The Role of Medications for Opioid Use Disorder (MOUD) in Child Welfare Outcomes: Evidence From Ohio’s START Implementation

This study examines medication for opioid use disorder (MOUD) utilization within Ohio's implementation of the Sobriety Treatment and Recovery Teams (START) model. This study assesses whether MOUD is associated with improved parent and child outcomes. Using an observational design relying on administrative data, 449 adults with documented opioid use were included. Key outcomes included case length, percent of time sustaining sobriety, successful Ohio START program completion, out-of-home placement, and reunification. MOUD was the primary independent variable. Multilevel regressions were conducted to account for parents nested within families and counties. MOUD was significantly associated with longer case duration, a higher percentage of time sustaining sobriety, and greater odds of successful Ohio START program completion. MOUD was not significantly associated with out-of-home placement or reunification after children were removed. These results suggest that MOUD may support sustained recovery engagement among parents participating in child welfare treatment programs.