The National Institutes of Health (NIH) estimates that one in five women (19.5%) will experience alcohol use disorder (AUD) in their lifetime, while 7.1% will experience other substance use disorders (SUDs). 

Beneath that statistic is a group of girls and women who suffer from SUDs and are pregnant or raising children. According to Shoshana Walter, author of the new book, Rehab: An American Scandal, roughly 70% of women with SUDs are raising children. In a dramatic understatement of the difficulties seeking treatment while parenting, an NIH report states, “barriers to accessing effective substance use treatment exist for women.”

The lack of adequate childcare is a dramatic barrier to sustaining an addiction treatment program. The fear of having one’s children taken away by the state is another gigantic barrier. The Affordable Care Act and subsequent Medicaid expansion opened the floodgates for better addiction treatment — but not for everyone.

In an article for The Marshall Project, author Shoshana Walter writes:

[S]ince around the start of the opioid epidemic, the number of treatment facilities that cater to patients with children has drastically declined.

How bad is it? Less than 5% of addiction treatment facilities in the U.S. provide childcare for patients receiving treatment, and only 3% allow patients to bring children with them to treatment, according to Walter. Pregnant women are “routinely turned away from treatment,” reports Walter.

While drug overdose deaths are declining after years of climbing in the U.S., drug overdoses among women with children are skyrocketing. A recent report from The Commonwealth Fund documents the alarming increase in overdose fatalities among reproductive-age women. For women aged 14-44, overdose deaths tripled between 2003 and 2023.

Women are right to fear losing custody of their children if they seek addiction treatment. Walter reports these troubling consequences:

• Women have been prosecuted for seeking treatment for addiction
• Women have lost custody of their children as a result of seeking treatment
• Women have lost custody of their children for taking prescribed addiction medications
• Women have lost custody of their children for false positive results on drug tests

Furthermore, addiction manifests differently in women than it does in men. Women have a shorter latency period from being introduced to an addictive substance and developing a disorder. They also present more severe symptoms than men upon seeking treatment, and are more likely to have simultaneous depression or anxiety.

The only positive news for mothers with SUDs is that most will age out of addiction. An estimated 7.8% of women between the ages of 18 and 26 suffer from substance use disorders. That number declines to 1.8% for women over age 26. So why isn’t more being done to help young women who struggle with SUDs get through those tough years?

Here are some recommendations for improvement from The Commonwealth Fund:

• Improve screening for SUDs, particularly prenatal screening
• Expand options for addiction treatment and expand insurance coverage
• Increase recovery housing support, especially family housing support
• Provide education and therapy on successful parenting

All these things cost money upfront, but save a great deal of money down the road. They result in more parents staying sober for longer periods of time, and more children growing up in homes where substance use is no longer a problem.

Written by Steve O’Keefe. First published August 20, 2025.

Sources:

“Drug Overdoses Are Skyrocketing Among Mothers. Why Is Rehab Unavailable?,” The Marshall Project, August 14, 2025.

Rehab: An American Scandal, by Shoshana Walter, published in 2025 by Simon & Schuster.

“Epidemiology of Substance Use in Reproductive-Age Women,” Obstetrics and Gynecology Clinics of North America, June 1, 2015.

“How the U.S. Can Better Understand — and Prevent — Maternal Deaths Related to Substance Use,” The Commonwealth Fund, June 3, 2025.

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