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DRUG 'ABUSING WOMAN

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CHARACTERISTICS
OF THE
LDRUG 'ABUSING WOMA

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
Public Health Service
Alcohol, Drug Abuse, and Mental Health Administration

National Institute on Drug Abuse .
5600 Fishers Lane '
Rockville, Maryland 20857

E;

 

The Services Research Reports and Monograph Series are issued by the staff of
the Services Research Branch, Division of Resource Development, National Insti-
tute on Drug Abuse. Their primary purpose is to provide reports to the drug
abuse treatment community on the service delivery and policy—oriented findings
from Branch-sponsored studies. These will include state of the art studies, inno-
vative service delivery models for different client populations, innovative treatment
management and financing techniques, and treatment outcome studies.

 

 

 

This report is a product of NIDA contract No. 271-76-4401 to Burt Associates, Inc., 7315 Wis-
consin Avenue, Bethesda, Maryland 20014.

The material contained herein does not necessarily reflect the opinions, official policy, or posi-
tion of the National Institute on Drug Abuse of the Alcohol, Drug Abuse, and Mental Health
Administration, Public Health Service, U.S. Department of Health, Education. and Welfare.

.5; / f /_”v./

99
9!.

DHEW Publication No. (ADM) 79-816
Printed 1979

 

For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington, DC. 20102

Stock Number 017%?

 

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OF?!
PMBL/

FOREWORD

In recent years considerable attention has been given to the status of women as drug abusers

and as clients in drug treatment programs. Studies have shown that women differ from men in
their rates and patterns of drug use. Further, women of all ages are underrepresented in drug
treatment systems supported by the Federal Government. The Client Oriented Data Acquisition
Process (CODAP), the Federal reporting system, found that in 1976, of the 95,000 federally sup-
ported treatment slots, 25,000 (26 percent) were filled by women.

There has been much speculation on the meaning of these statistics. Some investigators have

concluded that women have a lower incidence of opiate addiction. Others have claimed that the
drug treatment programs are not organized or structured to serve female drug abusers since

the programs tend to be dominated by male staff. There have been reports of overt and covert
sexism in drug programs.

Treatment programs have acknowledged the importance of giving special attention to the needs
of women. In developing a strategy to address female issues in the drug treatment field, the
Services Research Branch of the National Institute on Drug Abuse (NIDA) initially elected to
compile a comprehensive review of available information from studies and surveys, from existing
data, and from the literature.

Often research endeavors are initiated and treatment programs designed without the benefit of
exploring that which has gone before. This document on the characteristics of drug-abusing
women attempts to meet that need.

This study, conducted by Burt Associates between June 1976 and December 1977, is a reference
guide that provides information on the research that has been done on the characteristics of
female drug abusers. An effort is made to identify, assess, integrate, and analyze all of the
available data on the characteristics of women's reported drug use patterns, demographic charac-
teristics. and personality attributes. This information is in turn contrasted with comparable
data for males. In addition, discussion is made of the treatment implications of findings pre-
sented.

The report is divided into three major sections as follows:

0 Prevalence Of Drug Abuse: Household Surveys. The emphasis in this chapter is on national
household surveys which were conducted in 1974-75 and 1975—76.

 

0 Characteristics of Male and Female Drug Abusers as Reflected in Data Systems. Here large-
scale, ongoing data systems which focus on clients who come to the attention of service com-
ponents are surveyed. Also surveyed are selected, small-scale data sets which usually
focused on individual programs.

0 A Review of the Literature is divided into two parts: characteristics of male and female drug
abusers as reflected in the literature and psychological characteristics of female drug abusers.
Both published and unpublished literature are surveyed.

 

Margruetta E. Hall
Project Officer

iii

 

I! I: IlILIri ntlllll

 

 

 

CONTENTS

FOREWORD

1.

PREVALENCE OF DRUG ABUSE: HOUSEHOLD SURVEYS

Use of Illicit Drugs
Nonmedical Use of Psychotherapeutic Drugs

CHARACTERISTICS OF MALE AND FEMALE DRUG
ABUSERS AS REFLECTED BY DATA SYSTEMS

Large-Scale Data Systems
Small-Scale Data Systems
Analysis of the Data

A REVIEW OF THE LITERATURE
Characteristics of Male and Female Drug

Abusers as Reflected in the Literature
Psychological Characteristics of Female Drug Abusers

4. CONCLUSIONS
5. DISCUSSION
FOOTNOTES

REFERENCES

page

iii

30

30
33

71
73
7'5

77

Table

1

Figure 1

Table

Table

Table

Table

Table
Table
Table

Table

Table
Table
Table
Table
Table
Table
Table
Table
Table

Table

2

10
11
12
13
14
15
16
17
18

19

Tables and Figure

Use of Certain Illicit Drugs by Adults
and Youth-—1975-76

Medical Experience with Types of Psycho-
therapeutic Drugs Among Females and Males

Nonmedical Experience with Types of Psycho-
therapeutic Drugs Among Subgroups: Prevalence
(Ever Used)--Over the Counter and/or
Prescription, 1975/76

Nonmedical Experience with Psychotherapeutic
Drugs Among Subgroups: Prevalence (Ever Used)
and Recency of Use (Over the Counter and/or
Prescription), 1975/76

Nonmedical Experience with Prescription Psycho-
therapeutic Drugs Among Subgroups: Trends

in Prevalence (Ever Used), 1975-76

Contacts with Emergency Rooms Due to Drug
Problems—-24 Large SMSAs, April 1974-April 1975

Large and Small Data Systems Considered
Age, by Sex

Age, by Sex (Condensed)

Age, by Sex and by Type of Drug Used in
Contacts with DAWN Emergency Rooms and
Crisis Centers

Race/Ethnicity, by Sex

Marital Status, by Sex

Educational Status, by Sex

Employment Status, by Sex

Primary Source of Support, by Sex
Arrests, by Sex

Admission Type, by Sex

Use of Specific Drugs, by Sex

Primary Drug of Abuse, by Sex
Secondary Drug of Abuse, by Sex

vi

page

11

12

13
15
16
17
19
20
21
23
24
25

26

Table

Table

Table
Table

Table

Table

20

21

22

23

24

25

Tables and Figure (Continued)

Psychotropic Drug Use--Total Percentages

Number of Drugs Which Are Used or Cause
Problems, by Sex

Treatment Studies
Nontreatment Studies

Review of Studies Noting Psychological
Characteristics of Female Drug Abusers

General Conclusions Regarding Overall

Psychological Functioning of Female vs.
Male Drug Abusers

vii

page
28

29
35
S3

61'

70

 

 

 

 

1!

1. Prevalence of Drug Abuse:
Household Surveys

The data reported in this section are from
household surveys. Like all such surveys,
they have some limitations. For example,
the sample sizes are limited and subject to
sampling variability; the household surveys
exclude persons not living in household units,
such as persons living in dormi-tories, transi-
ents, or persons with no fixed address; and
the national surveys reported response rates
of slightly less than 80 percent.

This study excludes consideration of drug
use surveys conducted in schools. Several
surveys of school populations have been con-
ducted recently employing varying methodol-
ogies (Butler 1975; Harrison 1974; Hays 1974;
Linder et al. 1974; Michigan Department of
Public Health 1975; San Mateo County 1974).
The results were summarized by Glenn and
Richards (1976) who observed that differences
in nonmedical drug use by school age males
and females appear to be negligible.

The emphasis in this chapter is upon national
household surveys of drug use which were
conducted in 1974-75 (Abelson and Atkinson
1975) and 1975-76 (Abelson and Fishburne 1976)
by the George Washington University Social
Research Group and Response Analysis Cor-
poration. The results of those surveys may
be divided into two categories: use of illicit
drugs and nonmedical use of psychotherapeu-
tic drugs.‘

Use of Illicit Drugs

Table 1 depicts use of certain illicit drugs,
by sex. Among adults in 1975—76, there were
no statistically significant’ differences in "cur-
rent use" between females and males, except
for rnarihuana (male prevalence was higher).
However, male prevalence ("ever used") is
significantly higher for all the drugs indi-
cated.

Among youth, the only statistically significant
male/female difference in "current use" is for
hallucinogens (male prevalence is higher).

Statistically significant male/female differences
in “ever used" occur only for inhalants, mari-

huana, and hashish (male prevalence is

higher) .

Nonmedical Use of
Psychotheraputic Drugs

A great deal of confusion exists in the litera-
ture with regard to the use and definition of
such words as "psychotropic," "psychothera-
peutic," and "prescription drugs." These
terms are sometimes used interchangeably.
Psychotropic drugs as defined by Cooperstock
(1976) include all tranquilizing agents (anti-
barbiturates and the nonbarbiturate sedatives)
and stimulants (largely amphetamines and
other amphetaminelike aneorexlants). Gener-
ally, this does not include analgesics although
they do affect the central nervous system.

