Community Perspectives on Adolescent Substance Use and Treatment Needs: Implications for Social Work Practice and Policy

Background and Purpose: Adolescent substance use continues to present complex challenges for social work practice, particularly in the context of evolving substance trends and persistent gaps in treatment access. Despite increased attention to youth substance use, less is known about how community members and frontline providers perceive treatment needs, service effectiveness, and priorities for intervention. This study examines community and provider perspectives on adolescent substance use and treatment needs in Arizona to inform more responsive, youth-centered systems of care.

Methods: Data were drawn from a cross-sectional, anonymous online survey administered between March and June 2025 to individuals age 18 and older who live or work in Arizona. Participants were recruited through two strategies: (1) social media outreach targeting community members and (2) email and in-person outreach to behavioral health providers and professionals in education, juvenile justice, and child welfare systems. Of 150 initial responses, 90 met eligibility criteria and were included in analyses after excluding ineligible and incomplete cases. The survey included multiple-choice and multi-response items assessing perceptions of adolescent substance use trends, treatment availability and effectiveness, attitudes toward youth substance use (including a validated stigma vignette), and knowledge and opinions regarding medications for opioid use disorder (MOUD). Descriptive statistics (means, percentages) were used to summarize findings.

Participants had a mean age of 43.7 years (SD = 14.1) and were predominantly female (74.4%). The sample reflected a range of professional roles, with the largest proportion working in behavioral health services (31.1%), followed by medical/primary care, education, and community-based settings. Most respondents were directly engaged in adolescent-serving roles: 67.1% reported providing services to adolescents, 58.5% worked in agencies offering substance use treatment, and 68.3% reported referring adolescents to treatment. Participants represented urban (36.7%), suburban (47.8%), and rural (15.6%) communities across Arizona.

Results: Respondents identified adolescent substance use as both serious and increasing, with 74.2% reporting perceived increases over the past year. Cannabis (86%), illicit opioids (70%), and alcohol (58%) were identified as the substances with the greatest increases. Although 70.5% of participants reported awareness of local treatment programs, perceived effectiveness was limited, with most rating programs as only “somewhat effective.” Structural barriers were prominent: among respondents working in treatment settings, 72% identified limited availability of adolescent-specific services as a key challenge. Training priorities included working with justice-involved youth, trauma-informed care, child welfare-involved youth, and co-occurring mental health conditions. While respondents reported moderate familiarity with MOUD, attitudes toward its use with adolescents were more cautious than for adults. Attitudinal findings indicated elevated levels of empathy toward adolescents with substance use disorders alongside some evidence of residual social distancing.

Conclusions and Implications: Our results highlight critical gaps in adolescent treatment capacity, workforce preparedness, and system coordination. Social workers are uniquely positioned to address these gaps through trauma-informed, developmentally responsive practice, cross-system collaboration, and advocacy for expanded access to evidence-based care, including MOUD. Efforts to reduce stigma and incorporate community-informed perspectives are essential to improving engagement and outcomes for adolescents.