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Substance abuse treatment for women: Changes in the settings where women received treatment and types of services provided, 1987–1998

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Abstract

Changes in social policies during the last 2 decades have had major implications for the provision of substance abuse treatment services to women. The goal of this analysis was to examine (a) changes in the proportion of women clients served within different types of treatment facilities and (b) the services provided in these facilities. Data were analyzed from national surveys of treatment providers for the period of 1987 to 1998. Overall, there were gradual increases in the proportion of women clients across treatment facilities and greater concentrations of women in more intensive treatment modalities. The provision of childcare increased over time, particularly in programs with only women clients. Treatment facilities in which there were higher proportions of women generally had higher rates of providing services related to pregnancy, parenting, and domestic violence. These findings can be used to assess the adequacy of service delivery to women in substance abuse treatment.

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References

  1. Reed BG. Developing women-sensitive drug dependence treatment services: why so difficult?Journal of Psychoactive Drugs. 1987;19(2):151–164.

    Google Scholar 

  2. Kandel DB. Gender differences in the epidemiology of substance dependence in the United States. In: Frank E, ed.Gender and its Effects on Psychopathology. Washington, DC: American Psychiatric Press; 2000:231–252.

    Google Scholar 

  3. Mahan S.Crack, Cocaine, Crime, and Women: Legal, Social, and Treatment Issues. Thousand Oaks, Calif: Sage; 1996.

    Google Scholar 

  4. Breitbart V, Chavkin W, Wise PH. The accessibility of drug treatment for pregnant women: a survey of programs in five cities.American Journal of Public Health. 1994;84(10):1658–1661.

    Google Scholar 

  5. Schmidt L, Weisner C. The emergence of problem-drinking women as a special population in need of treatment. In: Galanter M, ed.Recent Developments in Alcoholism: Alcoholism and Women. New York: Plenum; 1995:309–334.

    Google Scholar 

  6. Chavkin W, Breitbart V, Elman D, et al. National survey of the states: policies and practices regarding drug-using pregnant women.American Journal of Public Health. 1998;88(1):117–119.

    Google Scholar 

  7. General Accounting Office.Drug Exposed Infants: A Generation at Risk. Washington, DC: Government Printing Office; 1990. Report No. (GAO/HRD)90-138.

    Google Scholar 

  8. Center for Substance Abuse Treatment.Telling Their Stories: Reflections of the 11 Original Grantees That Piloted Residential Treatment for Women and Children for CSAT. Rockville, Md: Center for Substance Abuse Treatment, Substance Abuse & Mental Health Services Administration; 2001. SAMHSA Publication No. (SMA)01-3529).

    Google Scholar 

  9. Eisen M, Keyser-Smith J, Dampeer J, et al. Evaluation of substance use outcomes in demonstration projects for pregnant and postpartum women and their infants: findings from a quasi-experiment.Addictive Behavior. 2000;25(1):123–129.

    Google Scholar 

  10. Nunes-Dinis M. Drug and alcohol misuse: treatment outcomes and services for women. In: Barth RP, Pietrzak P, Ramler M, eds.Families Living With Drugs and HIV: Intervention & Treatment. New York: Guilford Press; 1993:144–176.

    Google Scholar 

  11. Rahdert ER, ed.Treatment for Drug-exposed Women and Their Children: Advances in Research Methodology. Rockville, Md: US Dept Health & Human Services, National Institutes of Health; 1996. NIDA Research Monograph, No. 165.

    Google Scholar 

  12. Blumenthal SJ. Women and substance abuse: a new national focus. In: Wetherington CL, Roman AB, eds.Drug Addiction Research and the Health of Women. Rockville, Md: US Dept of Health & Human Services, National Institutes of Health, National Institute on Drug Abuse; 1998:197–222.

    Google Scholar 

  13. Kissin WB, Svikis DS, Morgan GD, et al. Characterizing pregnant drug-dependent women in treatment and their children.Journal of Substance Abuse Treatment. 2001;21:27–34.