The distinction between licit and illicit use of
psychotherapeutic drugs can cause confusion.
One can differentiate the source as being
medical vs. nonmedical, but the definition
remains unclear because many physicians un-
knowingly become the source for illicitly used
psychotropics (Prather and Fidell 1977).
Abelson and Atkinson (1975) and Abelson and
Fishburne (1976) defined "nonmedical use of
psychotherapeutic drugs“" by an individual
based on a "yes" response to any one (or
more) of the following three items:

0 Did you ever take any of these kinds of
pills just to see what it was like and how
it would work?

0 Did you ever take any of these kinds of
pills just to enjoy the feeling they give
you?

0 Did you ever take any of these pills for
some other nonmedical reason, and not
because you needed it?

Surveys of such drug use or combined med-
ical/nonmedical drug use typically find preva-
lence substantially higher among females
(Abelson and Atkinson 1975; Abelson and
Fishburne 1976; Cooperstock 1976; Cooperstock

Thbkl
USE OF CERTAIN ILLICIT DRUGS BY ADULTS AND YOUTHS--1975-76

 

 

(percentage)
Other
Use/Sex Heroin Opiates Cocaine Hallucinogens Inhalants Marihuana Hashish

Adults (Age 18+!
Current Use(a)_

Females (n=1,561) 0.1 0.4 0.4 0.1 0 5 l S 0.9

Males (n=1,029) * 0.5 0.9 0.5 0 2 11.1 2.0
Ever Used

Females (n=1 561) 0.6 3.6 2.5 3.5 1.9 14.5 6.1

Males (n=1,059) 1.8 S 7.2 5 5.8 S 6.4 S 4.9 S 28.7 S 13.6 S
Youths (Age 12-17]
Current Use

Females (n=467) 0.1 (b) 0.8 0.1 S 0.5 10.6 2.9

Males (n=519) 0.5 (b) 1.2 1.6 1.2 14.1 2.7
Ever Used

Females (n=467) 0.4 (b) 2.9 5.2 4 7 S 18.6 S 8.1 S

Males (n=519) 0.7 (b) 3.9 5.0 11.5 26.0 11.1

 

(a) Indicates use during the month preceding the interview.

(b) Data not available.

* Less than 0.05 percent.

8 Indicates female/male difference is significant at .05 level.

Source: Special tabulations of the SRG/RAC survey data provided by Ira Cisin, Ph.D.

Percent Ever Used

Figure 1

MEDICAL EXPERIENCE WITH TYPES OF PSYGiOI'HI‘IRAPEIH'IC
DRUGS N‘DNG FHV‘IALES AN'D MALES
(percent ever used)

100 fi I = Females
1:] = Males
75 '—
50 '—
25 "
0 # _*_____ ,__

 

 

 

 

  
   

 

 

 

 

Any Sedatives Tranquilizers

Source: Abelson and MkInson (1975).

Stimulants

Age/ Sex

Table 2

NONMEDICAL EXPERIENCE WITH TYPES OF PSYG-IO'IHERAPEUTIC DRUGS

Any Psychotherapeutic

AADNG SUBGROUPS:

THE COUNTER AND/OR PRESCRIPTION, 1975/76

(percentage)

Any orc

Any Rx Sedatives

PREVALANCE (EVER USED) --OV'.ER

Any Rx Tranquilizer

Any Rx Stimulants

 

All Youths: age 12-17

Male (n=519)
Female (n=467)

All Adults: age 18+

Male (n=l,029)
Female (n=l, 561)

Young Adults: age 18-25

Male (n=401)
Female (n=481)

Older Adults: age 26+

Male (n=628)
Female (n=l,080)

14
10

S

U10

14
10

U1U'I

MN

MO

14
10

NM

no:

NM

 

S Indicates the difference between males and females is significant at the .05 level.

Source:

Abelson and Fishburne (1976).

 

Table 3

NONMEDICAL EXPERIENCE WITH PSYOiOTHERAPEUTIC DRUGS AMONG
SUBGROUPS: PREVALENCE (EVER USED) AND RECENCY OF USE
(Over the Counter and/or Prescription), 1975/76

 

 

(percentage)
Past Year, Not
Age/Sex Ever Used Past Month Not Past anth Past Year Never Used

All Youths: age 12-17

Male (n=Sl9) 9 2 2 4 91

Female (n=467) 12 2 4 6 88
All Adults: age 18+

Male (n=1,029) 18 S 4 3 11 S 82 8

Female (n=1,561) 13 3 3 7 87
Young Adults: age 18-25

Male (n=401) 29 9 8 12 71

Female (n=481) 22 8 6 9 78
Older Adults: age 26+

Fhle (n=628) 14 S 2 1 11 S 86 S

Female (n=1,080) 10 2 2 7 90

 

r‘

0 Indicates the difference between males and females is significant at the .05 level.

Source: Abelson and Fishburne (1976).

 

Tabh4

 

NONMEDI CAL EXPERIENCE WITH PRESCRIPTION PSYGIO'IHERAPEUTIC DRUGS

ANDNG SUBGROUPS:

TRENDS IN PREVALENCE (EVER USED), 197246

 

 

 

(percentage)
Age/Sex 1972 1974 1975—76

All Youths: age 12-17

Male 6 0

Female 7 9
All Adults: age 18+

Male 9 14

Female 5 9
Source: Abelson and Fishburne (1976).

and Sims 1971; Fejer and Smart 1973; Levine
1969: Manheimer et al. 1968; Mellinger et al.
1971; Parry et al. 1973; Swanson et a1. 1973).
For example. a recent household survey of
the U.S. population (figure 1) shows that
psychotherapeutic drug use is significantly
greater among females than males.

Table 2 depicts the percentage of nonmedical
use by females and males of over-the-counter
and prescription medications. Among youth,
differences in male/female use of the various
types of drugs are not statistically significant.
Among adults, male prevalence is significantly
higher for "any psychotherapeutic," with
highest prevalence in the 18-25 age group.

In terms of recent nonmedical psychotherapeu-
tic drug use, table 3 indicates no statistically
significant male/female differences in use dur-
ing the "past month" or "past year, not past

month."

Trends in the percentages of males and
females who have ever used psycho-therapeu-
tic drugs are shown in table 4. There is little
change shown in use by youth during 1972 to
1975-76; female use is slightly higher during
all 3 years. Male and female use by adults
was equal (10 percent) in 1972, but in 1975-76
female use was lower than male use (9 versus
14 percent).

These data probably disguise the comparative
frequency with which females and males exper-
ience drug problems with pscho-therapeutic
drugs because medical use is excluded. Table
5 depicts contacts with emergency rooms due
to drug problems in 24 large Standard Metro-
politan Statistical Areas (SMSAs) during the
time period covered by the national household
surveys cited. Considerably more contacts
were made by females than males for psycho-
therapeutic drug problems. It is also inter-
esting to note that nearly twice as many
female contacts with these emergency rooms
were diagnosed as drug overdose problems
compared to male contacts.

Table 5

(DNI‘ACTS WITH EMERGENCY ROOMS DUE TO DRUG PROBLEi‘vB
24 LARGE SABAS, APRIL 1974-APRIL 1975
(numbers in thousands)

 

 

 

Female
Drug Problem Male Female Difference

Heroin/Morphine 15.2 6.6 -8.6
bbthadone 2.9 1.3 -1.6
Cocaine 1.1 0.5 -0.6
Barbiturates 8.3 11.4 +3.1
Amphetamines 0.4 2.2 +1.8
Tranquilizers 19.3 41.9 +22.6
Hallucinogens 3.6 1.5 -2.1
Inhalants, Solvents, Aerosols 0.9 0.4 -0.5
Alcohol 12.8 14.3 +1.5
Nonbarbiturate Sedatives 7.8 14.9 +7.1
Nonnarcotic Analgesics 6.4 18.2 +11.8
Cannabis 3.2 1.7 —1.5
Others 12.6 21.2 +8.6
Total 94 S 136 1 +41.6
Overdose* 47.2 87.7 +40.5

 

 

 

 

*Accounts for 134,902 of 186,608 total contacts.

Source: DAWN 111, April l974-April 1975.

 

 

 

2. Characteristics of Male and Female
Drug Abusers as Reflected by
Data Systems

Characteristics of male and female drug
abusers will be addressed in two parts: treat-
ment populations as reflected by existing data
systems and drug abusers in both treatment
and nontreatment populations as reflected in
the literature.

The large and small data systems that were
used in preparing this report are described
below:

Large-Scale Data Systems

The Client Oriented Data Acquisition Process
(CODAP) was instituted (in a revised form)
in May 1973 as the single reporting system
required of all participating Federal agencies.

The CODAP "Admission Report" is a reporting
form filled out on each client upon entrance
to a treatment program. It provides admission
status, client characteristics, drug problems,
and prior treatment data. The "Discharge
Report“ is completed for every client leaving
treat-ment. It provides discharge status,
client characteristics, drug use, and time in
treatment data. Currently. approximately
1,600 clinics report almost 40,000 client admis-
sions and discharges each month.

These data provide a potentially rich source
of information on client char-acteristics and
clients' problems and status at the time they
enter and leave treatment.

A quite different type of large-scale data sys-
tem is the Drug Abuse Warning Network
(DAWN) sponsored by NIDA and the Drug
Enforcement Administration. The DAWN sys-
tem collects only abuse episodes that have
resulted in a crisis. The person involved
has sought help (or died) and has subse-
quently been reported by one of the three
facility types: emergency rooms of non—
Federal, short-term general hospitals; crisis

centers: and medical examiners or coroners
in 24 SMSAs (Standard Metropolitan Statisti-
cal Areas). In Zl of the SMSAs. reporting
is from all hospitals. Hospitals are sampled
in the three largest SMSAs.

The Polydrug Data Set consists of data col-

lected from programs that were designed to
uncover what was felt to be a hidden popula-
tion of polydrug abusers. Thirteen polydrug
projects were initiated in 1973 offering serv-
ices that were not readily available at the
time. These pilot projects, operating between
April 1973 and March 1975, collected data on
more than 2,000 patients who had abused a
variety of psychoactive drugs. Cross-tabula-
tions of these data were obtained from the
Polydrug Research Center, in Philadelphia,
Pennsylvania.

The Drug Abuse Reporting Program (DARP).
operated by Texas Christian University's
Institute of Behavioral Research, collected
data on clients admitted to treatment (via
"Admission Reports") from June 1969 through
March 1973 on 38,433 patients who entered
treatment at 52 agencies located in the United
States and Puerto Rico. "Status Evaluation
Reports," covering treatment received and
outcome data, were completed for each client
up to March 31, 1974.

