Use of mental health and substance abuse treatment services by female injection drug users

This article examines whether female injection drug users (IDUs) who have a history of using mental health services (i.e., one or more psychiatric hospitalizations or counseling) enter types of drug treatment different from those of female IDUs who do not have a history of using mental health services. Data used for this exploration originate from a statewide drug-treatment database covering all women who entered drug treatment in the state of Massachusetts from 1996 to 2001. A total of 7776 women were included in the study. Through the use of logistic regression analysis, the study determined that those female IDUs who had a mental health service history, compared with female IDUs who had no such history, were about two-thirds more likely to enter substance abuse treatment other than detoxification only. Specifically, women with a mental health service history were about 66% more likely to enter substance abuse treatment modalities such as drug-free outpatient counseling, methadone maintenance, and/or long-term residential services rather than detoxification alone. This is a positive result, indicating that female IDUs who have mental health problems and therefore have high needs for effective substance abuse treatment are entering the more intensive and/or longer term modalities likely to lead to better outcomes. Possible factors accounting for this, including the referral process within detoxification centers, the role of community referral agents, and the experience women gain as a consequence of receiving services in more than one service system, are discussed.