    Google Scholar 

  14. Haller DL, Knisely JS, Dawson KS, et al. Perinatal substance abusers: psychological and social characteristics.Journal of Nervous and Mental Disease. 1993;181:509–513.

    Google Scholar 

  15. Comfort M, Kaltenbach KA. Predictors of treatment outcomes for substance abusing women: a retrospective study.Substance Abuse. 2000;21(1):33–45.

    Google Scholar 

  16. Howell EM, Chasnoff IJ. Perinatal substance abuse treatment: findings from focus groups with clients and providers.Journal of Substance Abuse Treatment. 1999;17:139–148.

    Google Scholar 

  17. Brown VB, Sanchez S, Zweben JE, et al. Challenges in moving from a traditional therapeutic community to a women and children's TC model.Journal of Psychoactive Drugs. 1996;28(1):39–46.

    Google Scholar 

  18. Hodgins DC, el-Guebaly N, Addington J. Treatment of substance abusers: single or mixed gender programs?Addiction. 1997;92(7):805–812.

    Google Scholar 

  19. Stevens SJ, Arbiter N. A therapeutic community for substance-abusing pregnant women and women with children: process and outcome.Journal of Psychoactive Drugs. 1995;27(1):49–56.

    Google Scholar 

  20. Dahlgren L, Willander A. Are special treatment facilities for female alcoholics needed? A controlled 2-year follow-up study from a specialized female unit (EWA) versus a mixed male/female treatment facility.Alcoholism: Clinical and Experimental Research. 1989;13(4):499–504.

    Google Scholar 

  21. Jessup MA, Humphreys JC, Brindis CD, et al. Extrinsic barriers to substance abuse treatment among pregnant drug dependent women.Journal of Drug Issues. 2003;33(2):285–304.

    Google Scholar 

  22. Luthar SS, Walsh KG. Treatment needs of drug-addicted mothers: integrated parenting psychotherapy interventions.Journal of Substance Abuse Treatment. 1995;12:341–348.

    Google Scholar 

  23. Bloom B, Owen B, Covington S.Gender-responsive strategies: Research, Practice, and Guiding Principles for Women Offenders. Washington, DC: National Institute of Corrections, US Dept of Justice; 2003.

    Google Scholar 

  24. Grella CE, Polinsky M, Hser YI, et al. Characteristics of women-only and mixed-gender drug abuse treatment programs.Journal of Substance Abuse Treatment. 1999;17(1/2):37–44.

    Google Scholar 

  25. Uziel-Miller ND, Lyons SS. Specialized substance treatment for women and their children: an analysis of program design.Journal of Substance Abuse Treatment. 2000;19:355–367.

    Google Scholar 

  26. Copeland J, Hall W, Didcott P, et al. A comparison of a specialist women's alcohol and other drug treatment service with two traditional mixed-sex services: client characteristics and treatment outcome.Drug and Alcohol Dependence. 1993;32(1):81–92.

    Google Scholar 

  27. Reed BG, Leibson E. Women clients in special women's demonstration drug abuse treatment programs compared with women entering selected co-sex programs.International Journal of the Addictions. 1981;16(8):1425–1466.

    Google Scholar 

  28. Grella CE. Women in residential drug treatment: differences by program type and pregnancy.Journal of Health Care for the Poor & Underserved. 1999;10(2):216–229.

    Google Scholar 

  29. Grella CE, Joshi V, Hser YI. Program variation in treatment outcomes among women in residential drug treatment.Evaluation Review. 2000;24(4):364–383.

    Google Scholar 

  30. Szuster RR, Rich LL, Chung A, et al. Treatment retention in women's residential chemical dependency treatment: the effect of admission with children.Substance Use & Misuse. 1996;31:1001–1013.

    Google Scholar 

  31. Hughes PH, Coletti SD, Neri RL, et al. Retaining cocaine abusing women in a therapeutic community: the effect of a child live-in program.American Journal of Public Health. 1995;85:1149–1152.

