Alcohol Treatment Access and Engagement Among Women in the USA: a Targeted Review of the Literature 2012-2022

Overview

Journal Curr Addict Rep

Date 2024 Mar 20

PMID 38505370

Authors

Emily A Levine

Dawn E Sugarman

Mary Rockas

R Kathryn McHugh

Chloe Jordan

Shelly F Greenfield

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: The purpose of this review is to examine recent literature (2012-2022) on alcohol treatment access and engagement in women in the U.S. and propose future directions for research and clinical practice.

Recent Findings: A targeted literature review resulted in 27 studies encompassing screening and brief intervention (SBIRT), treatment utilization, treatment engagement, and barriers to treatment. Recent literature demonstrates overall low rates of screening and brief interventions and treatment utilization in the population with women less likely to be screened and utilize alcohol treatment. The magnitude of these gender differences varies with race/ethnicity. Extensive barriers to care include provider knowledge, structural barriers, and attitudinal barriers and these vary with service setting, gender, and race/ethnicity.

Summary: There is an increasing prevalence of alcohol use and Alcohol Use Disorder (AUD) in women with low rates of screening, brief treatment, treatment, and engagement which have resulted from extensive barriers to care. Possible areas of further inquiry include the impact of race/ethnicity on gender differences, improving provider and system level policies to promote SBIRT and treatment engagement and utilization, further developing digital interventions, and implementation research to investigate factors associated with optimizing effectiveness of gender-responsive and culturally tailored interventions that address the unique needs of women.

References

Del Re A, Gordon A, Lembke A, Harris A . Prescription of topiramate to treat alcohol use disorders in the Veterans Health Administration. Addict Sci Clin Pract. 2013; 8:12. PMC: 3716908. DOI: 10.1186/1940-0640-8-12. View

Martin C, Parlier-Ahmad A, Beck L, Scialli A, Terplan M . Need for and Receipt of Substance Use Disorder Treatment Among Adults, by Gender, in the United States. Public Health Rep. 2021; 137(5):955-963. PMC: 9379831. DOI: 10.1177/00333549211041554. View

Taylor E, Timko C, Harris A, Yu M, Finlay A . Receipt of pharmacotherapy for alcohol use disorder by justice-involved women in the Veterans Health Administration. Addict Sci Clin Pract. 2019; 14(1):1. PMC: 6317204. DOI: 10.1186/s13722-018-0129-x. View

Abraham T, Lewis E, Cucciare M . Providers' Perspectives on Barriers and Facilitators to Connecting Women Veterans to Alcohol-Related Care From Primary Care. Mil Med. 2017; 182(9):e1888-e1894. DOI: 10.7205/MILMED-D-17-00042. View

Luong J, Board A, Gosdin L, Dunkley J, Thierry J, Pitasi M . Alcohol Use, Screening, and Brief Intervention Among Pregnant Persons - 24 U.S. Jurisdictions, 2017 and 2019. MMWR Morb Mortal Wkly Rep. 2023; 72(3):55-62. PMC: 9869740. DOI: 10.15585/mmwr.mm7203a2. View

Kaufmann C, Chen L, Crum R, Mojtabai R . Treatment seeking and barriers to treatment for alcohol use in persons with alcohol use disorders and comorbid mood or anxiety disorders. Soc Psychiatry Psychiatr Epidemiol. 2013; 49(9):1489-99. PMC: 3983167. DOI: 10.1007/s00127-013-0740-9. View

Grant B, Chou S, Saha T, Pickering R, Kerridge B, Ruan W . Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: Results From the National Epidemiologic Survey on Alcohol and Related Conditions. JAMA Psychiatry. 2017; 74(9):911-923. PMC: 5710229. DOI: 10.1001/jamapsychiatry.2017.2161. View

Dawson D, Goldstein R, Grant B . Factors associated with first utilization of different types of care for alcohol problems. J Stud Alcohol Drugs. 2012; 73(4):647-56. PMC: 3364330. DOI: 10.15288/jsad.2012.73.647. View

Mauro P, Askari M, Han B . Gender differences in any alcohol screening and discussions with providers among older adults in the United States, 2015 to 2019. Alcohol Clin Exp Res. 2021; 45(9):1812-1820. PMC: 8908015. DOI: 10.1111/acer.14668. View

10.

