) an overview of the program's evolution and (2) an evaluation of (a) recruitment, retention, and engagement; (b) clinical characteristics; and (c) treatment outcomes. Method: Data come from the Young Adult Substance Use Program measurement-based care assessments and clinical chart reviews. A series of descriptive statistics and multilevel linear regressions were performed. Results: Between February 2021 and May 2024, 339 young adults attended an intake, 263 fully enrolled (78%), and 122 (51%) completed the core components of the program (similar to 74% attendance). Of those completed or discharged (n = 230), 49% attended groups, 47% received a specialized consult, and 20% received a new medication. Patients were most commonly seeking treatment for alcohol (61%) and/or cannabis (60%) use, with near universal (95%) co-occurring mental health problems. Statistically significant (ps < .001) and clinically important (per minimal clinically important differences) changes were present for substance use, depression, anxiety, posttraumatic stress disorder symptoms, and quality of life. Approximately 80% reported a clinically important improvement by similar to 12 weeks, although persistent clinical elevations were nonetheless present. Conclusions: Overall, the Young Adult Substance Use Program is an example of an effective evidence-informed developmentally tailored and iteratively refined pragmatic outpatient young adult substance use program. Challenges, lessons learned, and future directions are discussed.