 

Small-Scale Data Sets

The data sets used were from the Addiction
Services Agency (ASA) in New York City;
t e Narcotics Treatment Administration (NTA)
in Washington, D.C.; the We ne Count De-
partment of Substance Abuse Services and
the National Women's Drug Research Coordi—
natin Pro'ect, Detroit, Michigan; and the
University oi Miami (two intake and treatment
process surveys of clients entering treatment

programs in Dade County, Florida; and a hos—
pital emergency room survey (HERS) which

 

 

TaMe6

LARGE AND SMALL DATA SYSTEMS CONSIDERED

 

 

Percent
Data Systems Years Male Female Total Female

CODAP§ 1974 62,172 21,935 84,107 26
CDDAP3 1975 167,237 57,727 224,964 26
CDDAP 1976 91,728 31,881 123,609 26
DAWN (Emergency Rooms) 1974-75 75,597 108,812 184,403 59
DAWN (Crisis Centers) 1974-75 39,517 27,797 67,314 41
DAWN (Medical Examiners) 1974—75 5,532 2,991 8,523 35
DARP 1969-71 14,648 3,718 18,366 20
Polydrug 1974—75 698 426 1,134 38
Narcotics Treatment Administration

(NTA) 1970—74 156 33 189 17
Addiction Services Agency (ASA) 1970-74 291 83 374 22
Wayne County 1975—76 3,812 1,968 5,730 34
National Women's Drug Research

Coordinating Project (NWDRCP) 1975-76 —— 163 163 100
New Haven 4 1970-74 401 99 500 20
University of Miami (A)4 1974-75 983 302 1,285 24
University of Miami (B) 1975 6,547 2,742 9,289 30
Hospital Emergency Room Survey 1975-76 395 441 836 53

 

1

2Entry data only are considered in

Entry data only for the first three quarters are

this study.

considered in this study.

3Entry data only for the first two quarters are considered in this study.

4The N's in both of these studies are samples of the entire data set. Further, (A) is a subset of (B).

gathered data from hospital emergency rooms
in Miami and Denver).

Analysis of the Data

The analysis will focus upon the percentage
distributions of occurrences for males and

females for each variable examined. There
is concern not only with the distributions for
females and males, but more importantly with
differences between the two groups.

The first step in determining whether differ-
ences between the two groups deserve discus-
sion is to determine whether the differences
are statistically significant. The largest
national data sets (CODAP, DAWN, DARP)
have such a large number of observations
(n's) that statistical tests of significance will
not be required. However, some of the local
data sets (notably NTA, ASA, and New Haven)
have sufficiently small n's that statistical test-
ing is required.‘ '

Table 6 gives the total number of n's in the
large and small data systems considered, the
number of males and females, and the percent
female.

The second step in discussing differences
between drug-abusing men and women is to
discuss the comparative distributions and
(where multiyear data are available) trends.

Finally, differences in distributions are dis-
cussed in terms of percentage differences for
males and females.

It should be noted again that the numbers of
men and women included in each data set are
often substantially different.

It must be emphasized that this section does
not address prevalence, but rather distribu—
tion of certain characteristics among female
compared to male drug-abusing populations
as contained in each of the data sets analyzed.

A common table format is used to depict data
for each variable discussed across all data

systems examined. This is done to display

inconsistencies and gaps in the data and to
avoid the distracting effects of a series of

collapsing and expanding tables.

Age

National Data Systems. Table 7 indicates that
a consistent pattern of age differences between

males and females appears to exist in the data
systems surveyed.

10

The presence of this pattern is best noted if
the age categories are condensed in the man-
ner shown in table 8. There, a larger per—
centage is seen to exist across each CODAP
year, two DAWN facilities,” and the DARP
System, of more: (1) females than males in
the under 21 years of age category; (2) males
than females in the 21 to 30 years of age cate-
gory; and (3) males than females in the 31
years of age and over category.

An aberration in this pattern is seen among
clients over 30 in the DAWN emergency room
and crisis center facilities. There, the gen-
eral pattern noted above is reversed and the
percentage of males is slightly less than that
for females (27 versus 35 percent and 12 ver-
sus 17 percent, respectively). Data pre-
sented in table 9 indicate the percentage, by
sex and drug, of the total contacts of emer-
gency rooms and crisis centers by clients
under 31 years of age and 31 years of age
and over. These data are presented in order
that the specific drugs which may have influ-
enced the aberration of the male/ female con-
tact pattern might be identified. Inspection
of these data suggest that it is a greater use
of barbiturates, amphetamines, and to a larger
extent, tranquilizers, nonbarbiturate seda-
tives, and nonnarcotic analgesics (i.e., all
legal and often medically prescribed drugs)
which brings women over 30 into emergency
rooms and crisis centers at a greater rate
than males.

The percentage of males and females under
the age of 21 in federally funded treatment
programs declined from 1974 to 1976 (see table
8), but there is still a greater percentage of
females in the "under 21" age group. This
is a consistent pattern in the CODAP data
for all 3 years considered. During this same
period, there were slight increases in the
percentage of both males and females who
were over the age of 30.

In the DAWN medical examiner facilities (see
table 7), a striking difference exists between
males and females whose deaths are drug re—
lated in some manner. Female deaths are
more than twice as likely to occur in the 36
or older age category than are male; and male
deaths are more likely to occur between 21

and 30 years of age.

Local Data S stems. Four of the local sys-
tems surveyed lASA, Wayne County, New
Haven, and Miami [A]) follow the pattern of
a higher proportion of females in the under
21 years of age category and a higher propor-
tion of males over 30 years of age. These
differences, however, as indicated in tables
7 and 8, are generally negligible and neither

II

 

Table 7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AGE, BY SEX
(percentage)
NATIONAL DATA SYSTEMS IDCAL DATA SYST'BB
.. UNIV. 5 7 HOSP.
DAhN DAWN DAWN DARP POLY:6 OF 4 WA ASA WAYNE NWDRCP ; :.;‘.' BERG.
CATEGDRY OJDAP (DDAP CODAP (IEMERG . (CRISIS (MED. DRUG‘ MIAMI (I). 6 HAVEN m
19741 1975 19762 ROOM) CENTER) EXAM) (A) SURVEY
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
Under 18 10 20 10 19 8 14 12 14 17 21 2 3 7 11 4 4 5 10 £ 5 11 6
18-20 14 18 13 15 11 13 15 13 20 19 9 7 18 21 19 20 6 .3 15 28 8 11 28 33
21-25 35 32 33 33 3O 34 28 21 32 29 31 17 34 33 i6 46 47 55 36 47 28 29 33 36 39
26-30 21 17 23 18 27 21 18 16 18 14 22 14 17 16 21 21 24 30 27 11 29 25 44 13 13
31-36 10 7 10 7 12 9 11 13 7 8 13 12 23 19 7 9 10 12 10 4 18 15 {16 6 S
Over36 10 6 11 7 12 8 16 23 6 9 23 48 6 4 13 8 7 12 10 6
H H H H H x— H H H
““1 8§§§§8§§§§§§38 88888388 888
H H H
9, 2 2 s 2 e a e as 2 m N A u y r
- -. a v v v v " " ‘ " ' " ' ‘ {o (,1 1—- N 00 ‘0 H A
“‘ E§§§§§§EE§§§EE saga ace 38$
1

First three quarters only.
2First two quarters only.
3Polydrug data not available.

4The age categories in this study were: Under 20, 20-25, 26-30, 31-35, Over 35.
5Clients under 18 were not included in this study.

6The age categories in this study were: Under 18, 18-21, 22-25, 26-29, 30-36, Over 36.

7Data were not collected on males in this study.

Note: Totals may not add to exactly 100 due to rounding.

 

 

 

21

Table 8

AGE, BY SEX (COVDENSED)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(percentage)
NATIONAL DATA SYSTEMS LOCAL DATA SYSTH‘IS
HOSP.
UNIV. NEW BERG.
DAWN DAWN DATE-J DARP POLY' OF 1 MFA ASA WAYNE NWDRCP HAVEN m-I
CATEGORY CDDAP (DDAP CODA;7 (EMERG. (CRISIS (MED. DRUG MIAMI" (I). SURVEY
19741 1975 1976‘ ROOM) CENTER) EXA‘f) (A)
H F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
Under 21 24 38 22 34 18 28 27 27 38 40 11 9 25 32 19 20 6 3 19 31 14 21 39 39
21-30 57 49 56 51 58 56 46 38 50 43 $3 31 52 49 67 67 71 85 63 58 57 54 49 53
Over 30 20 14 22 15 25 17 27 35 12 17 36 60 23 19 14 13 23 12 18 11 29 25 12 8
Total 55535535555355 55355355 55
|-‘ H O O I—l 0—1 O O O O C) O O O O C) O O O O O O O O
n—a H
n= 5 F g :3 58 y: a 3 5 5 m N 5 o. 9. 5
58555355255352: 35535333 53
N U1 \1 \l W H \l N \l \l N H on W O \l 6‘ L14 0-4 LN N 00 H ‘0
1First three quarters only.
2First two quarters only.
3’I’he age categories for this analysis were: Under 20 20-30 Over 30.

4

Cl-ients under 18 years of age were not included in the sample.

Note:

Totals my not add to exactly 100 due to rounding.