    Google Scholar 

  32. Stevens SJ, Patton T. Residential treatment for drug addicted women and their children: effective treatment strategies.Drugs & Society. 1998;13(1/2):235–249.

    Google Scholar 

  33. Wobie K, Eyler FD, Conlon M, et al. Women and children in residential treatment: outcomes for mothers and their infants.Journal of Drug Issues. 1997;27(3):585–606.

    Google Scholar 

  34. Zlotnick C, Franchino K, St Claire N, et al. The impact of outpatient drug services on abstinence among pregnant and parenting women.Journal of Substance Abuse Treatment. 1996;13(3):195–202.

    Google Scholar 

  35. Volpicelli JR, Markman I, Monterosso J, et al. Psychosocially enhanced treatment for cocaine-dependent mothers: evidence of efficacy.Journal of Substance Abuse Treatment. 2000;18(1):41–49.

    Google Scholar 

  36. Wingfield K, Klempner T. What works in women-oriented treatment for substance abusing mothers. In: Kluger MP, Alexander G, eds.What Works in Child Welfare. Washington, DC: Child Welfare League of America Inc; 2000:113–124.

    Google Scholar 

  37. Brindis CD, Berkowitz G, Clayson Z, et al. California's approach to perinatal substance abuse: toward a model of comprehensive care.Journal of Psychoactive Drugs. 1997;29(1):113–122.

    Google Scholar 

  38. Howell EM, Heiser N, Harrington M. A review of recent findings on substance abuse treatment for pregnant women.Journal of Substance Abuse Treatment. 1999;16(3):195–219.

    Google Scholar 

  39. Lanehart RE, Clark HB, Rollings JP, et al. The impact of intensive case-managed intervention on substance-using pregnant and postpartum women.Journal of Substance Abuse. 1996;8(4):487–495.

    Google Scholar 

  40. Strantz IH, Welch SP. Postpartum women in outpatient drug abuse treatment: correlates of retention/completion.Journal of Psychoactive Drugs. 1995;27(4):357–373.

    Google Scholar 

  41. Weisdorf T, Parran TV, Graham A, et al. Comparison of pregnancy-specific interventions to a traditional treatment program for cocaine-addicted pregnant women.Journal of Substance Abuse Treatment. 1999;16:39–45.

    Google Scholar 

  42. Camp JM, Finkelstein N. Parenting training for women in residential substance abuse treatment: results of a demonstration project.Journal of Substance Abuse Treatment. 1997;14(5):411–422.

    Google Scholar 

  43. Sanders LM, Trinh C, Sherman BR. Assessment of client satisfaction in a peer counseling substance abuse treatment program for pregnant and postpartum women.Evaluation and Program Planning. 1998;21:287–296.

    Google Scholar 

  44. Smith BD, Marsh JC. Client-service matching in substance abuse treatment for women with children.Journal of Substance Abuse Treatment. 2002;22(3):161–168.

    Google Scholar 

  45. Marsh JC, D'Aunno TA, Smith BD. Increasing access and providing social services to improve drug abuse treatment for women with children.Addiction. 2000;95(8):1237–1247.

    Google Scholar 

  46. Orwin R, Francisco L, Bernichon T.Effectiveness of Women's Substance Abuse Treatment Programs: A Meta-analysis. Fairfax, Va: Caliber Associates; 2001. NEDS Analytic Summary Series No 21.

    Google Scholar 

  47. Ashley OS, Marsden ME, Brady TM. Effectiveness of substance abuse treatment programming for women: a review.American Journal of Drug and Alcohol Abuse. 2003;29(1):19–53.

    Google Scholar 

  48. General Accounting Office.ADMS Block Grant: Women's Set-aside Does Not Assure Drug Treatment for Pregnant Women. Washington, DC: US General Accounting Office; 1991. Report No. (GAO-T-HRD)91-37.

    Google Scholar 

  49. Chavkin W, Breitbart V. Substance abuse and maternity: the United States as a case study.Addiction. 1997;92(9):1201–1205.

