More Resources, Training, and Data Are Needed to Improve Adolescent and Young Adult Substance Use Disorder Inpatient Management in the US

Managing adolescent and young adult (AYA) substance use disorder (SUD) presents a unique set of challenges. Researchers conducted semi-structured interviews to explore the experiences of physicians (N=12) treating AYA patients hospitalized for substance-related concerns at nine US academic pediatric hospitals, November 2023–June 2024.

• All nine institutions reported involvement of adolescent health, child and adolescent psychiatry, and social work services among AYA with SUD-related hospitalizations.
• There were differences across the institutions in medications and types of psychosocial support offered, and linkage to other levels of care.
• Qualitative analyses also revealed the following themes:
  • training and experience in AYA SUD care is insufficient;
  • clinical pathways and algorithms help standardize SUD care;
  • medical problems take precedence over SUD care during hospitalizations;
  • facilitators and barriers to access to AYA SUD care include provider attitudes, insurance coverage, location, and legal concerns;
  • AYA SUD is likely under-recognized and under-coded, leading to inadequate allocation of resources;
  • SUD in AYAs suffers from lack of recognition, while the need for interventions is growing; and
  • individual or group champions for AYA SUD care are facilitators to institutional improvement.

Comments: Identification of common challenges to the provision of AYA SUD care can inform solutions at educational, institutional, and policy levels. Future studies could focus on implementing potential solutions with the goal of achieving evidence-based standardization and optimization of inpatient substance use-related care for the AYA demographic. It should be noted this study occurred at nine academic pediatric medical centers, so generalizability to resource-limited settings is unknown.

Emily Nields, DO

Reference: Kronish A, MacFarlane Z, Miller V, Herrera MC. Physician experiences of substance use disorder management in pediatric hospitals: a qualitative study of key informant interviews. J Adolesc Health. 2025;77(6):1108–1114.