Objectives Disparities in substance use disorder (SUD) treatment use persist across groups, including gender. Using a gender-informed approach to expand treatment capacity and reduce barriers to treatment engagement is vital. We examined SUD treatment need and receipt among people with SUD in the United States, by gender, and assessed gender-specific sociodemographic factors associated with unmet need for SUD treatment and reported treatment barriers. Methods We conducted an analysis of data among adults aged ≥18 with a past-year SUD from the National Survey on Drug Use and Health (2015-2018). We computed population-adjusted frequencies and proportions for SUD treatment need and receipt and assessed gender differences. Multivariate logistic regression assessed gender-specific sociodemographic variables associated with SUD treatment receipt. Results Among adults with a past-year SUD, 63.4% were men and 36.6% were women ( P < .001), only 10.6% received SUD treatment, and a greater percentage of women than men needed treatment for opioid use disorder (11.9% vs 9.9%; P = .002). Receipt of SUD treatment was lowest among women with alcohol use disorder followed by men with alcohol use disorder (7.5% vs 8.9%; P = .052). Non-Latinx Black men had fewer than half the adjusted odds of receiving SUD treatment than non-Latinx White men (adjusted odds ratio [aOR] = 0.44; 95% CI, 0.27-0.71). Latinx women (aOR = 0.37; 95% CI, 0.18-0.73) and non-Latinx Black women (aOR = 0.51; 95% CI, 0.27-0.94) had significantly lower odds of receiving SUD treatment than non-Latinx White women. Conclusions As public health efforts target expanding SUD treatment capacity and addressing disparities in use of SUD treatment, interventions informed by gender and culture should be prioritized.

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Purpose: The purpose of this study was to compare the hospital length of stay in patients presenting to the emergency department (ED) with unspecified chest pain who were admitted through the ED to an inpatient bed prior to the initiation of the emergency department observation unit (EDOBS) and compare those patients admitted after the implementation of the EDOBS. Method: A retrospective, randomized descriptive study using chart review was performed at a large hospital system in the metropolitan Detroit region. Charts with an admission [International Classification of Diseases-9 Code 786.5, unspecified chest pain (n = 92)] were randomly selected. Results: For the inpatient group, ED registration time to unit was 6.4 hr and time from the unit to discharge was 80 hr (i.e., 3.3 days). For the EDOBS group, ED registration time to unit was 3.5 hr and time from EDOBS to discharge was 16 hr (i.e., 0.67 days). Length of stay decreased by 2.7 days overall. Conclusions: Using EDOBS for patients with unspecified chest pain provides for prompt and complete cardiac evaluation. Furthermore, the utilization of the emergency nurse practitioner helped alleviate the increased workload placed on the ED physicians in this type of unit. For example, the emergency nurse practitioner facilitated consults, reviewed diagnostic and laboratory findings (e.g., serial cardiac enzymes), and expedited hospital admission or discharge from the EDOBS. Study Limitations: Study limitations included a small random selection sample from one institution. Data collection was limited to review of the medical record and the accuracy of documentation. Key words: ED observation unit, ED nurse practitioner, length of stay, unspecified chest pain C HEST PAIN is one of the most common chief complaints of patients seen in emergency departments (EDs). The chief complaint of chest pain must be taken From ER-One, Incorporated, Professional Emergency Care, P.C., Livonia, Mich.

People with opioid use disorder (OUD) are vulnerable to negative health outcomes related to substance use and psychosocial issues, such as interpersonal trauma (IPT). Participants receiving buprenorphine completed a cross-sectional survey (July–September 2019). OUD outcomes were prospectively abstracted over a 28-week timeframe. More than a third reported recent IPT (40% women, 36% men). Sexual violence was more common among women than men ( p = .02). For women only, IPT was associated with substance use during follow-up (β = 20.72, 95% CI: 4.24, 37.21). It is important for public health strategies in the opioid crisis to address IPT using sex- and gender-informed approaches.

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