 

SI

lele 9

AGE, BY SEX AND BY TYPE OF DRUG

USED IN CONTACTS WITH DAWN EMERGEMIY Rm AND CRISIS CRITERS

(percentage)

 

DRUG CATEGORYl

 

 

 

 

 

 

 

AGE CATEGORY HEROIN/ BARBI- AMPHETA- TRANQUIL- HALLUCI- NONBARB. NONNARC.
mRPHINE ME'IHAIDNE COCAINE 'IURATES MINES IZERS NmENS IM-IAIANTS ALCOl-DL SEDATIVES ANALGESICS CANNABIS OTHER
M F M F M F M F M F M F M F M F M F M F M F M F M F
Eneggencz Rooms
g 30 21 8 39 1 14 1 10 10 4 3 22 33 6 2 15 -- 15 11 10 12 8 18 S 2 16 21
> 30 17 3 3 1 1 -- 12 11 2 1 33 48 1 -- -- -- 22 17 12 17 9 13 1 -- 16 17
>—- H H a v-d H 1—- H r—I N
U“ 5" I" J" I" .°° i“ i" 1" 1" I" f" 3" .N 3‘ 7’ 3‘ 5" 3° 5" J" .N J“
Tota1n= .3 gz’ “gasses 5:33 a; 2: a: $3 a a: use:
\I 'VJ b (1) (.rl ‘v—i (D N 43 LN \l 0" (II tn 04 H \l U) m 0‘ O m 0 (7‘ N 5
Crisis Centers
5 30 24 19 2 1 4 3 13 14 9 12 8 13 16 12 3 -- 10 9 7 9 3 4 19 19 9 10
> 30 35 11 2 1 4 Z 10 13 7 13 15 3 10 2 -- ~ 10 11 6 10 3 6 9 5 13 15
t: o H m a 4:- 3:- b ‘41 ON (A «b N z.» (A H ._. \l m .n L»
L ”N c» A To to 'o "N L. L- I:- L- 'oo L to - 1» 'oo 'o “o "m ”o In “m L In
0:! N C» H N {3 O A N 5 r—‘ 03 U1 O N LD 3‘ N U1 LO 0‘ N k0 H J} LN
Total n= H Lo LA 0 L» w \l u u: co on o \l L0 L11 \3 N o on \I ,_. u «o o \1 Lo

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1Total percentages are greater than 100 because DAWN collects multiple abuse data.

 

 

 

the New Haven nor the Miami (A) differences
are statistically significant.3

The two remaining systems--NTA and the
National Women's Project--do not reflect this
pattern. However, it cannot be determined
whether the NTA differences are statistically
significant.4 The National Women's Project
data indicate that nearly 80 percent of the
female clients fall into the 20- to 30-year-old
category, while only 5 percent of the female
clients are under 21. These data, also, do
not fit the pattern of the other systems.
Since male comparison data are not available
for this data system, it is difficult to ascer-
tain whether these data are true reversals of
the pattern or artifacts of the particular 'treat-
ment systems included in the survey.

Race/Ethnicity

National Data Systems. Each of the national

drug treatment data systems gathered informa-
tion on the race/ethnicity of their clients.
These data, summarized in table 10, suggest
several systematic male/female differences on
this variable.

First, when black and white clients only are
considered by sex, the percentage of white
male clients is seen to be greater than the
percentage of black male clients across all
national programs with the exception of the
DARP. Similarly, the percentage of white
female clients is greater across all programs
with the exception of the DARP.

In addition, a consistent pattern of differ-
ences is found not only within racial groups
by sexes but also between male and female
clients. This pattern lies in the magnitude
of the differences found in the percentage of
black vs. white male and female clients in
the CODAP and DAWN systems. In each
CODAP year and component of the DAWN re-
porting system the discrepancy between the
percentage of balck and white female clients
is considerably greater than that between
black and white male clients. Thus, for
example, the 1976 CODAP data show a differ-
ence of 26 percent between black and white
female clients (32 vs. 58 percent) but only 11
percent between black and white male clients
(37 vs. 48 percent). Whether this pattern
is a reflection of actual drug use rates for
these groups or evidence of underrepresenta-
tion of black female clients in treatment is a
question for future research.

Second, utilization of the various service
delivery modalities represented by these data
systems show differing patterns where sex
and race are concerned. CODAP data (1974-—
76) indicate that the largest client groups

are (in descending order) white males, black
males, white females, and black females.
DARP does not follow CODAP patterns and
the order is black males, white males, black
females, Puerto Rican males, and white fe-
males. In the DAWN system, the order for
emergency rooms is white females, white
males, black females, and black males; the
order for crisis centers is white males, white
females, black males, and black females.
Finally, female clients were less likely than
males to be either Puerto Rican or Mexican
American.“

Local Data Systems. The data obtained from
the local systems were analyzed and no sig-
nificant sex by race differences were found
within any one system.“

Females are more likely than males to utilize
a hospital emergency room; the percentage of
black male clientsis generally greater than
the percentage of black female clients; and
the percentage of white male clients is gener-
ally smaller than the percentage of white
female clients.

Marital Status 7

National Data S stems. The Polydrug Project
(see table' 115 collected data regarding the
marital status of its clients. The results
show that females are more likely to be mar-
ried than males (22 vs. 15 percent). Females
also were more likely than males to be wid-
owed, separated, or divorced.

Local Data Systems. The differences be-

tween males and females are not statistically
significant for NTA, ASA, New Haven, or
HERS. The University of Miami and Wayne
County data show a considerably higher pro-
portion of females than males as widowed,
separated, or divorced. The National Wom-
en's Project, although not making male/female
comparisons, reported the highest percentage
of separated females (22 percent) of the local
data systems surveyed.

Educational Status

National Data Systems. Educational status

data were collected on a national basis in the
CODAP (1975 and 1976), DARP, and Polydrug
Project systems. Table 12 reveals no clear
pattern of differences in educational status
between male and female clients in these sys-
tems. There is some indication, however,
that male clients are more likely to have com-
pleted 12 or more grades than female clients,
but these differences are not large (Polydrug
Project: 57 vs. 54 percent; CODAP 1975: 48
vs. 42 percent; CODAP 1976: 49 vs. 44
percent).' The DARP system, although not

14

91

Table 10

ACE/ETHNICITY, BY SEX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(percentage)
NATIONAL MIA SYSTEMS LOCAL DATA SYSTEMS
DAWN DAWN DAWN POLY - UNIV . WAYNE NEW HOSP .
CATEGORY COMP1 CODAP CODAPZ (EMERG. (CRISIS (MED. DARP DRUG OF NTA ASA c0. NWDRCP HAVEN EMERG.
, 1974 1975 1976 R(I)M) CENTER) EXAM) MIAMI Row
(A) SURVEY
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
Black 40 34 37 32 37 32 27 23 17 13 32 22 51 52 11 11 51 52 90 82 51 46 73 60 59 53 46 66 57
White 49 59 50 59 48 58 70 74 79 85 62 76 30 35 86 85 41 40 43 49 27 4O 33 44 53 15 20
Puerto Rican3 4 2 5 2 s 2 12 8 7 7 12 3 6 6
Mexican American 7 4 7 S 8 6 6 4 11 15
American Indian 1 1 1 2 2
Asian American
Other 1 1 1 1 3 3 4 2 6 2 1 1 3 4 1 1 10 18 6 S 1 1 1
Total ’5 8 S S ’5‘ S S ’5 S ’5 8 S ’5 S 8 S S S ’5 ’5 S S ’5 ’5 S S S ’3 S
O O O O O O O D O D O D O O O D O O O O O O O O O o O O—‘ H
r—I
0" N 0‘ U1 {0 bl Ch 0 b N H
n= 4: N o \l u—d v-a \l o u—I on tn N a m N H
1-1 wk 1" :1 ‘01 '00 “\O ”O ‘0‘ :4 ‘Ln ID ‘0‘ "\l 0‘ A to N H N 7—! :4 r—I (A (N 5
H C” O N H \l O‘ LN 0‘ O C) O" b D-l ‘0 N W 50 U1 LA LC 03 O H 0‘ Q {0 £0 3
\l LN # \l b \I on 4) CD H \I co co m (D 0‘ O \l 0 DJ H W N O N \l CD 5) H
1First three quarters only.
2First two quarters only.
3This category includes Cuban, as well as Puerto Rican, clients in both the

University of Miami data and the Hospital Energency Room Survey.

 

Table 11

MARITAL STATUS, BY SEX

 

 

 

 

91

 

 

 

(percentage)
NATIONAL DATA SYSTEMS IDCAL DATA SYSTEViS
DAWN DAWN DAWN POLY — UNIV . WAYNE NEW PDSP .

CODAP CODAP CDDAP (BERG . (CRISIS (MED . DARP DRUG 0F NTA ASA C0 . M\'DRCP HAVEN BERG .

CATEGORY 1974 197 S 1976 R004) CBVITER) EXAM) MIAMI ROOM
(A) ; SURVEY
M F M F M F M F M F M F M F M F M F i M F M F M F M F M F M F
Married 15 22 25 23 29 30 17 8 32 27 15 18 12 22 26
Single 67 52 56 45 71 70 67 69 51 39 53 68 67 44 37
Widowed 1 3 1 3 1 4 1 5 2 3
Separated 9 11 9 16 11 21 10 20 30 9 15 9 13
Divorced 8 13 9 13 4 2 6 10 9 4 1 23 21
._. v—I r—J r—I r—I v-I b—l r—I p—I r—I v—I ._. H
Total 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8

LR >—-

n= Ox 4} RD N r—I N “o “N H w w a
‘O N 00 ‘0 U1 bl LO W O‘ U" G O on O A
O‘ J> O \l 0‘ (A O LN U1 W O 0‘ K9 U1 H

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Note: Totals may not add to 100 due to rounding.

