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Gender differences in retention in treatment for substance use disorders

Thomas M. Brady, PhD, Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Parklawn Building, 5600 Fishers Lane, Suite 16-105, Rockville, MD 20857, (301) 443-9049, tbrady@samhsa.gov, Olivia Silber Ashley, DrPH, Center for Interdisciplinary Substance Abuse Research, RTI International, P.O. Box 12194, Research Triangle Park, NC 27709-2194, and Lev S. Sverdlov, MD, PhD, Synectics for Mnagement Decisions, Inc., 1901 North Moore Street, Suite 900, Arlington, VA 22209.

Research suggests that longer retention -- completion of planned treatment and/or time in treatment -- is associated with improved outcomes post-discharge. Favorable outcomes include abstinence from substance use, gains in employment, and decreases in criminal behaviors. Although there is no consensus in the literature, research has shown that retention is lower among women than men. This is generally attributable to a number of factors: lack of childcare, insufficient gender-specific treatment options, medical-legal barriers, mental health differences and increased stigma for female drug use. This paper examines the relationship between gender and completion of planned treatment and length of stay (LOS) among adult substance abuse treatment clients, using a nationally representative random sample of clients (n=4,179). Methods: Data from the Alcohol and Drug Services Study (ADSS) were analyzed for this study. Descriptive and multivariate statistics were used. Findings: Results of descriptive analyses showed that 52 percent of female and 55 percent of male clients completed treatment. Among clients in non-hospital residential treatment, LOS was shorter among women (34 days) than men (61 days), but LOS was similar among women and men in outpatient facilities and facilities offering a combination of types of care. Results of multiple logistic regression indicated that gender was not associated with completion of treatment (OR=1.05; 95% CI={0.85, 1.31}; p=0.64); survival analyses also indicated that gender was not associated with LOS (HR=1.02; 95% CI={0.88, 1.18}; p=0.78), after controlling for individual and organizational characteristics. Discussion: Additional research is needed to study differences in retention between female and male clients.

Learning Objectives:

Keywords: Gender, Substance Abuse Treatment

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Gender, Ethnic and Income Disparities in Access to Care

The 132nd Annual Meeting (November 6-10, 2004) of APHA