Young adults in drug treatment : the function of substance use to alleviate anxiety and depression

Section 1- Literature review Young adults in drug treatment have predominantly been heroin users, many with mental health problems. (1) Young adulthood is a distinct developmental period. It encompasses transisitons to adulthood that are now more difficult to negotiate than in the past and may be disrupted by dependent heroin use; (2) Mental health problems are common amongst those in drug treatment but few studies report separate young adult results; (3) Models including the use of drugs to regulate uncomfortable mood states are reviewed as possible explanations for the relationship between substance misuse and mental health problems. In conclusion, more research is needed on the effect of substance misuse on the transition to adulthood and the relevance of self regulation of affect to young adults in drug treatment. Section 2- Research report Relationships were explored between mental health problems and perceived functions for using heroin, crack cocaine, alcohol and cannabis. Participants were fifty-one young adults in drug treatment aged 16-25 years, 96% were opiate users. Questionnaire measures included: Substance use history; negative mood functions/social functions of past year use of heroin, crack cocaine, alcohol and cannabis; Hospital Anxiety and Depression Scale. Clinically significant mental health problems were common (anxiety 47%; depression 24%). Heroin was most often taken to block out negative mood states and such use showed a statistically significant relationship with anxiety and depression. Use of alcohol to alleviate negative mood showed a significant relationship with anxiety but not depression. These relationships were primarily explained by the pharmacological effects of each substance with heroin particularly effective at reducing awareness of uncomfortable mood states. Drug treatment interventions therefore need to address young adult mental health problems and the relationships between mental health and functions of use. Section 3- Critical Appraisal Reflections on the process of conducting the literature review and research report.