    Google Scholar 

  50. Chavkin W, Wise P, Elman D. Policies towards pregnancy and addiction: sticks without carrots. In: Harvey JA, Kosofsky BE, eds.Cocaine: Effects on the Developing Brain. New York: New York Academy of Sciences; 1998;335–340.

    Google Scholar 

  51. Drug Strategies.Keeping Score. Women and Drugs: Looking at the Federal Drug Control Budget. Washington, DC: Drug Strategies; 1998.

    Google Scholar 

  52. Shepard DS, Larson MJ, Hoffmann NG. Cost-effectiveness of substance abuse services: implications for public policy.Psychiatric Clinics of North America. 1999;22(2):385–400.

    Google Scholar 

  53. Weisner C, McCarty D, Schmidt L. New directions in alcohol and drug treatment under managed care.American Journal of Managed Care. 1999;5:57–69.

    Google Scholar 

  54. Blanch AK, Levin BL. Organization and services delivery. In: Levin BL, Blanch AK, Jennings A, eds.Women's Mental Health Services: A Public Health Perspective. Thousand Oaks, Calif: Sage; 1998:5–18.

    Google Scholar 

  55. Schreter RK. Ten trends in managed care and their impact on the biopsychosocial model.Hospital & Community Psychiatry. 1993;44(4):325–327.

    Google Scholar 

  56. Reed BG, Mowbray CT. Mental illness and substance abuse: implications for women's health and health care access.Journal of American Medical Women's Association. 1999;54(2):71–78.

    Google Scholar 

  57. Bloom B, Owen B, Covington S. Women offenders and the gendered effects of public policy.Review of Policy Research. 2004;21(1):31–48.

    Google Scholar 

  58. Marquart JW, Brewer VE, Mullings J, et al. The implications of crime control policy on HIV/AIDS-related risk among women prisoners.Crime & Delinquency. 1999;45(1):82–98.

    Google Scholar 

  59. Bureau of Justice Statistics. Prison statistics, summary findings on December 31, 2002. 2002. Available at: http://www.ojp. usdoj.gov/bjs/prisons.htm/. Accessed February 5, 2004.

  60. Mauer M, Potler C, Wolf R.Gender and Justice: Women, Drugs, and Sentencing Policy. Washington, DC: The Sentencing Project; 1999.

    Google Scholar 

  61. General Accounting Office.Women in Prison: Issues and Challenges Confronting US Correctional Systems. Washington DC: Government Printing Office; 1999. Report No. (GAO/GGD)00 22.

    Google Scholar 

  62. Jordan BK, Federman EB, Burns, BJ, et al. Lifetime use of mental health and substance abuse treatment services by incarcerated women felons.Psychiatric Services. 2002;53(3):317–325.

    Google Scholar 

  63. Teplin LA, Abram KM, McClelland GM. prevalence of psychiatric disorders among incarcerated women: pretrial jail detainees.Archives of General Psychiatry. 1996;53(6):505–512.

    Google Scholar 

  64. Office of Applied Studies.Uniform Facility Data Set (UFDS): 1998. Data on Substance Abuse Treatment Facilities. Rockville, Md: Department of Health & Human Services, Substance Abuse & Mental Health Services Administration; 2000.

    Google Scholar 

  65. Etheridge RM, Hubbard RL, Anderson J, et al. Treatment structure and program services in the drug abuse treatment outcome study (DATOS).Psychology of Addictive Behaviors. 1997;11(4):244–260.

    Google Scholar 

  66. Gerstein DR, Harwood HJ, eds.Treating Drug Problems. Vol 1. Washington, DC: National Academy Press; 1990.

    Google Scholar 

  67. Office of Applied Studies, Substance Abuse and Mental Health Services Administration.The DASIS Report: Women in Substance Abuse Treatment. Rockville, Md: US Dept of Health & Human Services; 2001.

    Google Scholar 

  68. Office of Applied Studies.Uniform Facility Data Set (UFDS): Data for 1996 and 1980–1996. Rockville, Md: Dept of Health & Human Services, Substance Abuse & Mental Health Services Administration; 1997.

