Sex differences are examined for the period during which addiction develops after initial narcotics use. About 25% of the 546 heroin addicts studied became addicted within 1 month after initial use. More women than men fell into this category, and, on the average, women took less time to become addicted. For the majority of those studied (whose addiction occurred 1 month or longer after initial use), patterns of narcotic use during this phase of the addiction career were not significantly different by sex within Anglo or Chicano groups. Differences between female and male addicts in interpersonal relationships, other substance use, drug dealing, legal employment, and criminal behaviors parallel traditional sex role expectations.

Comparisons of behaviors during treatment were made between a sample of women and a sample of men methadone maintenance clients. Women in this study exhibited high motivation for treatment. Overall, however, small differences were found between the sexes with respect to treatment process and outcome measures. The observed differences that were significant included use of substances other than heroin, interpersonal relationships, drug dealing, employment, and criminal behaviors. The differences seemed to be in accordance with traditional sex role expectations. The distinctive behavior pattern of Chicanas demonstrated in this study demands special attention. It is suggested that treatment programs should incorporate more services to meet women-specific needs.

This chapter reviews the literature on factors related to quality of self-report data on drug use and discusses two series of empirical studies investigating the quality of those data. One set of analyses examined the quality of the longitudinal retrospective self-report from narcotics addicts, including validity of recent narcotics use, reliability of various measures, stability of relationships among these measures, and pattern reliability among latent constructs. Results contribute strongly to confidence in the validity of the relationships among these data derived from addicts' self-report. The second set of analyses focused on validity of self-reported drug use among high-risk groups, including samples from sexually transmitted disease (STD) clinics, hospital emergency rooms (ERs), and jails. Results suggest that the accuracy of self-report of recent drug use varies by the sample sources, drug types, and subject characteristics. Targeting these high-risk groups may improve prevalence estimation. The chapter concludes that empirical validation of self-report is always necessary to enhance the utility of collected self-report data and provide means of controlling for potential biases.

Part I of this series compared characteristics of 546 Chicanos and Anglo men and women methadone maintenance (MM) clients. In Part II, specific differences between Chicanos and Anglos are analyzed, by sex, for each of five stages in the addiction career: preexperimentation, experimentation addiction, initial MM treatment, and posttreatment. The analysis examines narcotic and other drug use, arrest, incarceration and legal supervision histories, criminal involvement, employment, interpersonal relationships, and treatment history. Whereas preaddiction differences between addicts parallel ethnic differences found in the general population, after addiction occurs the similarities are greater than the dissimilarities between ethnic groups, except for Chicanas. Chicanos appear to continue to function as part of their community after addiction, but Chicanas appear to risk becoming marginal. Treatment outcomes for Chicanos were, in general, less successful than for Anglos.

Pattern reliability, or the invariance of relationships among variables, was investigated in this study. The consistency of theoretical constructs reflected by measures taken at two separate occasions can be tested using confirmatory factor analysis. Self-report data were obtained from 323 narcotics addicts in two face-to-face interviews conducted in 1974/75 and 1985/86. The two interviews overlapped approximately 4 years between 1970 and 1974/75. Through the testing of the invariance of measurement and structural models, pattern reliability was confirmed in one of the models developed. Explication of pattern reliability offers an alternative means of assessing validity of self-report data.