Quick Summary
Young adults between 18 and 25 are among the groups most affected by substance use and mental health problems, and national survey data show they are the least likely to get treatment when they need it. That gap is the real story. This guide covers what the latest federal numbers show, why “young adult” is not one uniform group, how substance use and mental health often overlap, and what to ask a program before you or someone you love enrolls. Every person is different, and nothing here replaces an individual assessment.
Key Takeaways
- In the 2025 National Survey on Drug Use and Health (NSDUH), 9.6 percent of young adults aged 18 to 25 who needed substance use treatment received it. For adults 26 and older the figure was 17.1 percent.
- About 41 percent of young adults had a mental illness or a substance use disorder in the past year. These problems often show up together.
- The National Institute of Mental Health describes the brain as still maturing into the mid-to-late 20s. That is a general pattern, not a rule for any one person.
- Adults 18 and older make their own treatment decisions. Family can help, but involvement is generally the young adult’s call.
- Ask any program who it actually treats, who is in the groups, and how it handles school, work and privacy.
What the National Numbers Say
The most recent federal snapshot is the 2025 NSDUH annual national report from SAMHSA. The survey asks a large sample of people in the United States about substance use and mental health. It reports what people say about their own experience, so treat the numbers as estimates, not a head count.
Two findings stand out for young adults aged 18 to 25.
First, the treatment gap. Among young adults who needed substance use treatment, 9.6 percent (about 845,000 people) received it. That was the lowest share of any age group. Among adults 26 and older it was 17.1 percent, and across everyone surveyed it was 16.0 percent.
Second, how often problems overlap. In 2025, 41.2 percent of young adults (14.9 million) had either a mental illness or a substance use disorder in the past year. Another 11.1 percent had both. That “both” figure was down from 13.3 percent in 2021, which is good news, but it still means millions of young people are dealing with two things at once.
These are group averages. They say nothing about whether a specific 22-year-old has a problem. What they do show is a treatment gap among young adults. The survey does not explain why each person did or did not get care.
Why “Young Adult” Is Not One Group
A 19-year-old college sophomore, a 23-year-old working two jobs and a 25-year-old new parent can all be in the same survey category. Their risks, schedules, supports and treatment needs are very different. Good care starts from the person, not the age bracket.
It helps to know what researchers say about development, as long as it is used carefully. The National Institute of Mental Health notes that the brain finishes developing and maturing in the mid-to-late 20s, and that the prefrontal cortex, which handles planning and decision-making, is one of the last areas to mature. That is a population-level description. It does not mean every young adult has poor judgment, and it does not mean anyone is beyond help once they pass a certain birthday. It is one reason clinicians pay attention to how substance use and stress interact with a still-developing brain.
Treat this as context, not a label. Plenty of young adults are thoughtful, motivated and ready to change. The goal is a plan that fits their life.
When Substance Use and Mental Health Overlap
The 2025 NSDUH found that 28.6 percent of young adults (10.3 million) had any mental illness in the past year. Anxiety, depression, trauma and substance use can feed each other. Someone may drink to take the edge off social anxiety, then find the anxiety is worse the next day. Someone else may start using after a major loss and not notice how much they are relying on it.
That is why an assessment should look at both. When mental health symptoms and substance use occur together, assessing and addressing both can help the care team avoid missing an important part of the picture. Programs that address both in a coordinated way are often described as co-occurring care. If you want to know what that involves, our guide to co-occurring mental health conditions explains the basics.
Real-World Factors Worth Planning Around
Young adults often have practical constraints that older adults do not, or have them in a different form. Some are worth raising early, because they affect whether someone can actually start and finish care.
- School and work. Ask whether a program can document a leave of absence, and what happens to classes, financial aid or a job while you are away. Do not assume the answer. Call the registrar or HR and ask.
- Insurance. Under federal law, many young adults can stay on a parent’s health plan until age 26. HealthCare.gov explains the rule. If you are on a parent’s plan, the explanation of benefits may go to the policyholder, so ask the insurer how privacy works before you use it.
- Housing and supports. Where you go after treatment matters as much as the treatment itself. A plan that sends someone back to the same roommates, the same routines and the same stressors needs a hard look.
- Social life. Many young adults say the hardest part is that friends still drink or use. A realistic plan includes how to handle that, not just a promise to avoid it.
Adult Decisions, Privacy and Family Involvement
At 18, you are an adult in treatment settings. That means you consent to your own care, and a program generally needs your written permission before it shares information with anyone, including a parent who is paying the bill. Rules vary by program and situation, so ask each one how it handles releases of information and who it will and will not talk to.
