Over the last decades, age at onset of substance use has progressively decreased, with earlier initiation being associated with worse prognosis and greater clinical severity.
This descriptive study examined patterns of use, clinical severity and psychopathological dimensions in 111 patients under 26 years old treated at Onda1 - SSD Nuove Dipendenze Asl Città di Torino in 2024.
Assessments were based on clinical records, the Adolescent Behavior Questionnaire (ABQ) and the Seven Domains Addiction Scale (7DAS).
Cannabis was the most frequent primary substance (≈70%), but with increasing age a shift emerged towards crack, inhaled cocaine and polysubstance use, which reached 20% in the 23-25 age group. More than half of the sample (52.3%) presented severe Substance Use Disorder, with severity signifi cantly associated with age and substance pattern.
Although fewer in number, female patien ts showed more severe clinical impairment and higher levels of psychopathology across all 7DAS domains.
Overall, findings indicate an age-related trajectory of clinical worsening from adolescence to young adulthood and underline the need for specialized public services able to provide early, multidisciplinary and gender-sensitive interventions to intercept developmental vulnerability and prevent progression towards more complex and severe patterns of use.