Hospital Data Says the Drinking Problem Is Getting Younger, and Delivery-Room Clinicians Admit They're Afraid of Patients Who Use

Three papers landed this week that, read together, describe the same problem from three different hospital floors: who is showing up, how the staff feel about them when they do, and what happens to their kids.

Most of the damage in these papers is done before the patient says a word: by the age bracket nobody screens, and by the fear in the room.

Alcohol admissions are climbing fastest in people under 35

The biggest dataset belongs to Jacob Steinle, Kevin Xu, and colleagues, whose paper in the American Journal of Psychiatry analyzed 5,190,680 substance-related emergency and inpatient encounters in US insurance records from 2016 to 2023. The split by age is stark. Among adolescents, cannabis was involved in 70 to 78% of substance-related admissions and alcohol in 19 to 26%. Among adults 55 to 64, it flipped: alcohol in 73 to 76%, cannabis in 10 to 11%.

The trend lines are the news. The share of admissions involving alcohol grew fastest among adults 25 to 34, by 1.80 percentage points a year, and among 35- to 44-year-olds, by 1.19 points a year, per the Partnership to End Addiction summary. Cannabis rose fastest in 19- to 24-year-olds, at 1.81 points a year.

In plain language: when a 30-year-old ends up in a hospital bed because of a substance, it is increasingly alcohol. That cuts against the story the culture tells, that younger adults are drinking less and the alcohol problem belongs to older people. Calibrate it: these are shares of substance-related admissions among insured patients, not population drinking rates, and a rising share can also mean other substances are falling. But it lines up with what we wrote this week about clinicians staying silent with heavy drinkers. If your clinic screens hard for opioids in young adults and assumes alcohol is an older person’s issue, this paper says to screen both. Our alcohol hub and cannabinoids hub track the rest.

Clinicians say birthing patients with SUD make them anxious, and they know it

The smallest paper may be the most honest. Margaret Sherin, Daisy Goodman, and colleagues interviewed 13 clinicians at a New England tertiary care hospital about caring for people with substance use disorder during birth, published in the journal Birth. Four themes came back. Clinicians saw these patients as uniquely hard to care for, because of resource needs and concerns about behavior. They worried about whether the patients could parent safely. They described apprehension about the emotional experience of the care itself. And some found the work rewarding and inspiring.

Thirteen people at one hospital is not a national sample, and the authors do not claim it is. What it gives is a rare admission from inside the room: the clinician’s worry about your parenting starts before the baby is born. The authors warn these perceptions can turn into bias. If you have ever given birth while in recovery or on methadone or buprenorphine and felt watched rather than cared for, this paper suggests you were not imagining it. That feeling has a source, and naming it is the first step to fixing it.

For labor and delivery units, the move is a team conversation this month: which assumptions do we make about patients on MOUD before we’ve met them? Rooming-in, pain management plans, and who calls child protective services and why are all places where those assumptions become policy.

Pediatricians get new guidance on parents who use

The third paper is a clinical report from the American Academy of Pediatrics, led by Davida Schiff with the AAP’s councils on child abuse and neglect and on substance use. It is guidance, not a study, so there are no headline numbers. It covers substance use during pregnancy and parenting, the influence of bias and structural inequities, toxicology testing, screening, what to tell families, and how to recognize genuine concern for a child’s safety.

The fact that bias and structural inequity sit in the same document as abuse recognition matters. Pediatricians are among the people most likely to trigger a child-welfare report. Guidance that asks them to separate a parent’s substance use from actual danger to a child, and to notice their own assumptions, is the policy version of what the Birth paper found at the bedside.

Pediatricians are among the people most likely to trigger a child-welfare report.

The thread

Put the three together and you get a system that sees the wrong patients, fears the ones it does see, and is only now writing down how to treat their families fairly. None of these papers is a breakthrough. Each is a mirror. The research roundup desk will keep holding it up.