INTRODUCTION:Female substance abusers are a vulnerable population facing numerous barriers to care, especially gynecological health. Access to contraception is a crucial part of women’s health; however, research on contraceptive use in substance abusers is limited. Our aim was to investigate contraceptive methods in a women’s substance abuse rehabilitation facility. METHODS:Data was taken from 697 intake surveys of reproductive-aged women between 2013 and 2019. Analysis examined contraceptive use by sociodemographic variables. Trends were compared with data from 2015-2017 National Surveys of Family Growth and 2017 state-level data from the CDC. RESULTS:The majority of women did not use contraceptives (40.3%), were sterilized (22.7%) or used condoms (21.1%). Compared to national and Louisiana-specific rates, this data reveals significantly higher proportions of no contraception and sterilization; conversely, there were lower rates of hormonal and long-acting reversible contraceptive methods (6.9; 4.9%). Substance-abusing women reported sterilization at a younger age (37) compared to national averages. 64.8% reported Medicaid enrollment; education and insurance were independent of contraceptive choice (X2=5.76, P=.22; X2=3.15, P=.53; P<.05). CONCLUSION:Women in rehabilitation reported both a high rate of sterilization, and limited use of reversible contraceptives. Lack of variability in method could include amenorrhea from chronic substance use, mistrust of the healthcare system, and inadequate education on gynecological health. Residential rehabilitation facilities provide a unique opportunity for providers to deliver contraceptive education in a positive, encouraging environment, while women are focused on making positive lifestyle changes. Addressing this need would give these women greater autonomy over their health and fertility.