Welfare reform and the changing landscape of substance abuse services for low-income women

Recent welfare reform policies could fundamentally change the nature of public-sector substance abuse services available to women. This review summarizes what is presently known about substance abuse services and women on welfare, and identifies limitations in our current knowledge about the potential effects of welfare reform. Five crucial areas are examined in which research on services has fallen short: (1) assessing the need for substance abuse services across a broad spectrum of welfare populations, (2) exploring the role that alcohol and drug problems play in welfare dependency, (3) examining how welfare programs can serve as pathways to alcohol and drug treatment, (4) evaluating the effectiveness and costs of innovative welfare-treatment programs, and (5) understanding systems-level adaptations in substance abuse services for women that result from changing welfare policies. We conclude that researchers who study services should take a broad view of these issues - one that considers the unique situation of poor women and single mothers, that views substance abuse within a work impairment or disabilities framework, and one that is attuned to future changes in the effects of welfare reform as the economy and labor markets undergo change.