Factors Associated With Wait Time to Substance Use Treatment Among Pregnant Women in the United States

Substance use during pregnancy is associated with a range of negative outcomes for both newborns and pregnant women. However, few pregnant women who need substance use treatment access it, and wait time remains a factor determining access to treatment. This study examines individual and structural factors as predictors of wait time among a sample of pregnant women accessing substance use services.

Using observational data from the 2022 TEDS-A dataset, which contains demographic, clinical, and substance use characteristics of admissions to alcohol and drug treatment facilities in the United States, we describe admissions across variables, including living arrangement, referral source, primary substance used, co-occurring disorders, and use of medication for opioid use disorder as part of treatment plans, and demographics. Multivariable ordinal logistic regression was used to assess associations between independent variables and dependent variables to identify predictors of wait time among pregnant individuals.

The sample included 2695 pregnant women admitted to substance use treatment, including detox, inpatient, and ambulatory settings. Individuals experiencing homelessness had greater odds of longer wait times than those living independently and people living in states without pregnancy-priority policies had greater odds of longer wait times than those with. Compared with self-referral, pregnant women referred by other health care providers had lower odds of longer wait times. Individual factors such as having a co-occurring disorder and being black or Indigenous were also associated with lower odds of longer wait times.

Findings suggest individual and structural factors are associated with wait times to substance use treatment for pregnant women and highlight the need for improvement in existing systems. Policymakers can consider enacting laws and policies which recognize the unique needs of pregnant women seeking substance use treatment, emphasizing those that decrease wait times for those accessing treatment.