Government assistance and Medicaid: The relationship with drug treatment and medication for opioid use disorder among women in the United States

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

Methods: We used data from women ages 18-64 who met criteria for past-year DSM-5 DUD (n=2,784) and OUD (n=458) in the 2022 public-use National Survey for Drug Use and Health. We estimated the odds of past-year DUD treatment among women with DUD and past-year MOUD treatment among women with OUD 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 DUD receiving both Medicaid and government assistance were more likely to report past-year DUD treatment (aOR: 3.60, 95% CI=1.36, 9.51) compared to women receiving neither. Women with past-year OUD receiving both Medicaid and government assistance were more likely to report MOUD (aOR: 3.41, 95% CI=1.01, 11.61) compared to those receiving neither. Secondary analysis results were in the same direction.

Conclusion: Drug treatment and MOUD receipt among women with DUD and OUD, 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; our findings suggest that government support programs may help to buffer these known barriers.