ELDERLY AFRICAN AMERICAN WOMEN SUBSTANCE ABUSE

Elderly African American Women Substance Abuse

Elderly African American Women Substance Abuse

Introduction

Gender is an important variable to cons ider when designing and analyzing studies in all areas and at all levels of biomedical and health-related research (Wizemann & Pardue, 2001). Consideration of gender and dissemination of data regarding gender differences, or lack thereof, has been recommended by the Institute of Medicine (IOM). Gender is especially important in substance abuse treatment services research because the background characteristics, substance abuse patterns, and personal histories of female substance users may differ from those of males. As such, treatment programming designed specifically for Elderly African American women is needed to address not only Elderly African American women's substance abuse-related problems but also their special needs and barriers to treatment.

Although many service providers acknowledge and address gender differences among substance abuse treatment clients, these differences and the programming that addresses them have not been adequately studied. At the national, State, and local levels, policymakers and service providers need new knowledge to understand how male and female substance abuse treatment clients differ in terms of sociodemographic and substance use characteristics and retention in treatment. Information about the availability and effectiveness of substance abuse treatment programming for Elderly African American women can help guide public policy about how the treatment system should be structured.

This report discusses the need for substance abuse treatment programming for Elderly African American women and summarizes evidence about the effectiveness of such programming. The report compares characteristics of male and female clients discharged from substance abuse treatment and estimates the availability of substance abuse treatment programming targeting Elderly African American women's needs. Finally, the report provides new information about the relationship between gender, substance abuse treatment programming for Elderly African American women, and retention in treatment.

This chapter includes a brief history of how gender has been addressed or ignored in sentinel substance abuse treatment research studies. The chapter examines current data about gender differences in substance abuse treatment utilization, substance use epidemiology, social context and etiology of substance use, barriers to receiving treatment, physiological consequences of substance use, and retention in substance abuse treatment. In addition, a brief introduction to the Alcohol and Drug Services Study (ADSS) is presented, followed by an overview of the remaining chapters in this report.

Gender Differences in Physiology

Compared with male substance abusers, female substance abusers may have more physical problems, and females appear to be more vulnerable than males to the physiological effects of substance use. For example, in a study of alcohol problems among trauma center patients, Elderly African American women were significantly more likely than men to have liver disease (Gentilello et al., 2000). Differences in the way Elderly African American women absorb, distribute, eliminate, and metabolize alcohol may increase their vulnerability to alcohol-related problems (Mumenthaler, Taylor, O'Hara, & Yesavage, 1999; Wasilow-Mueller & Erickson, 2001). The female liver appears to be more sensitive to the toxic effect of chronic alcohol intake than the male liver (Colantoni et ...