Purpose: The purpose of this study is to examine the underresearched transformative service research (TSR) and social marketing segment of young adults who use drugs and identify motivators that have been studied in previous literature, using a service ecosystem lens and provide direction for future research into this area. This research provides the evidence-based knowledge for transformative service and social marketing practitioners to design transformative services that target these motivators. Design/methodology/approach: This systematic review, guided by the preferred reporting items for systematic reviews and meta-analysis framework, examines and analyses 207 articles published between 2015 and 2020. Findings: This study identified that young adults are motivated to take drugs to enhance one’s experience, to cope, for social reasons, because of individual characteristics and for other reasons. Research has largely focused on microsystem and mesosystem motivators with data collected mainly using a microsystem approach. Originality/value: This paper contributes to the TSR and social marketing literature by providing a holistic investigation into all motivators relevant to young adult drug use. An ecosystem classification and theoretical framework of the motivators is curated to help guide future TSR and social marketing research and interventions.