Substance Use and Substance Use Disorders as Foster Youth Transition to Adulthood

Little research has previously examined substance use and substance use disorders as youth age out of foster care. This study examined rates of getting drunk, marijuana use, and substance use disorders over time for a cohort of 325 older youth in foster care in Missouri. Rates of past month marijuana use increased from 9% at age 17 to 20% at age 19. Rates of getting drunk in past year increased from 18% at age 18 to 31% at age 19. Compared to the general population, older foster youth had lower rates of substance use but higher rates of substance use disorders (SUD), with 15% of youth meeting criteria for a SUD at age 19. Youth who had left the custody of the state had significantly higher rates of alcohol and marijuana use at ages 18 and 19. Transitions out of residential care and into independent living situations were associated with use of substances at age 18. Different risk factors were associated with substance use at ages 18 and age 19 while risk factors for SUDs were more stable over time. Findings highlight the need to screen and provide treatment for SUDs before youth leave state custody and to consider substance abuse treatment in decisions to extend care beyond age 18.