Abstract Background Although men have historically exhibited the higher levels of alcohol use and alcohol‐related harm, sex differences in alcohol consumption have narrowed in recent decades. Whether similar convergence has occurred in the proportion of substance‐related acute care encounters involving alcohol remains unclear. Methods We conducted a retrospective longitudinal cohort study using national administrative claims from the Merative MarketScan Commercial and Multi‐State Medicaid databases (January 2016 to December 2023). Individuals aged 16–64 years with at least one emergency department (ED) or inpatient encounter involving a non‐nicotine substance‐related diagnosis (ICD‐10‐CM F10‐F19, excluding F17) were included. Alcohol involvement was defined using multiple classifications: any alcohol‐related diagnosis, alcohol‐only encounters, inpatient admissions with alcohol as the primary diagnosis, and acute alcohol‐related morbidity identified using CDC external cause codes. We estimated monthly sex‐specific trends in the proportion of substance‐related encounters involving alcohol using generalized estimating equation models with quadratic time terms. Results The cohort comprised 1,355,161 individuals (54.7% male, 45.3% female) with 5,190,680 substance‐related ED and inpatient encounters. Among individuals with substance‐related encounters, alcohol involvement was more common among males than females (61.5% vs. 43.2%). Across all alcohol‐related outcomes, models demonstrated accelerating convergence in the sex gap over time (all p < 0.001). From 2016 to 2023, the male–female gap in the proportion of substance‐related encounters involving alcohol narrowed by 6.0 percentage points (95% CI, 4.9–7.1), 4.7 points (95% CI, 3.6–5.8) for alcohol‐only encounters, and 4.9 points (95% CI, 4.0–5.8) for inpatient admissions with alcohol as the primary diagnosis. Trends in total substance‐related encounter volume did not differ by sex. Conclusions From 2016 to 2023, alcohol accounted for an increasing proportional share of substance‐related acute care encounters among women relative to men, independent of changes in overall substance‐related healthcare utilization volume.
Xu et al. (Sun,) studied this question.