Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample

Gilbert, Paul A.; Pro, George; Zemore, Sarah E.; Mulia, Nina; Brown, Grant

doi:10.1111/acer.13965

Cited by 73 publications

(67 citation statements)

References 57 publications

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“…It should be noted that there was a high correlation between help‐seeking and treatment utilization in this study, but we chose to report and discuss them separately due to their conceptual and clinical distinctions. There were many notable differences in overall service use across generation, some of which interacted with sex and revealed new insights into the known fact that females seek use fewer services than males (Alvanzo et al, ; Chartier and Caetano, ; Gilbert et al, ; Ilgen et al, ; Raimo et al, ). Regardless of generation, younger females were less likely than males to seek help or utilize treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Many of the generational differences in service use found in the current study interacted with sex, and there were also significant sex differences by themselves. It has been repeatedly found that females are less likely than males to utilize services for AUD (Alvanzo et al, ; Chartier and Caetano, ; Gilbert et al, ; Raimo et al, ). The current findings align with this and add additional insights.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, multiple studies have found that females receive fewer services than males, and exploring whether these sex differences persist across generations in a high‐risk sample can inform public health and research endeavors related to treatment access among those with AUD. Being female decreases likelihood of seeking help among those with AUD (Gilbert et al, ; Ilgen et al, ), an effect that has been shown since the early 1990s (Chartier and Caetano, ). Treatment utilization rates also differ between males and females with females receiving significantly fewer services (Alvanzo et al, ; Chartier and Caetano, ; Gilbert et al, ; Raimo et al, ; Zemore et al, ).…”

Section: Service Use For Alcohol Problemsmentioning

confidence: 96%

“…Treatment utilization rates also differ between males and females with females receiving significantly fewer services (Alvanzo et al, ; Chartier and Caetano, ; Gilbert et al, ; Raimo et al, ; Zemore et al, ). Accordingly, being male has been found to predict receiving any treatment as well as seeking help with alcohol or drug problems (Chartier and Caetano, ; Gilbert et al, ; Ilgen et al, ) and inpatient care (Raimo et al, ). Women have reported barriers to receiving services for substance use to be stigma, lack of support from family, difficulty finding services, and cost (Pinedo et al, ).…”

Section: Service Use For Alcohol Problemsmentioning

confidence: 99%

“…Being female decreases likelihood of seeking help among those with AUD Ilgen et al, 2011), an effect that has been shown since the early 1990s (Chartier and Caetano, 2011). Treatment utilization rates also differ between males and females with females receiving significantly fewer services (Alvanzo et al, 2014;Chartier and Caetano, 2011;Gilbert et al, 2019;Raimo et al, 1999;Zemore et al, 2014). Accordingly, being male has been found to predict receiving any treatment as well as seeking help with alcohol or drug problems (Chartier and Caetano, 2011;Gilbert et al, 2019;Ilgen et al, 2011) and inpatient care (Raimo et al, 1999).…”

Section: The Importance Of Studying Sex Differencesmentioning

confidence: 99%

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Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

Bourdon

Tillman

Francis

et al. 2020

Alcoholism Clin & Exp Res

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Background There are gaps in the literature on service use (help‐seeking and treatment utilization) for alcohol problems among those with alcohol use disorder (AUD). First, policy changes and cultural shifts (e.g., insurance) related to AUD have occurred over the last few decades, making it important to study generational differences. Second, multiple studies have found that females receive fewer services than males, and exploring whether these sex differences persist across generations can inform public health and research endeavors. The current study examined service use for alcohol problems among individuals with AUD. The aims were as follows: (i) to describe service use for alcohol problems; (ii) to assess generational differences (silent [b. 1928 to 1945], boomer [b. 1946 to 1964], generation X [b. 1965 to 1980], millennial [b. 1981 to 1996]) in help‐seeking and treatment utilization; and (iii) to examine sex differences across generations. Methods Data were from affected family members of probands who participated in the Collaborative Study on the Genetics of Alcoholism (N = 4,405). First, frequencies for service use variables were calculated across generations. Pearson chi‐square and ANOVA were used to test for differences in rates and types of service use across generations, taking familial clustering into account. Next, Cox survival modeling was used to assess associations of generation and sex with time to first help‐seeking and first treatment for AUD, and time from first onset of AUD to first help‐seeking and first treatment. Interactions between generation and sex were tested within each Cox regression. Results Significant hazards were found in all 4 transitions. Overall, younger generations used services earlier than older generations, which translated into higher likelihoods of these behaviors. Regardless of generation, younger females were less likely to use services than males. Conclusions There are generational and sex differences in service use for alcohol problems among individuals with AUD. Policy and clinical implications are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Service Use For Alcohol Problemsmentioning

