Online Program

Sex and race/ethnicity differences for initiation of alcohol-related service use among persons with alcohol dependence

Monday, November 4, 2013

Anika Alvanzo, MD, MS, Department of Medicine/Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
Carla Storr, ScD, School of Nursing, University of Maryland Baltimore, Baltimore, MD
Lareina La Flair, MPH, PhD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Ramin Mojtabai, MD, PhD, MPH, Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Lauren Pacek, B.S., Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Kerry Green, PhD, Department of Behavioral and Community Health, University of Maryland, College Park, College Park, MD
Rosa Crum, MD MHS, Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Bernadette Cullen, BCh, BAO, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore
Background: Prior studies on treatment or services used for alcohol problems have yielded mixed results with respect to sex and race/ethnicity disparities. Additionally, little is known about differences in time to first alcohol-related service contact amongst persons with alcohol dependence. In this study, we explored sex and race/ethnicity differences in first alcohol-related service utilization in a population-based sample. Methods: Using data from Wave I of the National Epidemiologic Survey on Alcohol and Related Conditions, we used weighted bivariate analyses and Cox proportional hazard methods to assess adults with lifetime alcohol dependence within sex and race/ethnicity strata (n=3,311). Covariates for multivariate analyses included: age, drinking onset age, education, income, insurance, urbanicity, family history, alcohol consumption, and comorbid psychiatric and drug use disorders. Results: Of the 3,311 persons with lifetime alcohol dependence, only 19.5% reported seeking alcohol-related services. Overall, women had a lower prevalence and were less likely than men to receive alcohol-related services. Women initiated services at a younger age than men and had a shorter interval between drinking onset and first service. These findings are primarily explained by differences between White women and men, with inconsistent sex differences between Blacks and Hispanics likely reflective of smaller sample sizes. There were few race/ethnicity differences. Conclusions: There are important sex differences in receipt of and time from drinking initiation to alcohol-related service utilization among persons with alcohol dependence. Increased recognition of these differences may promote investigation of the factors underlying these differences and identification of the barriers to service utilization for women.

Learning Areas:


Learning Objectives:
Describe sex and race/ethnicity differences for first alcohol-related service utilization among individuals with alcohol dependence in a population-based sample.

Keyword(s): Alcohol, Alcoholism

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a diplomate of the American Board of Addiction Medicine and the Medical Director of an inpatient Substance Use Disorders Consultation Service. I have previously published on sex and race/ethnicity differences in progression to alcohol dependence.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.