The epidemiology of combined alcohol and drug use within treatment agencies: a comparison by gender.

As clinical and research attention focuses on the phenomenon of combined alcohol- and drug-related problems and alcohol and drug systems merge, important questions remain regarding the role of gender across treatment systems. This study examines epidemiologic characteristics in a comprehensive sample of female and male clients in one county's separately administered alcohol treatment (N = 381) and drug treatment (N = 304) systems. Large differences were found between women in alcohol and drug treatment agencies on measures of alcohol and drug patterns and problems. Women in alcohol treatment reported more combined use of problem attribution than women in drug treatment. The same patterns were found for men in comparisons across the two systems. A multivariate model predicting membership in drug versus alcohol treatment discriminated better between women than between men. An unexpected finding was that for all measures of alcohol and drug use and problems, gender differences within treatment systems were smaller than differences comparing women and comparing men between the two treatment systems. The findings point to the heterogeneous nature of both women and men in alcohol and drug programs, and call for further examination of these differences in planning treatment strategies in combined alcohol and drug programs.