[Show abstract][Hide abstract] ABSTRACT: The current study examined medical care need and utilization patterns among a substance abusing and recovering population (n= 876), investigating factors such as employment and drug use categories (e.g., pharmaceutical use, cocaine use, heroin use, alcohol use). It was found that those who were unemployed needed and utilized greater medical care than those who were employed. Results indicated that heroin, cocaine, and/or alcohol use was not predictive of medical care need or utilization, whereas pharmaceutical drug use was predictive of medical care need and utilization. Trauma and risky use of substances were not significant predictors of medical care need or utilization whereas the suicide severity composite was significant. Potential implications for misuse of medical services (e.g., to obtain pharmaceutical drugs of use) and federal medical care expenditure allocation are discussed.