 

[.1

Table 12

EDUCATIOIAL STATUS, BY SEX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(percentage)
NATIONAL DATA SYSTEMS IDCAL DATA SYSIBB
1 DAWN DAWN DAWN POLY— UNIV. WAYNE 3 NEW FDSP.
CATEGORY CODAP CODAP CODAP (BERG . (CRISIS (MED . DARP DRUG OF NTA ASA C0 . NWDWP HAVEN FMERG .
1974 1975 1976 ROOM) CENTER) EXAM) MIAMI Road
(A) SURVEY
M F M F M F M F M F M F M F M F M F M F M F M M F M F M F
Hi hest Grade
leetai
Under9 12 13 12 12 10 10 7 10 6 9 1 4 21 22
9 10 12 10 11 [34 [36 8 11 6 6 13 11 12
10 15 16 14 16 17 16 26 21 18 21 16 9 16
11 16 17 15 17 20 2 23 21 26 35 24 13 17
12 34 30 35 32 30 30 31 27 33 42 25 19 27 29 29
Over 12 14 12 15 12 26 24 17 12 6 9 9 13 17 28 16
ha p—A H >4 r-‘ t—I r—I b—I H r—I r—d r—I ,_ |—‘
Total 8888 88888888 8 88
E“- U1 ‘0 0|
at \l O b—l
n: '\l ‘C ‘W ”\J 5‘ 3“ k0 M D—‘ N b-i LN b
\J on O N KS N m O U1 LN C W O\ u: 'vl
£- 0 H H 00 O LN N U1 04 O LN O '44 on
W 1
In School 10 4 i
Not in School 90 96
Total g g
LN
Ln m
a o
n:
. 2
Educatlon Level
Low. 10 10
mdnm 87 88
High 3 2
H v—-
Total 8 8
03 N
”o 'o
\l U1
n: on N
2 3Couecced daéa from female clients only.

1First two quarters only.
Note: Totals may not add to exactly 100 due to rounding.

The categories used here are

adapted from Sells (1974).

 

collecting data on a "highest grade completed"
basis, nevertheless provides data which also
indicate essentially little male/female client
educational status difference.

Local Data Systems. As indicated in table

12, the local data systems also show no con-
sistent pattern of male/female client educa-
tional status differences. However, compar-
ability is not possible between all of those
systems which collected data on this variable.

New Haven did not use a "highest grade com-
pleted" category and the National Women's
Project did not collect comparative male data.
In the other local systems, none of the male/
female differences is statistically significant,
with the exception of the HERS data.9

Employment Status

National Data Systems. Employment data
were collected for the CODAP (1975-76),

DAWN (three facility types), and DARP sys-
tems. While the percentage of all clients
employed is generally low, females are far
less likely to be employed than males (table
l3).‘° The DAWN data system includes a
housewife category (CODAP did not) and wom-
en who did not report being employed gener-
ally reported being unemployed or being
housewives. Although utilizing different cate-
gories, data collected in the DARP system
appear .to coincide with these findings.

Data collected by the DAWN Medical Examiner
facilities provide an unexpected finding.
Among both males and females suffering drug
related deaths, employment (at the time of
death) was higher than among the groups of
males and females seeking treatment. The
difference in employment between males and
females in this category (68 vs. 31 percent)
is nevertheless considerable.

A second finding of interest in the DAWN
Medical Examiner facility data concerns the
large percentage (48 percent) of females suf-
fering drug related deaths who were house-
wives. Differences in this category between
females in this data system and others is strik-
ing. The percentage of female housewife
clients in the DAWN Emergency Room data
system is 28 compared to l9 in the DAWN
Crisis Center data system and 48 percent in
the DAWN Medical Examiner data system.

Local Data Systems. The local data systems
surveyed reveal percentage differences be-

tween male clients and female clients on
employment status similar to those found in
the national data. However, only the Miami
and New Haven differences are statistically
significant."

18

The National Women's Project, although lack-
ing comparative male data, follows the other
data systems in reporting high (94 percent)
female unemployment. This is the highest
unemployment rate of all the data sources.

Primary Source of Support

National Data Systems. The Polydrug Project

was the only national data system to collect
information regarding the primary source of
support of its clients. Those data (see table
14) show that females are less likely than
males to have a job as a primary source of
support (23 vs. 30 percent), more likely to
receive welfare (27 vs. 23 percent), more
likely to be dependent upon others (42 vs.
30 percent), and less likely to be dependent
on illegal activities as their primary source
of support (4 vs. 11 percent).

Local Data Systems. Four local data sys~
tems--NTA, ASA, Wayne County, and the

National Women's Project--collected information
regarding the primary source of support of
their clients. The NTA and ASA data report
multiple sources of support, while the Wayne
County and NWDRCP report only the primary
source of support. In those systems where
male/female comparisons were made, there
were moderate differences reported. In the
Wayne County system, females are more likely
than males to be receiving welfare assistance.
The other local data systems either did not
report or did not collect this data on males.
NTA, Wayne County, and ASA do report,
however, that females are far more likely to
be dependent on others than are males.
Males are more likely to be dependent on
illegal activities than females. Additionally,
as primary sources of support, however, it
should be noted that significant percentages
of males and females are involved in illegal
activities (see table 14).

Arrests

National Data Systems. As table 15 indicates,

the only national drug abuse data system sur-
veyed which obtained information specifically
concerning arrest history‘,2 was the Polydrug
Project. The proportion of females arrested
(27 percent) is significantly less than males
(57 per-cent).

Local Data Systems. The Local systems sur-

veyed indicate differences between male and
female arrest patterns, although they are
generally not so strong as those suggested
by the Polydrug data. The differences for
NTA and ASA are not significant; the Miami
(A) and HERS data do indicate significant
differences.13 The Wayne County data, which
constitute too large a sample for statistical

61

Table 13

EMPLOYMENT STATUS, BY SEX

 

 

 

 

 

 

 

 

 

 

 

(percentage)
NATIONAL DATA SYSTEMS IDCAL DATA SYSTEMS
1 DAWN DAWN DAWN POLY - UNIV . WAYNE 2 NEW HOSP .
CATEGORY CODAP CODAP CODAP ( EMERG . (CR1 SIS (MED . DARP DRUG OF NTA ASA C0 . NWDRCP HAVEN FMERG .
1974 1975 1976 ROOM) CBW’ER) EXAM) MIAMI ROOM
(A) SURVEY
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
Employed 25 17 26 16 32 21 32 23 68 31 29 16 32 19 21 20 6 20 11
Unemployed 75 83 74 84 46 32 43 29 17 ll 71 84 68 81 79 80 94 78 88
Student 18 18 24 28 10 6
Job Training 2
Housewife 28 19 47 1
Retired 2 1 4 4
Other 2 l 1 l 1
a s s s s o s o g e a s s s g a s g g
Total C o o o o H o o o 6 o o o o o o o c: o
1-1
0‘ U1 '~O LN 45> \1 LA N
O \l H H on # N N (A N
1—: ”a "N l: 7- In ”N L» 3—- L- 10 w .—- N >—- m
n= 00 0‘ ID 00 O l0 lo 0‘ b \l 00 O U1 Lrl m 00 Ln U1 CD
00 \I LO C!) O O \l U) N O I)! 0 U1 N m D m to h
gmglovment Record3
Poor 48 66
Average 42 30
Good 10 4
H 8
Total 8 o
on N
n= '3 '3
on N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1First two quarters only.

2Collected data from female clients only.

Note: Totals may not add to exactly 100 due to rounding.

3These categories are adapted from Sells (1974).

 

Table I4

PRIMARY SGJRCE OF SUPPORT, BY SEX

 

 

 

 

OZ

 

 

 

(percentage)
NAT I ONAL DATA SYSTEMS LOCAL DATA SYSTEMS
DAWN DAWN DAWN POLY - UNIV . 1 ., WAYNE NEW HOSP .
ATEGORY CODA? CODAP CODAP (EMERG . (CR1 S l S (MED . DARP DRUG OF NTA ASA" C0 . NWDRCP HAVEN EMERG .
1974 1975 1976 ROOM) CENTER) EXAM) MIAMI ROOM
(A) SURVEY
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
Salary/Wages 30 23 33 26 l6 16 46 17 7
Welfare _ 23 27 26 17 40 49
Social Security 1 2
Other Pensions [ 1 [ 2 6
and Benefits 3 1
Dependent on
Others 30 42 28 39 15 24 17 31 19
Illegal
Activities 11 4 55 41 65 48 19
Other 6 4 7 l l 1 6 9
H H r—I ._. r-I H H >—-
[U til 8 8 \1 N 8 8 g 8 g
p—I
U‘l
J> (A N b—l
I |—' h w
n: O‘ 5 H I N \0 Lil H
‘0 N U" LN \l 00 ID on In
H (II U1 N DJ 0 M 00 N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1This data base asked clients to report all sources of
support, not only primary, two months prior to admission.

2 . . .
Several male clients report more than one man source of income.

 

IZ

ARRESTS, BY SEX

Table 15

 

 

 

 

 

 

 

(percentage)
NATIONAL DATA SYSTEMS LOCAL DATA SYSTEMS
DAWN DAWN DAWN POLYi UN IV . 3 3 WAYNE: NEW PDSP .
CATEGORY CODAP CODAP CODAP (EMERG. (CRISIS (MED. DARP DRUG OF 2 NTA ASA CO. NWDRCP HAVEN EMERG.
1974 197 S 197 6 R004) CENTER) EXAM) MIAMI Ra“
(A) SURVEY
M )7 M I- M F M F M F M F M F M F M F M F M F M F M F M F M F
Arrested 57 27 89 72 28 12 29 24 27 21 76 41
Not Arrested 43 73 11 28 72 88 71 76 73 79 24 59
,—a r—I v—a H H r-a O-l r—I H >—- g
Total 8888 88 88 88 86
LA ,_.
U! C (A [A b
“- § 5 § § E m 8 8 a 8 a 8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

l

~Ever.

