Social Safety Net Programs: The Relationship With Drug Treatment Among Women

Abstract

Introduction: Social safety net programs (e.g., Medicaid and government assistance) may facilitate drug use disorder treatment receipt. This study explored the associations of social safety net programs with drug treatment and medication for opioid use disorder receipt among women with drug use disorder and opioid use disorder, respectively.

Methods: Data were from the 2022 public-use National Survey on Drug Use and Health (analyzed in 2024) from women aged 18-64 years who met the criteria for past-year DSM-5 drug use disorder (n=2,784) and opioid use disorder (n=458). Odds of past-year drug use disorder treatment among women with drug use disorder and past-year medication for opioid use disorder treatment among women with opioid use disorder were estimated by government assistance and/or Medicaid receipt in primary analyses, followed by secondary categorizations of exposure (any government assistance, number of programs received), using separate logistic regressions, controlling for sociodemographics.

Results: In primary analyses, women with drug use disorder receiving both Medicaid and government assistance were more likely to report past-year drug use disorder treatment (AOR=2.91; 95% CI=1.60, 5.29) than women receiving neither. Women with past-year opioid use disorder receiving both Medicaid and government assistance were more likely to report medication for opioid use disorder (AOR=3.41; 95% CI=1.01, 11.61) than those receiving neither. Secondary analyses results were in the same direction.

Conclusions: Likelihood of drug treatment and medication for opioid use disorder receipt among women with drug use disorder and opioid use disorder, respectively, increased when Medicaid was combined with other forms of government assistance. Treatment costs and other barriers such as lack of insurance, childcare, and employment support are critical determinants of drug treatment; This study's findings suggest that government support programs may help to buffer these known barriers.