Substance misuse profiles of women in families receiving temporary assistance for needy families (TANF) benefits: Findings from a national sample

Objective: Women in families receiving Temporary Assistance for Needy Families (TANF) cash assistance are twice as likely to have a substance use disorder (SUD) than their non-TANF counterparts in the past year. However, evidence is limited about substance misuse patterns and comorbid mental health problems among women in TANF families. Method: Data from the 2015–2018 National Survey on Drug Use and Health were used to examine the prevalence of substance misuse and use disorders among women age 18 or older in TANF families. We used latent class analysis to identify subgroups of distinctive substance misuse behaviors and tested the associations between SUD/ serious psychological distress (SPD) and the group classification. Results: Despite higher odds of having an SUD in all substance categories than their non-TANF counterparts, more than 84% of the women in TANF families were considered to have low substance misuse risks. Of the three identified at-risk groups, the polysubstance and the prescription pain reliever and alcohol misuse groups reported higher risks of having an SUD and SPD than the low-risk group. Individuals at risk of marijuana and alcohol misuse, represented by young, Black mothers, reported the lowest rates of treatment receipt despite having past-year SUD, SPD, or both. Conclusions: Although special attention needs to be paid to integrated care for those at risk of multiple substance misuse, additional efforts are required to increase substance abuse and mental health treatment among women at risk of marijuana and alcohol misuse.