3During past 2 months.

wring past 2 years.
,

Imx‘ing past year .

 

testing, indicate the same pattern as the
other local data systems concerning arrests--
the percentage of female clients arrested (21)
is less than the percentage of male clients
arrested (27). However, the differences be-
tween males and females in the Wayne County
data are much less than those reported in
the Polydrug Project.

Admission Type

National Data Systems. The CODAP system,
during 1975 and the first 6 months of 1976,

collected information regarding the voluntary
or involuntary admission status of both male
and female clients. The results, given in
table 16 indicate that most client admissions,
regardless of sex, were voluntary.“ Males
had higher per-centages of involuntary admis-
sions than females although the differences
were small for both 1975 (5 vs. 2 percent)
and 1976.

Local Data Systems. The local data systems
surveyed follow a pattern similar to that found

in the CODAP data for admission type. Male
clients were more likely than females to be
involuntary admissions: the difference in

male/female involuntary admissions for the
NTA system was statistically significant and
quite large15 (3l percent of the males vs. 6
percent of the females). Differences in the
two other local systems which gathered data
on this variable were in a similar direction.

Drugs of Abuse

National Data Systems. Comparability among

the national drug treatment systems on this
variable is difficult to achieve. Each sys-
tem--CODAP, DAWN, DARP, and Polydrug--
collected drug use data in a different manner.
CODAP asked its clients about primary and
secondary‘6 drug usage; DAWN asked its cli-
ents what drugs they were using at the time
of contact and recorded the first three men-
tioned; Polydrug asked its clients what drugs
they were currently using and recorded all
of them; and DARP asked its clients what
drugs they were using during the 2 months
prior to treatment and recorded all of those
mentioned. Nevertheless, several systematic
similarities may be seen in these data, as
shown in tables l7, l8, and 19.

First, the percentage of males using herior
exceeds the percentage of female heroin users
in each CODAP year as well as each data sys-
tem, although the CODAP system data present
evidence which suggests that this difference
may he becoming attenuated. Table 18 sug-
gests that while the percentage of both males
and females listing heroin as their primary
drug of abuse increased between 1974 and

1976, the rise was notably steeper for females.
Whereas the percentage of male clients in-
creased by 3 percent (from 60 to 63 percent)
during these years, females increased by 8
percent (from 50 to 58 percent), suggesting
that heroin as a primary drug of abuse may
be rising more quickly for females than for
males in the CODAP population.

Second, the percentage of female clients abus-
ing psychotropic drugs (i.e., barbiturates.
other sedatives, amphetamines) and tranquil-
izers is greater than the percentage of male
clients abusing these drugs. It is difficult
to discuss this class of drugs as a group be-
cause both the DAWN and DARP systems col-
lect multiple abuse data, making it impossible
to be specific regarding what percentage of
the population under consideration is using a
particular drug. For example, table 17 indi-
cates that ll percent of the male DAWN Emer-
gency Room clients were using barbiturates
at the time of contact and 25 percent were
using tranquilizers. It is not possible, how-
ever, to say on this basis that 36 percent of
the male clients are using barbiturates or
tranquilizers since there is no way of know-
ing the percentage of overlap; that is, what
percentage of the barbiturate users are also
tranquilizer users.

With this caution in mind, and with the knowl-
edge that, at least for the DAWN clients,
multiple drug use for males and females was
essentially equal, table 20 presents the total
percentages of psychotropic drugs used by
males and females in each data system. The
data in this table indicate that female clients
are more likely than male clients to consider
psychotropics their primary or secondary
drug of abuse (CODAP), to have used one
or more psychotropics during the 2 months
prior to treatment (DARP), and to have used
one or more psychotropics at the time of emer-
gency room or crisis center contact (DAWN).
As indicated previously, the prevalence of
nonmedical use of psychotropics is higher for
males than females, while the prevalence of
medical use is higher for females. The DAWN
data (table 17) show more females than males
contacting hospital emergency rooms and cri-
sis centers. This could suggest that females
are experiencing problems with use of pre-
scribed psychotropics taken for medical rea-
sons.

Finally, tables 17, 18, and 19 indicate that
male clients may be more likely than female
clients to abuse methadone, alcohol, cocaine,
or inhalants, whereas female clients may be
more likely than men to abuse over-the-
counter drugs and drugs not included in cate-
gories presented in these tables.

22

 

E2

Table 16

ADMISSION TYPE, BY SEX

 

 

 

 

 

 

 

(percentage)
NATIONAL DATA SYSTHVS IOCAL DATA SYSTE‘IS
DAWN DAWN DAWN POLY— UNIV . WAYNE NEW HOSP .
CATEGORY CODAP CODAP CODAP (I-MERG . (CR1 5 I S (. MED . DARP DRUG OF NTA ASA CO . NWDRCP HAVEN FMERG .
1974 1975 1976 ROOM) CENTER) EXAM) MIAMI ROOM
(A) fifiuEY
M F M F M F M F M F M F M I- M F M F M F M F M F M F M F M F
Voluntary 95 98 81 88 69 94 80 88 92 97
Involuntary 5 2 19 12 31 6 20 12 8 3
E S S S S S '5 E ’S E
Total 3 O O O c> o o o o c
y—I
W U1 05 LN
o 3—» .\' :4 3. .H
_ LN A to u b—I N o 3»
n- 3 a a a a a a: 3 a 2:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Table 17
USE OF SPECIFIC DRUGS, BY SEX1

 

 

 

 

I72

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(percentage)
NATIONAL DATA SYSTEMS LOCAL DATA sysrms
DAWN DAWN DAWN POLY- UNIV. WAYNE NEW 1135?.
CATEGORY CODAP CODAP CODAP (B/l‘ERG. (CRISIS (MED. DARP DRUG OF NrA ASA co. NWDRCP HAVEN mam.
1974 1975 1976 R0011) CENTER) EXAM) MIAMI RCXM
(A)2 SURVEY
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
None
Heroin 20 6 24 16 83 80 21 13 81 80 9s 97 83 73 64 75
Illegal Methadone 4 1 2 1 163 213 36 30 19 12
Other Opiates 17 16 21 23 25 20
Alcohol 17 13 9 9 51 43 9 6
Barbiturates 11 1o 12 13 21 27 53 58 43 45 17 12 25 32 15 20
Other Sedatives 10 13 8 10 51 S6
Amphetamines 3 2 9 13 13 16 41 46 34 36 26 21 14 11 14 17
Cocaine 1 0 4 3 34 32 26 17 57 50 59 52 41 34 22 24
Marilmna 4 1 16 16 43 38 73 55 97 81 72 73 57 43 44 37
Pallucinogens 5 1 15 10 10 10 32 25 39 31 12 9 11 13 11 13
Inhalants 1 o 2 1 5 2 7 2
Over the Counter 2 5 1 1
Other Drugs 16 19 11 12 3 3 10 11 6 6 11 3
Tranquilizers 25 33 10 16
1—4 N N ‘14 N «b A LN bl N N H H
Tomi u I; R '5 2 :3 t: 32 S E 8 8 S E 9: $
H
\I H A LN H (N
n: 5" P F .N 3‘ f” O \’
O O Uh M J) *—‘ RD N \l C) m Cal '0 on (A 0*)
Ln LA N b 00 00 00 Ch 0‘ H O LN H N g U1
1Column totals greater than 100 percent due to multiple drug use. 21116 categories concern drugs "ever used."

334ethadone was not classified as legal or illegal in this data base.

 

Table 18
PRIMARY DRIKS OF ABUSE, BY SEX

 

 

 

 

SZ

 

 

 

(percentage)
NATICNAL DATA SYSTEMS wCAL DATA srsrms

DAMN DAWN DAWN POLY- UNIV. WAYNE NEW 1059.
CATEGORY 619% 0113? 0109112132 (133:. fig? 31% HARP mus £31 N'rA ASA 00. anmp HAVEN $43136.
(A) SJRVEY
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
None 1 1 3 4 2 3 19 3a
Heroin so so $8 51 63 58 51 48 87 77 7o 12 7
Illegal Methadone 1 1 1 1 1 1 23 23 101 21 11

Other Opiates Z 2 2 Z 2 2 3 [1 [1
Alcohol 5 o 8 6 8 s 2 2 1 1 12 9
Barbiturates s 8 4 6 4 6 7 1o ' 1o 6

[s [12
Other Sedatives 1 4 2 5 2 4 2 14 18
Amphetamines 4 s 4 s 4 6 1 2 1 2 5 3
Cocaine 1 1 1 1 1 1 4 2 1 2 2 1
Marihuana 1o 20 14 1s 9 9 26 25 2 2 4 9 4
Hallucimgens 3 3 3 2 2 2 1 1 3 4 4 2
Inhalants 1 1 1 1 1 2 1 1 1
Over the Counter 3 4
Other Drugs 1 3 1 1 1 1 6 7 6

Prevention 1

Total 2252339 §§ 2:5 §§

n= 9 3 § a :2 a 0 N P I“

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1First three matters only.

2First two quarters only.
3Methadone was not classified as legal or illegal in this data base. Note: Totals may not add to 100 due to rounding.

