Need for and Receipt of Substance Use Disorder Treatment Among Adults, by Gender, in the United States

Abstract

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.

Factors related to substance use treatment attendance after peer recovery coach intervention in the emergency department

“…Although we included sex and race as factors in the analyses, we did not observe statistically significant differences in linkage to treatment as a function of these variables. As previously noted, sex and racial disparities in treatment receipt and referral have been documented in the emergency department referral to treatment setting and in national databases ( Amaducci et al, 2020 ; Martin et al, 2021 ; Webb et al, 2021 ). The lack of association in the present study may be due to our smaller sample size relative and differences in sampling design (e.g., clinical data extracted from a single ED located in Maryland vs. nationally representative sampling frames) ( Amaducci et al, 2020 ; Martin et al, 2021 ).…”

“…As previously noted, sex and racial disparities in treatment receipt and referral have been documented in the emergency department referral to treatment setting and in national databases ( Amaducci et al, 2020 ; Martin et al, 2021 ; Webb et al, 2021 ). The lack of association in the present study may be due to our smaller sample size relative and differences in sampling design (e.g., clinical data extracted from a single ED located in Maryland vs. nationally representative sampling frames) ( Amaducci et al, 2020 ; Martin et al, 2021 ). Prior data observing racial disparities among Black patients referred to treatment by peer specialists was similar to the present study in terms of overall sample size, but the present study had a somewhat higher percentage of Black patients (32% vs. 21%) and the characteristics of the sample (e.g., geographic region) or intervention strategy may differ in ways that are not captured by the present analysis ( Webb et al, 2021 ).…”

“…Similarly, gender disparity has been observed, as women are less likely to be linked to treatment from the ED compared to men ( Amaducci et al, 2020 ). These systematic gender and racial disparities to treatment entry are observed in national data such that there is a greater discrepancy between treatment need and treatment receipt among women relative to men and among Black and Hispanic persons relative to White persons ( Martin et al, 2021 ). If clinicians are aware of risk factors for failure to attend treatment, they might identify those most likely to benefit from treatment referrals, while developing novel strategies to improve success rates for those who are less likely to attend treatment.…”

Effects of neonatal fentanyl on late adolescent opioid-mediated behavior

“…Clinically, the role of sex in fentanyl and other opioid use is more complicated. Men have higher rates of opioid use disorder and opioid-related deaths as compared to women, but women show a stronger craving for drug cues, develop opioid use disorder faster than males, and are more likely to be prescribed opioid analgesics for pain management than men ( Back et al, 2011 ; Wightman et al, 2021 ; Martin et al, 2022 ; Romanescu et al, 2022 ).…”

Intake assessments of salivary cortisol, survey responses, and adverse childhood experiences are associated with recovery success in an abstinence‐based treatment program for substance use disorders

“…Substance use disorder (SUD) continues to be a sector of public health concern which needs more treatment modalities that reliably lead patients to long‐term sustained recovery. As of the 2015 to 2018 National Survey on Drug Use and Health, 20.7 million people in the United States needed treatment for SUD (Martin et al, 2021). Even among patients who participate in inpatient or residential treatment programs for SUD, relapse is an undesirably common outcome (Andersson et al, 2019).…”