Unmet substance use disorder treatment need among reproductive age women

•9 % of reproductive age women needed substance use disorder treatment (2007–2014).•Most women who needed substance use disorder treatment did for alcohol use disorder.•Less than 10 % of these women in need of substance use disorder treatment received it.•Pregnant women were not more likely to receive needed substance use disorder treatment. Substance use disorder (SUD) is a chronic medical condition in need of long-term treatment. The objective of the study is to describe the current unmet SUD treatment need among reproductive age women living in the United States with a focus on pregnancy and parenting status. Data were drawn from the 2007–2014 National Survey of Drug Use and Health for women 18–44 years old. The primary outcomes were past year SUD treatment need and receipt. Women with a SUD treatment need included those with a SUD and/or expressing a need for SUD treatment. Women were classified as pregnant, parenting (living with their children) or not pregnant nor parenting. Multivariable logistic regression determined if pregnancy/parenting status was associated with treatment need and receipt controlling for demographic factors. Among reproductive age women with a past year SUD treatment need, only 9.3 % (95 % CI 8.4–10.2 %) received treatment. Pregnant and parenting women were not more likely to receive treatment (pregnant AOR 0.9; 95 % CI 0.5–1.8 & parenting AOR 0.7; 95 % CI 0.5-0.9) compared to not pregnant nor parenting women. Black (AOR 0.3; 95 % CI 0.2-0.5) and Hispanic women (AOR 0.6; 95 % CI 0.4-0.9) were less likely to receive treatment. Few reproductive age women who need SUD treatment receive it in the US. Although pregnant women are considered a priority population, they are not receiving priority services. Racial disparities in unmet SUD treatment need exist. Barriers to SUD treatment, such as expanding gender informed services, must be addressed.