 

92

Table I9
SECONDARY DRUG 0F ABUSE, BY SB

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(percentage)
NATIONAL DATA SYSI'BIIS [AXIAL DATA SYSI'BJS
DAWN DAWN DAWN POLY - UNIV . WAYNE NEW HOSP .
CATHEDRY CODA? (DIM? (DDAP (FMERG. (CRISIS (MED. HARP DRUG 0F NTA CO. NWDRCP HAVEN MG.
1974 1975 1976 m4) CENTER) EXAM) MIAMI mm
(B) SURVEY
M F M F M F M F M F M F M F M F M F M F F M F M F M F M F
None 39 42 48 49 50 50 20 22 52 52
Heroin 3 2 2 2 2 4 3 1 1
Illegal Methadone 4 3 2 2 2 2 12 22
Other Opiates 4 3 3 3 3 3 3 3 [ 7 [ 1
Alcohol 7 8 8 7 7 7 5 5 7 7
Barbiturates 8 10 6 8 6 8 10 13
Other Sedatives 1 2 3 2 4 13 12 [5 [7
Amphetamines 5 6 S 5 4 5 3 4 1 3
Cocaine 10 6 7 S 7 5 13 12 8 6
Lhrihuana 15 13 13 ll 13 11 22 19 17 16
l-hllucinogens 3 4 3 3 3 2 3 2 1 2
Inhalants 1 1
Over the Counter
Other Drugs 1 2 2 2 1 1
Prevention
Total 8 s 5 e e 8 § § é a
E 3 5 3 3 S 9 _~ _~ :-
1Data were not collected for this category for (DDAP in 1974. Note: Totals my not add to 100 due to rounding.

2Methadclne was not classified as legal or illegal in this data base.

 

Local Data 5 stems. The NTA, ASA. New
Haven, an Miami (A) data systems each col-
lected data on the overlap basis noted in
several of the national data systems above.
The clients in these systems were asked what
drug(s) they were using during the 2 months
prior to treatment. The Wayne County and
Miami (B) systems asked their clients to list
their primary and secondary drugs of abuse.
The National Women's Project and HERS col-
lected data on their client's primary drug of
abuse.

The data in tables 17, 18, and 19 reveal mixed
patterns of local use. Heroin use is slightly
higher among males than females However, in
New Haven, significantly more females use
heroin than do males coming into treatment.

 

Viewing psychotropic drug use individually
and as totals (table 20). use is slightly higher
among female clients; however, none of the
differences is statistically significant.”

Number of Drugs Which
Are Used or Cause a Problem

National Data S stems. Differences between
males and females on this variable were neg-

ligible, as indicated in table 21.

Local Data Systems. Only one local data sys-
tem, Wayne County, collected data on this

variable. The male/female difference was, as
with the national data, small (23 vs. 28 per-
cent) although in the direction of more poly-
drug use for females.

27

82

 

 

 

 

 

lele 20
PSYCl-DI'RDPIC DRUG USE— -TUI‘AL PERCEM‘AGESl
NATIONAL DATA SYSTEMS LOCAL DATA SYSTEMS
DAWN DAWN DAWN POLY- UNIV. WAYNE NEW [-0512,
CATEGORY CODA? CODAP OODAP (ENERG. (CRISIS (Mi). DARP DRUG 0F NTA ASA CO. NWDRCP HAVEN BERG.
19741 1975 ‘19763 R004) CW‘ER) EXAM) MIAMI R004
(3) SURVEY
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
Total Percent of PRIMARY PRIMARY PRIMARY PRIMARY PRIMARY PRIMARY
Clients Reporting
Use of Any Psycho- 9 14 11 16 10 17 49 64 39 S4 34 43 94 104 10 16 42 43 40 43 6 10 2 29 37 29 27
tropic Drugs“
(including overlap)
SECCNDARY SECCNDARY SECONDARY SEMDARY SECINDARY
13 16 13 17 12 16 ‘ 26 29 6 14

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1Caution should be used in mterpreting this table; see "Drugs of Abuse" in this chapter.

2First three quarters only.

3First two quarters only.

4Psychotr'copics here include barbiturates, other sedatives, amphetamines, and tranquilizers.

62

Table 21 .
NUMBER OF DRUGS WHICH ARE USED 0R CAUSE MBLEMS, BY SEXl

 

 

 

 

 

(percentage)
NATIONAL DATA SYSTEMS wCAL DATA sysnaus
_ DAWNZ DAWNZ DAWN2 POLY— UNIV. WAYNE NEW l-DSP.
CODAP CODA? CODAP (EMERG. (CRISIS (MED. DAR? mu; op NTA ASA co. NWDRCP HAVEN EMER.
CATEGORY 1974 1975 19762 Room CENTER) EXAM) , MIAMI ROOM
(A) SURVEY
MFMFMFMFMFMFMFMFMFMFMFMFMFMFMF
301‘ less 65 64 99 99 100 100 77 72
Over3 35 36 1 1 23 28
H H p—- H 0- o-I H
T0811 8 8 8 8 8 8 8 8
v—I
a E 3' S 3 S _~
n: 1—- ' ' ' ' L. H a
S g g L8»! g E g g;
Zor less 72 72
Over 2 28 27
>4 n—I
Total 8 8
c.
8 E
n: ‘N ”o
G‘ N
bl h

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1These category divisions are based on those utilized in the respective data collection instruments for each system.

2First two quarters only.

3These data represent the mimber of drugs the client was using at the time s/he contacted the emergency room or crisis center; it is not necessarily
an indication, as are the (DEA? data, of how many drugs currently present a problem for the client.

 

 

3. A Review of the Literature

Characteristics of Male and Female
Drug Abusers as
Reflected in the Literature

Two broad types of studies are addressed in
this section: (1) treatment studies and (2)
nontreatment studies. The numbers refer-
enced in the text refer to the studies listed
in tables 22 and 23. Caution should be exer-
cised in viewing these studies. Inclusion here
does not necessarily indicate a good study
design but rather the presence of a discus-
sion of female or female vs. male drug abuse.

Sex

Treatment Studies. It is not possible, on
the basis of the studies considered here, to
speculate on the percentage of female as op-
posed to male drug abusers in the population.
Few of the samples were drawn with the
intention of collecting a representative (in
terms of sex) group of drug users.

In the majority of those studies in which the
sample was collected either randomly or from
consecutive admissions (10, l7, 19, 20, 2l,
22, 24), the percentage of male clients was
greater than that of female clients, although
study 21 suggests that the male/female gap is
declining over time. An exception to the
general finding, however, is study 22, whose
sample consists of clients treated at a hospi-
tal emergency room for acute drug reactions.
In this case, the percentage of female clients
is greater, a finding not unexpected in light
of similar findings on a national basis in the
DAWN data.

Nontreatment Studies. The data in these
studies also were not collected with the inten-
tion of indicating the relative percentage of
male and female drug abusers in the popula-
tion. The one study (1N) in which data were
collected in such a manner as to offer an
indication of this shows that, at least in the
mid-19605, the percentage of males arrested
for heroin and/or marihuana use in one North-
eastern city was sharply higher than that of
females arrested for the same offenses.

30

A single study, of course, cannot be viewed
as an accurate barometer of the extent of
male vs. female drug abuse in the population.
Seen in the context of the larger data collec-
tion systems described earlier. however, such
an individual finding can serve to further
bolster those more objective results.

Age

Treatment Studies. While the studies being

considered have not attempted to reflect an

accurate representation of the age patterns

of male and female drug abusers in the popu-
lation, they do offer some insight into this

question.

In those studies where the mean age of the
clients is compared for males and females,
little difference exists; where mean age is
given in female only samples the range is
wider, but this appears to be due to the pur-
pose of the particular study, and facility from
which the sample was drawn, rather than a
true indication of the age of female drug
abusers in the population.

The one pattern which appears to exist may
be examined among the female only samples '
which are broken down by age and race cate-
gories (3, 6, l3, 14, 22). In three of these
studies (3, 6. 22) either the mean age or
percentage of white female clients approxi-
mately 30 years of age and over considerably
exceeds that of black female clients. Two of
these studies (3, 22). one covering a hospital
emergency room and the other the NIMH
Center at Lexington, gathered data from con-
secutive admissions. Of the two remaining
studies. the female age by race data differ-
ence was negligible in one (14) and consider-
able in the other (13), although the latter
sample was "matched" with male clients in
the same facility rather than collected ran-
domly.

Nontreatment Studies. Only one nontreatment

study (7N) presents age data relevant to fe-

male drug abuse. This study indicates that,
among a sample drawn from a female prison
population, heroin users were significantly
(p < 0.01) more likely to be younger than
nonheroin users. No other studies examined

in this category gathered age data in terms
of drug abuse.

Race/Ethnicity

Treatment Studies. Among the studies being
considered here which collect race/ethnicity
data, a majority (l, 5, 8, 12, l4, l6, 17, 19,

24) reveal a greater percentage of black than
white female drug abusers. Exceptions to

this finding (2, 4, 6, 13, 22, 23) occur in

emergency room and therapeutic community

settings and in data collected from the NIMH
Clinical Research Center.

Nontreatment Studies. One study (8N) in
this category presents race/ethnicity data in
a meaningful manner. In this study, the
number of black "narcotics involved" females
is significantly (p < 0.001) greater than white
females in the same categories.

Marital Status

Treatment Studies. Data on this variable
are collected in several studies (3, 5, 6, 9.
l3, l4, 18, 24, 25). Although no clear pat-
tern of sex differences emerges, these stud—
ies do suggest that female drug abusers may
be more likely than males to be either sepa-
rated, divorced, or widowed.

Nontreatment Studies. One study (7N) in
this category gathered data concerning mari—
tal status. This study compared female
heroin users and nonusers among a prison
population. A significant difference (p < 0.50)
was found between the number of heroin
users and nonusers who were divorced, with
users being less likely to be divorced, a find-
ing in conflict with that discussed above for
treatment samples.

