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Identification of a problem is the first step toward treatment, whether by the person needing treatment, or by a family member, health care professional, employer, or government agency.The likelihood that a person’s substance abuse problem will be identified appears to differ by gender in some settings.Future health services research should consider or develop methods for (1) improving care for women who seek help in primary care or mental health settings, (2) increasing the referral of women to specialized addiction treatment, (3) identifying subgroups of women and men who would benefit from gender-specific interventions, and (4) addressing gender-specific risk factors for reduced treatment initiation, continuation, and treatment words:health services research; health care delivery research; primary health care; mental health care; AOD (alcohol and other drug) abuse; treatment outcome in HSR (health services research); AODU (AOD use) treatment method; treatment referral; treatment barriers; gender differences; single gender group; mixed gender group; women; female In the 1970s and 1980s, practitioners and researchers began to call attention to how little was known about providing appropriate care for women with substance abuse problems, particularly alcoholism (Schmidt and Weisner 1995).Research traditionally had focused on how men fared in substance abuse treatment, and treatment programs were ill-equipped to help women.Women, in contrast, are more often referred by a social worker, suggesting family service agency involvement in their treatment entry (Grella and Joshi 1999).To date, researchers have not directly addressed how gender affects the processes leading to such mandates.For example, although women tend to be older than men, on average, when they begin a pattern of regular drunkenness, women’s drinking-related problems (e.g., loss of control over drinking, negative consequences of drinking) appear to progress more quickly than those of men (Randall et al. This faster progression also means that women experience shorter intervals than men between onset of regular drunkenness and first encountering the negative consequences of drinking, which include physical problems, interpersonal difficulties, negative intrapersonal changes (such as in personality or self-esteem), poor impulse control, and reduced ability to maintain normal social roles and responsibilities.Women also experience shorter intervals between first loss of control over drinking and onset of their most severe drinking-related consequences, and shorter intervals between onset of regular drunkenness and treatment-seeking (Randall et al. Women report more severe problems and experience more health-related consequences from substance use (Bradley et al.

Many studies provide evidence for gender differences in the type, strength, and number of barriers people encounter as they consider and attempt to access treatment.

Little is known about how families interact when a family member has substance abuse problems, about how the gender of that person influences how families or employers communicate about or manage these problems (see Room et al.

2004 for an intriguing exception), or about how gender might influence reflection prior to treatment-seeking.

Limited research suggests that gender-specific treatment is no more effective than mixed-gender treatment, though certain women may only seek treatment in women-only programs.

When gender differences in treatment outcomes are reported, however, women tend to fare better than men.

Consequently, the following review sometimes specifically distinguishes earlier research findings (i.e., from the 1970s and the 1980s) from more recent research findings.

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