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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2004.061762v1 96/11/2024    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Pollack, H. A. Articles by Reuter, P. Search for Related Content PubMed PubMed Citation Articles by Pollack, H. A. Articles by Reuter, P. Related Collections Other Health Financing Health Policy Access to Care Alcohol Drugs Women's Health

Harold A. Pollack, MPP, PhD and Peter Reuter, PhD

Harold A. Pollack is with the School of Social Service Administration and Center for Health Administration Studies, University of Chicago, Ill. Peter Reuter is with the School of Public Policy and Department of Criminology, University of Maryland, College Park and the Drug Policy Research Center, RAND Corporation, Santa Monica, Calif.

Correspondence: Requests for reprints should be sent to Harold Pollack, University of Chicago School of Social Service Administration, 969 East 60th St, Chicago, IL 60637 (e-mail: haroldp{at}uchicago.edu).

Objectives. We explored changing relations between substance use, welfare receipt, and substance-abuse treatment among low-income mothers before and after welfare reform.

Methods. We examined annual data from mothers aged 18 to 49 years in the 1990–2001 National Household Survey of Drug Abuse and the 2002 National Survey of Drug Use and Health. Logistic regression was used to examine determinants of treatment receipt.

Results. Among low-income, substance-using mothers, the proportion receiving cash assistance declined from 54% in 1996 to 38% in 2001. The decline was much smaller (37% to 31%) among low-income mothers who did not use illicit substances. Low-income, substance-using mothers who received cash assistance were much more likely than other low-income, substance-using mothers to receive treatment services. Among 2002 National Survey of Drug Use and Health respondents deemed "in need" of substance-abuse treatment, welfare recipients were significantly more likely than nonrecipients to receive such services (adjusted odds ratio=2.31; P<.05). Controlling for other factors, welfare receipt was associated with higher prevalence of illicit drug use. Such use declined among both welfare recipients and other mothers between 1990 and 2001.

Conclusions. Welfare is a major access point to identify and serve low-income mothers with substance-use disorders, but it reaches a smaller proportion of illicit drug users than it did prereform. Declining welfare receipt among low-income mothers with substance abuse disorders poses a new challenge in serving this population.