For parents, this can be hard to accept. It can help to know that family still has a role. You can share what you have seen, support the decision to seek help, and take part in family sessions if your adult child agrees. Pressure and ultimatums often backfire. A calm, specific conversation usually goes further. Name what you have noticed, say you are worried, and ask what kind of help they would be willing to try.
For young adults, it may help to know that asking about treatment is not a commitment. You can ask questions, request an assessment and decide afterward.
What to Ask a Program
Do not assume any program is built for young adults just because it accepts them. Ask directly, and listen for specifics instead of general reassurance.
- Do you accept people my age, and do you have staff who regularly work with young adults?
- Who will I be in groups with? Will I be one of the youngest or oldest?
- How do you treat anxiety, depression or trauma alongside substance use?
- How flexible is scheduling around school or work, and what level of care do you recommend for me?
- What does the plan look like after I leave?
- What will you share with my family, and what requires my written consent?
Our guide on how to choose a rehab center walks through more of these questions, including licensing and cost.
We’re here to make treatment as accessible and affordable as possible — and are in network with many insurance providers. Not sure about your coverage? We can help.
When to Reach Out for Help
Consider talking with a professional if you or someone you care about notices any of these:
- Using more than planned, or being unable to cut back when trying
- Missing classes, shifts or obligations because of use or recovering from it
- Using to cope with anxiety, low mood, stress or sleep problems
- Withdrawal symptoms, such as shakiness, sweating, nausea or severe restlessness, when use stops
- Friends or family expressing concern more than once
If you or someone you know is in emotional crisis, call or text 988. If anyone is in immediate danger or cannot stay safe, call 911 or go to an emergency department. If someone has stopped breathing, cannot be woken or may have overdosed, call 911, give naloxone if available, and stay with the person until help arrives. Heavy alcohol and sedative use can cause dangerous withdrawal, so do not stop suddenly after regular heavy use without medical advice.
Talking With a Professional
A first conversation is not a commitment. Bring a list of what you use and how often, any medications, how school or work is going, and your questions about privacy and insurance. The admissions team at Discovery Point Retreat can explain what an assessment involves. Ask which services are currently available and whether outside care might be needed. If you are not sure treatment is the right fit, a primary care doctor, campus health service or community counselor can also be a starting point.
FAQ
Is it too early to worry about substance use in my early twenties?
No. A substance use disorder can develop at any age, and getting help sooner is generally easier than waiting. A professional assessment can tell you whether what you are experiencing needs treatment.
Can my parents make me go to treatment if I am 18 or older?
Generally, no. Adults consent to their own care. Family can encourage, support and help with logistics, but the decision is usually the adult’s, except in specific legal situations that a lawyer or clinician can explain.
Will my parents find out if I go?
It depends on what you sign, how your insurance works and what you choose to share. Ask the program and your insurer how information is handled before you consent.
Does my age change what treatment I need?
Age is one factor. Your substance use, health, mental health, safety and living situation matter more. An assessment decides the level of care.
What if I have anxiety or depression too?
That is common. Ask any program how it treats both together, and whether it can assess and treat mental health conditions alongside substance use.
Can I keep up with school or work?
Sometimes, depending on the level of care and the program’s schedule. Ask what is possible, and check your school’s and employer’s leave policies directly.
References
- Substance Abuse and Mental Health Services Administration (SAMHSA). Key Substance Use and Mental Health Indicators in the United States: Results from the 2025 National Survey on Drug Use and Health (annual national report). Accessed October 2026. samhsa.gov
- National Institute of Mental Health. The Teen Brain: 7 Things to Know. Accessed October 2026. nimh.nih.gov
- HealthCare.gov. Coverage for Children and Young Adults Under 26. Accessed October 2026. healthcare.gov
- SAMHSA. National Helpline. Accessed October 2026. samhsa.gov
Related Reading
- Co-Occurring Mental Health Conditions
- How to Choose the Best Rehab Center
- 10 Questions to Ask a Rehab Center Before You Enroll
- The Rise of Social Cultures Around Substance Abuse
Resources
- 988 Lifeline. Call or text 988, or chat at 988lifeline.org. Free, confidential support 24/7.
- SAMHSA National Helpline. Call 1-800-662-HELP (4357) or visit the SAMHSA National Helpline page for free, confidential referrals to local treatment.
- 911. For any medical emergency, including a suspected overdose, call 911 immediately.
This article is general education and is not medical advice.
If you or someone you love is ready to talk, call Discovery Point Retreat at (855) 245-7133 to speak with our admissions team.
