The years between 18 and 25 are full of firsts in Central Oregon. A first apartment in Bend, a first job on a crew in Redmond, classes at OSU-Cascades or Central Oregon Community College, ski seasons on the mountain and summers on the river. They are also the years when drinking and drug use often peak, and when it can be hardest to tell the difference between a stage of life and a problem that is quietly growing.
If you are a young adult wondering whether your use has gone past "normal for my age," or a parent watching your grown child and not sure what you are seeing, this guide is for you. It covers how common substance use disorders are in this age group, why they so often go unnoticed, what signs matter, and how outpatient treatment can fit a life that is still taking shape.
More Common Than Most People Think
It is easy to assume that heavy use in your twenties is just part of growing up. The numbers suggest it is often more than that. According to the federal government's 2024 National Survey on Drug Use and Health, 25.9 percent of young adults aged 18 to 25, about 9.1 million people, had a substance use disorder in the past year. That is roughly one in four. The same survey found that 15.8 percent of young adults had a marijuana use disorder, making it the most common drug use disorder in this age group.
Mental health is closely tied in. The survey reported that nearly half of young adults, 45.8 percent, had either a mental illness or a substance use disorder in the past year.
Why So Few Young Adults Get Help
Here is the number that stands out most. In 2024, 26.8 percent of young adults needed substance use treatment, but only 3.0 percent received it, according to the same national survey.
There are plenty of reasons for that gap, and most of them will sound familiar:
- It looks like what everyone else is doing. When your friends drink every weekend or smoke every night, it is hard to see your own use as different.
- Life is already in motion. School, work, moving, and relationships leave little room to stop and take stock.
- Treatment sounds like something for older people. Many young adults picture rehab as a place for people who have lost everything, not someone who still has a job and a lease.
- Worry about what it means. Fear of a label, of disappointing family, or of losing friends keeps a lot of people from asking.
- Not knowing where to start. Insurance, appointments, and what to even say on the phone can feel like a wall.
Signs Use Has Become a Problem
Every person is different, but a few patterns are worth paying attention to, whether you are noticing them in yourself or in someone you love:
- Using to get through, not just to have fun. Drinking or using to sleep, to calm down, to face a social situation, or to stop feeling something.
- Losing control of the plan. Meaning to have a couple and ending up much further, more often than not.
- Slipping at school or work. Missed classes, late shifts, lost jobs, or grades and performance that do not match what you know you can do.
- Money and safety problems. Spending more than you can afford, driving after using, or getting into situations you would not choose sober.
- Friendships and interests narrowing. Spending time mostly with people who use, and dropping activities that used to matter.
- Trying to cut back and not managing it. Making rules about when and how much, and watching them fall apart.
A DUII is often the moment when this becomes impossible to ignore. If that is what brought you here, our guide to what happens after a DUII in Deschutes County walks through the process.
Cannabis, Alcohol, and the Central Oregon Lifestyle
For many young adults here, the main substances are alcohol and cannabis, both legal for adults 21 and older in Oregon and both woven into the social life of the region. That legal status can make it harder to recognize when use has become a problem. Our post on cannabis use disorder in Central Oregon goes deeper on that side of things.
College campuses add their own pressure. The National Institute on Alcohol Abuse and Alcoholism reported that in 2019, 33 percent of full-time college students ages 18 to 22 binge drank in the past month, compared with 27.7 percent of peers the same age who were not in college full time.
Not Sure It Is a Disorder Yet? Start Earlier
You do not have to wait until things fall apart to get support. If your use is not causing major problems yet but you can feel it heading that way, early intervention is designed for that stage. Rock Recovery offers early intervention at ASAM Level 0.5 for people whose use is at-risk or early-stage, which is often a shorter, lighter-touch starting point than full outpatient treatment. Our guide to early intervention for substance use explains who it is for.
What Outpatient Treatment Looks Like at This Age
For many young adults, outpatient care is a good fit because it works around the life you are building rather than pausing it. You can keep going to class, keep your job, and keep living where you live. In practice, treatment usually includes:
- An honest assessment. A counselor learns about your use, your health, your goals, and what else is going on, so the plan fits you and not a template.
- Individual counseling. Space to understand why you use, what it is doing for you, and what you want instead.
- Group counseling. Sitting with other people working on the same thing can take a lot of the shame out of it.
- Peer support. Certified recovery mentors who have walked this road themselves and can help with the day-to-day parts of change.
- Care for what is underneath. Anxiety, depression, and trauma are common at this age, and at Rock Recovery those concerns are addressed as part of substance use treatment.
If you are wondering what the first visit is actually like, our walkthrough of what to expect at your first outpatient appointment covers it step by step.
For Parents of Young Adults
Watching a grown child struggle is its own kind of hard. They are old enough to make their own decisions, and you are no longer the one making the appointments. A few things can help:
- Lead with concern, not a verdict. Describe what you have noticed and why it worries you, instead of naming a diagnosis.
- Know what you can and cannot control. You can offer support, information, and boundaries. You cannot make the decision for them.
- Respect their privacy. Because they are adults, a treatment team generally needs their written consent before sharing information with family.
- Get support for yourself. You are welcome to call us for yourself, even if your young adult is not ready.
Our guides on setting boundaries that help and supporting a loved one in early recovery offer practical places to start.
How Rock Recovery Helps in Central Oregon
Rock Recovery is an Oregon Health Authority-licensed outpatient treatment provider (Certificate of Approval #001776) based in Redmond, serving Bend, Prineville, Madras, Sisters, La Pine, Terrebonne, and the rest of Central Oregon. Our outpatient substance use disorder treatment is delivered at ASAM Level 1, with individual and group counseling, peer support from certified recovery mentors, and care for co-occurring mental health concerns within the same plan.
Shawn and Eugene Reece, who lead Rock Recovery, are both in recovery themselves, and many of our staff bring lived experience. We know what it is like to be told you are too young to have a real problem. You will be taken seriously here. We accept the Oregon Health Plan, Medicare, and most private insurance. You can learn more on our insurance page.
Frequently Asked Questions
How common are substance use disorders among young adults?
According to the 2024 National Survey on Drug Use and Health, 25.9 percent of young adults aged 18 to 25, about 9.1 million people, had a substance use disorder in the past year. That is roughly one in four.
Is heavy drinking or smoking in your twenties just a phase?
For some people it fades. For others it grows into something harder to control. If use is affecting school, work, money, safety, or relationships, or if cutting back has not worked, it is worth talking with someone who understands substance use.
Can I keep going to school or work while I get help?
For most people, yes. Outpatient treatment is designed to fit around school, work, and family, so you can keep your routine while you get support.
Can my parents find out about my treatment?
Because you are an adult, a treatment team generally needs your written consent before sharing information with family. Many young adults choose to involve a parent or partner, and that is your decision to make.
What if my use is not that bad yet?
That is exactly what early intervention is for. Rock Recovery offers early intervention at ASAM Level 0.5 for people whose use is at-risk or early-stage, often a shorter starting point than full outpatient treatment.
Does insurance cover treatment for young adults?
Rock Recovery accepts the Oregon Health Plan, Medicare, and most private insurance. Many young adults are still on a parent's plan, and our team can check your benefits before your first appointment.
One Plan. One Team. The Whole Way Through.
Your twenties are supposed to be about building a life, and you do not have to choose between that and getting help. Rock Recovery brings assessment, counseling, peer support, and care for what is underneath together under one team, so you are never handed off or left to start over.
Whether you are reaching out for yourself or for a son or daughter, contact us through our contact form or call us at (541) 234-3081. We will meet you where you are.
