Investigating interventions that lead to the highest treatment retention for emerging adults with substance use disorder: A systematic review

Initial Insights from a Quality Improvement Initiative to Develop an Evidence-informed Young Adult Substance Use Program

“…Specific to motivational brief interventions, although several reviews have not found changes in frequency of use regarding cannabis use (43, 44), there are benefits for alcohol and other substance use problems among adolescents (45) and adults (46, 47) and some evidence of benefit regarding other cannabis-related outcomes among emerging adults (44). Specific to emerging adults, though limited, existing research has shown potential benefits from cognitive-behavioural and motivational interventions, integrated mental health and substance use treatment, and higher emerging adult retention when programs include CBT (6, 48, 49).…”

“…Lastly, it is important to ensure access to medications for both psychiatric concerns and addictions, particularly for opioid used disorder (49, 64, 65). Although it is important to simultaneously treat psychiatric disorders with medications where indicated, solely intervening with medications for non-substance related psychiatric concerns is insufficient to treat adolescent SUD (66) and other psychological and pharmacological interventions for SUDs should be delivered concurrently (67).…”

Higher perceived stress during admission is associated with shorter retention in short-term residential substance use disorder treatment

“…Because higher stress during treatment admission is a predictor of treatment retention, appropriate stress management interventions may benefit those with higher perceived stress, especially during the first week of residential treatment ( Black and Amaro, 2019 , Bornovalova et al, 2012 ). Stress management interventions, combined with substance-dependent medications for SUD and behavioral therapy, may encourage longer treatment retention ( Dalton et al, 2021 ). Stress management is an essential factor to incorporate in all treatments and may improve treatment outcomes.…”

The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder

“…to have a small effect on reducing adolescent and young adult cannabis use and increasing treatment retention compared to behavioral health interventions without CM. 178,179 Additionally, in adults with StUD, CM represents the current standard of care: CM has been consistently associated with longer durations of continuous abstinence and lower rates of stimulant use than noncontingent reinforcement (ie, rewards that are not contingent on the desired behavior) and treatment as usual. 42 These effects were strongest during treatment and appeared to decrease gradually over posttreatment follow-ups.…”