Abstract
Young people with substance use problems are at risk of having a significantly more difficult transition to adulthood. Without a stable income, it is difficult to get their own home and live an independent life. This article reports findings from a longitudinal study that analyses the social establishment among young adults 5 years after initiating outpatient treatment for substance use problems, with a focus on those not in education, employment, or training (NEET). The study utilises a longitudinal design, combining structured interview data from 452 adolescents treated at Maria clinics in Sweden at intervention onset with national register data at 5-years post-treatment initiation. NEET status and indicators of substance use, mental health, and criminality were analysed using chi-square tests and logistic regression. Five years of post-treatment, three quarters of enrolled youth were socially established; however, one quarter met the criteria for NEET status. NEET was associated with ongoing substance use, mental health issues, and criminality. Key predictors of NEET were financial hardship, exposure to violence, institutional placement, and lack of upper secondary school eligibility. A cumulative risk load significantly increased the likelihood of NEET status. Most young adults achieved social inclusion post-treatment, but a subgroup remained excluded. Early interventions targeting cumulative risk factors are crucial to prevent long-term marginalisation.