A Review of Gender Differences Among Substance Abusers

Abstract

This article provides a review of various types of literature on gender differences among substance abusers. The authors begin this literature review by summarizing the literature on the differing treatment needs of men and women. The authors continue with a review of the empirically based literature on gender differences in background characteristics of substance users. They conclude with a review of treatment outcome studies. This review provides a context for identifying the gaps in the literature and identifies a research agenda that will help improve treatment services for women in both community-based and prison settings.Knowledge about gender differences in pathways into addiction and crime have established that these differences are critical in delivering effective treatment to both women and men. One fifth of all persons arrested are women, and many women who commit crimes have substance use problems. In a random sample of women arrested for any crime, 65% tested positive for one or more of the following drugs: cocaine, opiates, marijuana, methamphetamines, or phencyclidine (PCP; National Institute of Justice, 2003). In an effort to address this issue, many women have been mandated into substance use treatment programs in both residential (including prison-based) and community-based settings.To design effective substance use treatment programs for women who enter through the criminal justice system, an understanding of the research 343 BERNADETTE PELISSIER, Federal Bureau of Prisons. NICOLE JONES, Federal Bureau of Prisons.We thank Barbara Owen, who contributed to an earlier version of this article and the anonymous reviewers who provided invaluable comments.

Substance abuse treatment entry, retention, and outcome in women: A review of the literature

“…Many studies have reported the relatively low proportion of women in substance abuse treatment programs (Brady and Ashley, 2005;Pelissier and Jones, 2005;Schober and Annis, 1996;Weisner, 1993;Weisner and Schmidt, 1992) compared with the prevalence of these disorders among women in the general population. For example, in 1991 the ratio of men to women was 3.3:1 in alcohol treatment facilities (Dawson 1996), while the male to female ratio of alcohol use disorders in the population for that time period was estimated to be 2.7:1 (Grant et al, 1994).…”

“…The term "barriers" refers to reasons individuals do not utilize specialized addiction treatment services or do not modify target behaviors (Schober and Annis, 1996). Barriers to substance abuse treatment entry for women that have been documented in the past two decades (Brady and Ashley, 2005;Pelissier and Jones, 2005;Schober and Annis, 1996) include pregnancy, lack of services for pregnant women, fear of losing custody when the baby is born, or fear of prosecution (Ayyagari, et al, 1999;DeAngelis, 1993;Finkelstein, 1994;Grella, 1997;Paltrow, 1998). Women may have responsibilities for children coupled with lack of childcare outside of treatment or provided as part of treatment services (Allen, 1995;Brady et al, 1993;Copeland, 1997;Finkelstein 1994;Grella, 1997;Johnson and Meckstroth, 1998;Nelson-Zlupko et al, 1996;Schliebner, 1994;van Olphen and Freudenberg, 2004).…”

“…Because this paper focuses on treatment outcomes, we excluded studies of general characteristics and epidemiology of women with substance use disorders that have been reported and reviewed elsewhere Brennan et al, 1993;Bulik et al, 2004;Greenfield et al, 2002;Hanna and Grant, 1997;Holdcraft and Iacono, 2004;Pelissier and Jones, 2005;Regier et al, 1990). Previous reviews of the literature on women and substance abuse treatment outcomes have generally focused on gender differences and included studies of mixed-gender samples (Brady and Randall, 1999;Lex, 1991;Pelissier and Jones, 2005;Sinha and Rounsaville, 2002;Toneatto et al, 1992), or have focused on outcomes in women without a gender comparison (Ashley et al, 2003;Orwin et al, 2001).…”

“…Previous reviews of the literature on women and substance abuse treatment outcomes have generally focused on gender differences and included studies of mixed-gender samples (Brady and Randall, 1999;Lex, 1991;Pelissier and Jones, 2005;Sinha and Rounsaville, 2002;Toneatto et al, 1992), or have focused on outcomes in women without a gender comparison (Ashley et al, 2003;Orwin et al, 2001). Because this review focuses on treatment outcomes for women with substance use disorders, it includes both studies that utilized women-only samples and studies involving gender comparisons reported in mixed-gender samples.…”

Cost Variation among Subpopulations of Diverted Drug Offenders under California’s Proposition 36

“…In addition to the already mentioned subpopulations, it is important to note the specific effect of gender on the presentation of SUDs and on SUD treatment in particular, due to its substantial effect on SUD histories, treatment processes, and treatment outcomes [39][40][41][42][43][44][45][46][47][48][49].…”