Gender Disparities in Treatment for Alcohol Problems

OBJECTIVE: To examine women's access to treatment for alcohol problems in terms of the prevalence, characteristics, and treatment-seeking patterns of problem drinkers in a range of alcohol-specific and nonspecialized health care systems. DESIGN: In-person survey. SETTING: A Northern California county. PARTICIPANTS: Consecutive samples of admissions in public alcohol treatment (n = 381), drug treatment (n = 210), mental health treatment (n = 406), emergency health services (n = 2626), primary health clinics (n = 394), and adults in the county general population (n = 3069). PRIMARY OUTCOME MEASURES: Prevalence and relative risk (RR) of problem drinking and rates of alcohol-related treatment episodes. RESULTS: Rates of problem drinking were higher among men than women across all samples. However, after accounting for gender differences in general population rates, women in all of the non-alcohol-specific clinical samples were at greater risk than men for problem drinking (eg, RR = 5.6 for women and RR = 2.1 for men in the mental health sample). Men reported a greater variety in types of services sought in past alcohol-related treatment encounters, but women experienced greater symptom severity. CONCLUSIONS: Female problem drinkers were more likely than male problem drinkers to use non-alcohol-specific health care settings, particularly mental health treatment services, and to report greater symptom severity. Future research on women's access to services for alcohol problems should consider a range of health care systems and gender differences in seeking help.