    Google Scholar 

  69. Svikis DS, Golden AS, Huggins GR, et al. Cost-effectiveness of treatment for drug-abusing pregnant women.Drug and Alcohol Dependence. 1997;45:105–113.

    Google Scholar 

  70. Daley M, Argeriou M, McCarty D, et al. The costs of crime and the benefits of substance abuse treatment for pregnant women.Journal of Substance Abuse Treatment. 2000;19:445–458.

    Google Scholar 

  71. French MT, McCollister KE, Cacciola J, et al. Benefit-cost analysis of addiction treatment in Arkansas: specialty and standard residential programs for pregnant and parenting women.Substance Abuse. 2002;23(1):31–51.

    Google Scholar 

  72. Clark HW. Residential substance abuse treatment for pregnant and postpartum women and their children: treatment and policy implications.Child Welfare. 2001;80(2):179–198.

    Google Scholar 

  73. Mumola CJ.Substance Abuse and Treatment, State and Federal Prisoners, 1997. Washington, DC: US Dept of Justice, Office of Justice Programs; 1999. Bureau of Justice Statistics Special Report No. (NCJ)172871.

    Google Scholar 

  74. Prendergast ML, Wellisch J, Wong MM. Residential treatment for women parolees following prison based drug treatment: treatment experiences, needs and services, outcomes.The Prison Journal. 1996;76(3):253–274.

    Google Scholar 

  75. Prendergast ML, Wellisch J, Falkin GP. Assessment of and services for substance abusing women offenders in community and correctional settings.The Prison Journal. 1995;75:240–256.

    Google Scholar 

  76. Alemagno SA. Women in jail: is substance abuse treatment enough?American Journal of Public Health. 2001;91(5):798–800.

    Google Scholar 

  77. Haywood TW, Kravitz HM, Goldman LB, et al. Characteristics of women in jail and treatment orientations: a review.Behavior Modification. 2000;24(3):307–324.

    Google Scholar 

  78. Koons BA, Burrow JD, Morash M, et al. Expert and offender perceptions of program elements linked to successful outcomes for incarcerated women.Crime & Delinquency. 1997;43(4):512–532.

    Google Scholar 

  79. Reed BG, Leavitt ME. Modified wraparound and women offenders in community corrections: strategies, opportunities, and tensions. In: McMahon M, ed.Assessment to Assistance: Programs for Women in Community Corrections. Lanham, Md: American Correctional Association; 2000:1–106.

    Google Scholar 

  80. Hall EA, Baldwin DM, Prendergast ML. Women on parole: barriers to success after substance abuse treatment.Human Organization. 2001;60(3):225–233.

    Google Scholar 

  81. Sandmaier M.The Invisible Alcoholics: Women and Alcohol Abuse in America. New York: McGraw-Hill; 1980.

    Google Scholar 

  82. Blume SB. Women and alcohol.Journal of the American Medical Association. 1986;256:1467–1469.

    Google Scholar 

  83. Beckman LJ, Kocel KM. The treatment-delivery system and alcohol abuse in women: social policy implications.Journal of Social Issues. 1982;38(2):139–151.

    Google Scholar 

  84. Office of Applied Studies.The DASIS Report: Pregnant Women in Substance Abuse Treatment. Rockville, Md: US Dept of Health & Human Services, Substance Abuse & Mental Health Services Administration; 2002.

    Google Scholar 

  85. McLellan AT, Carise D, Kleber HD. Can the national addiction treatment infrastructure support the public's demand for quality care?Journal of Substance Abuse Treatment. 2003;25:117–121.

    Google Scholar 

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Correspondence to Christine E. Grella PhD.

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Grella, C.E., Greenwell, L. Substance abuse treatment for women: Changes in the settings where women received treatment and types of services provided, 1987–1998. The Journal of Behavioral Health Services & Research 31, 367–383 (2004). https://doi.org/10.1007/BF02287690

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