Need-Service Matching Predicts Drug Use Outcomes in Comprehensive Treatment for Mothers with Substance Use Disorder in the Child Protection System.

Background: Treatments tailored to client-specific needs are effective for treating substance use disorder (SUD), but studies of women in the child protection system are limited. Methods: A single group pre-post evaluation of comprehensive SUD treatment programs for 246 women with dependent children evaluated whether SUD outcomes were improved 6 months post-treatment by adding women-specific interventions and addressing women's family, employment, and psychiatric needs. The Addiction Severity Index measured women's treatment needs and outcomes. Results: Zero-inflated Poisson regressions of substance use at follow-up indicated that: (a) Abstinence rates were not predicted by the amount of SUD treatment-as-usual (TAU) or by women-specific services; (b) for women continuing to use drugs, length of TAU did not predict drug use days but number of women-specific services received predicted more drug use days; (c) for women continuing to use drugs, receiving more treatment meeting their family, employment, and psychiatric needs predicted a lower number of drug use days; and (d) for women with low psychiatric problems at baseline, greater use of psychiatric services was associated with a significantly higher number of drug use days. Conclusions: Matching services to clients' needs may improve substance use outcomes for women with dependent children in SUD treatment.