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Primary Submission Category: Reproductive health
Post-Dobbs Abortion Bans and Substance Use Treatment Admissions Among Reproductive-Aged Women in the United States, 2017 to 2023
Authors: Alaxandria Crawford, Parvati Singh,
Presenting Author: Alaxandria Crawford*
Abortion bans may increase reproductive uncertainty and heighten the perceived consequences of substance use among reproductive-aged women, which may correspond with greater treatment-seeking through risk management behaviors. We examined whether the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision influenced substance use treatment admissions among reproductive-aged women in the United States.
We defined our exposure as the state-year timing of a total or six-week abortion ban from 2017 to 2023. Treated states comprised 14 states that implemented a ban during the study period; all other states served as controls (ban indicator coded 1 if treated, 0 otherwise). The outcome was state-year rates of substance use treatment admissions among women and men aged 15-49 years, per 100,000 population, from the Treatment Episode Data Set- Admissions (TEDS-A), a census of admissions to state-funded treatment facilities. We conducted difference-in-differences analyses with two-way fixed effects and state-specific linear time trends. The interaction between abortion ban status (referent = pre-ban period) and sex (referent = male) served as the coefficient of interest. Analyses were conducted overall and stratified by race and age group.
Results (post confirmation of pretreatment parallel trends) fail to reject the null in the overall analysis. However, race-stratified models indicated a pronounced increase in treatment admissions among Black women following abortion bans (coef= 369.30; p< 0.001; relative to Black men), followed by White women (coef= 167.07; p< 0.01), with null findings for other racial groups. Age-stratified analyses showed a modest increase among younger individuals (15-20 years; coef= 131.56; p= 0.06), and no changes among older age groups.
These findings suggest that post-Dobbs abortion bans may have increased substance use treatment utilization among reproductive-aged women, with heterogeneous effects across racial and age groups.