confidence: 96%

Section: Service Use For Alcohol Problemsmentioning

confidence: 99%

Section: The Importance Of Studying Sex Differencesmentioning

confidence: 99%

See 3 more Smart Citations

Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

Bourdon

Tillman

Francis

et al. 2020

Alcoholism Clin & Exp Res

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Sex-Specific Association of Alcohol Use Disorder With Suicide Mortality

Lange,

Kim,

Lasserre

et al. 2024

JAMA Netw Open

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ImportanceDespite individual studies suggesting that sex differences exist in the association between alcohol use disorder (AUD) and suicide, most existing systematic reviews and meta-analyses have reported associations across the sexes.ObjectiveTo estimate the sex-specific association between AUD and suicide mortality.Data SourcesEmbase, MEDLINE (including MEDLINE In-Process), PsycINFO, PubMed, and Web of Science were searched from database inception to April 27, 2022.Study SelectionInclusion criteria consisted of the following: (1) original, quantitative study, (2) inclusion of a measure of association and its corresponding measure of variability (or sufficient data to calculate these [eg, 95% CI]), and (3) results stratified by sex.Data Extraction and SynthesisData extraction was completed by one reviewer and then cross-checked by a second reviewer. Risk of bias was assessed by study design. Categorical random-effects meta-analyses were conducted to obtain sex-specific pooled estimates of the association between AUD and suicide mortality risk. Methodological moderators (ie, study design and comparator group) were assessed using sex-stratified meta-regressions.Main Outcomes and MeasuresThe association between AUD and suicide mortality.ResultsA total of 16 347 unique records were identified in the systematic search; 24 studies were ultimately included for 37 870 699 participants (59.7% male and 40.3% female) (23 risk estimates for male and 17 for female participants). Participants ranged in age from 15 years to 65 years or older. Sex-specific meta-regression models indicated that study design (ie, longitudinal vs cross-sectional study design) affected the observed association between AUD and suicide mortality for both male participants (log odds ratio, 0.68 [95% CI, 0.08-1.28]; P = .03) and female participants (log odds ratio, 1.41 [95% CI, 0.57-2.24]; P &lt; .001). For males and females, among longitudinal studies, the pooled odds ratios were 2.68 (95% CI, 1.86-3.87; I2 = 99% [n = 14]) and 2.39 (95% CI, 1.50-3.81; I2 = 90% [n = 11]), respectively.Conclusions and RelevanceThis systematic review and meta-analysis yielded substantive evidence that AUD was associated with suicide mortality and that the association was similar across the sexes. The findings underscore the importance of identifying and treating AUD as part of a comprehensive suicide prevention strategy.

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Alcohol use disorder in community management of chronic liver diseases

Leggio

Mellinger

2023

Hepatology

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Rising rates of alcohol use disorder (AUD) combined with increases in alcohol-related liver disease (ALD) and other liver disease have resulted in the need to develop alcohol management strategies at all levels of patient care. For those with pre-existing liver disease, whether ALD or others, attention to alcohol use treatment and abstinence becomes critical to avoiding worsening liver-related consequences. Modalities to help patients reduce or stop alcohol include screening/brief intervention/referral to treatment, various therapeutic modalities including cognitive behavioral therapy, motivational enhancement therapy and 12-step facilitation, and alcohol relapse prevention medications. Harm reduction approaches versus total abstinence may be considered, but for those with existing ALD, particularly advanced ALD (cirrhosis or acute alcoholic hepatitis), total abstinence from alcohol is the recommendation, given clear data that ongoing alcohol use worsens mortality and liver-related morbidity. For certain populations, alcohol cessation is even more critically important. For those with hepatitis C or NAFLD, alcohol use accelerates negative liverrelated outcomes. In women, alcohol use accelerates liver damage and results in worsened liver-related mortality. Efforts to integrate AUD and liver disease care are urgently needed and can occur at several levels, with establishment of multidisciplinary ALD clinics for fully integrated comanagement as an important goal.

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Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample

Cited by 73 publications

References 57 publications

Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder

Sex-Specific Association of Alcohol Use Disorder With Suicide Mortality

Alcohol use disorder in community management of chronic liver diseases

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