Cucciare M, Lewis E, Hoggatt K, Bean-Mayberry B, Timko C, Durazo E . Factors Affecting Women's Disclosure of Alcohol Misuse in Primary Care: A Qualitative Study with U.S. Military Veterans. Womens Health Issues. 2015; 26(2):232-9. DOI: 10.1016/j.whi.2015.07.010. View

11.

Wolfe H, Biello K, Reisner S, Mimiaga M, Cahill S, Hughto J . Transgender-related discrimination and substance use, substance use disorder diagnosis and treatment history among transgender adults. Drug Alcohol Depend. 2021; 223:108711. PMC: 8114322. DOI: 10.1016/j.drugalcdep.2021.108711. View

12.

Hettema J, Cockrell S, Russo J, Corder-Mabe J, Yowell-Many A, Chisholm C . Missed Opportunities: Screening and Brief Intervention for Risky Alcohol Use in Women's Health Settings. J Womens Health (Larchmt). 2015; 24(8):648-54. PMC: 4628227. DOI: 10.1089/jwh.2014.4961. View

13.

Mellinger J, Winder G, DeJonckheere M, Fontana R, Volk M, Lok A . Misconceptions, preferences and barriers to alcohol use disorder treatment in alcohol-related cirrhosis. J Subst Abuse Treat. 2018; 91:20-27. DOI: 10.1016/j.jsat.2018.05.003. View

14.

Glasner S, Webb J, Michero D, Motschman C, Monico L, Ang A . Feasibility, Acceptability, and Preliminary Outcomes of an Integrated Telemedicine Intervention Combining Naltrexone and Cognitive Behavioral Therapy for Alcohol Use Disorder. Telemed Rep. 2022; 3(1):184-190. PMC: 9718429. DOI: 10.1089/tmr.2022.0029. View

15.

Rodriguez L, Litt D, Stewart S . Drinking to cope with the pandemic: The unique associations of COVID-19-related perceived threat and psychological distress to drinking behaviors in American men and women. Addict Behav. 2020; 110:106532. PMC: 7320671. DOI: 10.1016/j.addbeh.2020.106532. View

16.

Tansil K, Esser M, Sandhu P, Reynolds J, Elder R, Williamson R . Alcohol Electronic Screening and Brief Intervention: A Community Guide Systematic Review. Am J Prev Med. 2016; 51(5):801-811. PMC: 5082433. DOI: 10.1016/j.amepre.2016.04.013. View

17.

Sugarman D, Meyer L, Reilly M, Greenfield S . Women's and men's experiences in group therapy for substance use disorders: A qualitative analysis. Am J Addict. 2021; 31(1):9-21. PMC: 8799487. DOI: 10.1111/ajad.13242. View

18.

Greenfield S, Sugarman D, Freid C, Bailey G, Crisafulli M, Kaufman J . Group therapy for women with substance use disorders: results from the Women's Recovery Group Study. Drug Alcohol Depend. 2014; 142:245-53. PMC: 4150678. DOI: 10.1016/j.drugalcdep.2014.06.035. View

19.

McCrady B, Epstein E, Hallgren K, Cook S, Jensen N . Women with alcohol dependence: A randomized trial of couple versus individual plus couple therapy. Psychol Addict Behav. 2016; 30(3):287-99. PMC: 4880418. DOI: 10.1037/adb0000158. View

20.

OConnor E, Perdue L, Senger C, Rushkin M, Patnode C, Bean S . Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018; 320(18):1910-1928. DOI: 10.1001/jama.2018.12086. View