Educational Status

Treatment Studies. Essentially no differences
are seen between males and females in those
studies (3, 5, 6, 7, l4, l6, 17, 25) where
educational status data are gathered. There
is, however, some indication (studies 3, 6,
14) that white females are more likely to have
either completed high school or a greater num-
ber of grades than black females.

Nontreatment Studies. Educational status in
these studies is entirely dependent upon the
population from which the sample was drawn--
most often this is from a secondary school or
a university (with no nonschool comparison
group). Therefore, no differences between
males and females would be expected and none
are found. Three nonschool studies examined
in this category did not report educational
data.

Current Drug U se

Treatment Studies. Current drug use refers
to usage levels and types recorded at admis-
sion to treatment. There are no clear differ-
ence patterns between males and females in
this category. Although some differences do
appear between black females and white
females, these findings are limited to individ-
ual studies (3, 22) and should be regarded
cautiously.

Nontreatment Studies. Two studies (2N, ION)
in this category collected data on current
drug use, which refers to usage levels and
types recorded at the time of the study.
One study (ZN) indicates heavier use of bar-
biturates, bromides, and tranquilizers by
undergraduate females than males. The sec-
ond study (ION) indicates essentially no dif-
ference between male and female secondary
school students in use of a variety of drugs.

Drug U se History

Treatment Studies. Data concerning a large
number of variables were collected in this
category. However, only two variables--age
at first illicit drug use and source of drugs--
are dealt with by more than two studies.
Since there is little validity in discussing
variables covered in only one or two studies,
the remaining variables and the studies in
which they were investigated are listed below:

Study
No.
Basis of decision/failure to
withdraw 5
Length of time using heroin 25
Source of heroin introduction 25, 27
Source of support for drug habit 13, 25
People drugs were used with 25
Immediate precursor drug to
heroin 1, 8
Age at addiction to heroin 16
History of heroin use 3, 6
Situation at onset of addiction 3
Number of years between first
drug use and first heroin use 3
Ever used specific drugs 6
Length of time between first
heroin use and addiction 13
Number of times volunteered
for treatment 13

Age at first illicit drug use is discussed in
four studies (l, 14, 25, 26). No pattern of
male/female differences is established. Study
14 indicates that males began narcotics use
0.7 year earlier than females; study 25 indi-
cates that males began heroin use 1.1 years
earlier than females; study 26 indicates that

31

females began drug use earlier (no figure
given) than males; and study 1 deals only
with females and indicates that opiate use
began at a median age of 16 for these clients,
an age considerably younger than that found
for males in studies 14 and 25.

Source of drugs is discussed in three studies
(3, 6, 26). Two of these studies, 3 and 6,
deal only with female samples but compare by
race. In both of these studies, black fe-
males were more likely than white females to
have obtained their drugs from a pusher;
study 3 indicates that white females were
more likely than black females to have ob-
tained their drugs from a doctor or a drug-
store.

Study 26 compares males and females but does
not break down the comparison by race.
This study inidcates that females were signifi-
cantly more likely than males to have received
their drugs from friends (p < 0.05) and that
males were significantly more likely than
females to have obtained drugs by stealing
(p < 0.01). Males were also more likely than
females, although not significantly so, to have
received their drugs from a pusher or by
pushing drugs themselves.

Nontreatment Studies. The studies in this
category did not investigate as wide an array
of variables as did the treatment studies.
Variables which were dealt with in only one
study were time of introduction into cigarette
and/or alcohol use (5N), use of "decremental"
or "incremental" drugs (2N). drugs "ever
used“ comparing use by 7th-to-9th-grade and
lOth-to-IZth-grade males and females (ION),
and length of time using drugs (4N).

The only variable which was dealt with in
more than one study (2N, 4N, 9N) was age
at first drug use. The results were inconclu-
sive. One of these studies (4N) found that
females began use of nonspecific drugs at a
younger age than males; study 2N also found
that females began drug use at a younger
age than males but only among certain drugs
which were reported (barbiturates, bromides,
and tranquilizers); study 9N, however, indi-
cated that males had earlier initial drug exper-
iences than females.

Criminal Justice History

Treatment Studies. Variables concerning crim-
inal justice history were discussed in only
five studies (5, 9, 14, 23, 25) and compared
by sex in three (5, 14, 25). Study 5 indi-
cated that males were more likely to have com-
mitted illegal acts prior to use of heroin:'
study 14 found that males were more likely to
have been arrested at a younger age than

Treatment Studies.

females; and study 25 found a higher per-
centage of males than females referred to
treatment from the criminal justice system.

Nontreatment Studies. Only one study (8N)

collected data concerning criminal justice his-

tory. This study utilized an all female sample.
Racial comparisons indicated that among "nar-
cotics involved" arrestees, black females were
arrested more often than white females; this
finding held for five broad classifications of
crimes: prostitution. drug sales or posses-
sion, property offenses. personal offenses.
and "other."

Other Characteristics

A wide range of vari-
ables, inappropriate for consideration in
previous categories, were assigned to this
category. Variables treated in only one study
were results of the Rokeach Value Ranking
Test (12), addiction status of spouse (13).
results of depression and anxiety scale admin-
istrations (16), results of Personal Orientation
Inventory (18), results of a staff/resident
perception of problems questionnaire (20),
MMPI results (23), living arrangements before
treatment admission (26), and IQ (26).

Three variables--family background, employ-
ment/source of support, and suicide thoughts/
attempts--were dealt with in more than one
study. The first of these variables, family
background, is discussed in four studies (3,
I3, 15, 24). Investigated were the number
of female treatment program residents from
severely disturbed families (15), the percent-
age of female treatment clients reared in
broken homes (3), occupation classifications
of female treatment clients' fathers (l3), and
by whom male and female treatment clients
were raised (24). Only one of these studies
(24) compares males and females, but this
study, in conjunction with two others (3, 15)
indicates that male and female drug abusers
are very often products of a disorganized
family.

The second variable, employment/source of
support, is investigated in three studies (3,
6, 17). One of these studies ([7) compares
males and females, while the other two (3,
6) deal only with females (with race compari-
sons). Female treatment clients, especially
black females, appear to experience quite low
employment levels, a condition which, accord-
ing to one study (6), worsened between 1961
and 1967.

The final variable, suicide thoughts/ attempts.
is discussed in three studies (9. 22, 24).
One of these studies (24) indicates that
females had significantly (p < 0.01) more

32

suicidal thoughts and suicide attempts than
males. The other two studies (9, 22) inves-
tigated females only but reported high rates
of suicide attempts (46 percent and 45 per-
cent, respectively) and one (22) a signifi—
cantly (p < 0.01) higher percentage of white
than black female suicide attempters.

Nontreatment Studies. No pattern of differ-
ences emerged from the studies in this cate-
gory since no variable is dealt with by more
than one study. One study (7N) investigated
suicide thoughts/attempts in a female prison
population divided into heroin users and non-
users. The findings are an increment to the
suicide-related studies cited above--a greater
(though nonsignificant) percentage of female
heroin users than nonusers report suicidal
thoughts and suicide attempts.

Other variables discussed are value-issue dif-
ferences among college marihuana users and
nondrug users and noncollege heroin users
and nondrug users (3N); the male vs. female
percentages of identified addicts in Connecti-
cut during a 3-year period in the mid-19605
(IN); drug user vs. nonuser (no sex break-
down) differences in parental perceptions
(llN); heroin users VS. marihuana only users
vs. nondrug users on several social interac-
tion dimensions (6N); heroin vs. nonheroin
users; urban vs. nonurban; birth and cur-
rent place of living (7N); and source of
drugs (2N) .

Psychological Characteristics of
Female Drug Abusers

There is great potential for misunderstanding
and misusing assessment data in an area that
is controversial in itself, such as the psycho-
logical characteristics of the female drug
abuser. This does not imply, of course, that
study of controversial areas should not be
carried out. Rather, it should encourage
further investigation and reexamination of
already existing data. A necessary element
of this investigation and reexamination, how-
ever, is an awareness of the actual, alleged,
and potential short—comings of the validity of
the data and instruments being utilized.

Limitations of the Data

There is extensive literature concerning the
psychological characteristics of drug abusers.
Upon examination, however, there are limita-
tions to this literature. First, much of this
literature is based upon clinical impressions
rather than data collected under controlled

33

conditions. Second. there are numerous
methodological problems with many of these
studies. Sample sizes are generally small
and often not comparable across studies;
there is often little cross-study comparability
of instruments designed to measure the same
or similar characteristics; descriptions of
methodology, sample population, and findings
are incomplete in many studies; control
groups are often lacking; and very few inves-
tigations have concentrated on "normal" as
well as psychopathological attributes of drug
abusing populations, resulting in an emphasis
upon profiles of psychopathology with little
or no portrayal of "normality." Third, and
most relevant for this study, a sbustantial
majority of the studies in the area deal only
with male drug abusers, or where a sample
of males and females is obtained, results are
often not reported by sex.

Given these limitations and the possible con-
founding factors cited earlier, this review
contains only those studies which (a) utilize
specific, nonimpressionistic data, and (b)
report results utilizing either samples of
female and male subjects or female subjects
only. The setting of these criteria has the
effect of narrowing the number of eligible
studies a great deal. This scarcity of eligible
studies thus makes the need for additional
study in this area more obvious.

Study Results

A summary of the studies reviewed for this
section may be seen in table 24. Whether
they validate the perceptions of the staff
members cited in Levy and Doyle (1974) that
female drug treatment clients are implicitly
"sicker" than male clients is not at all clear.
Certainly, these studies note sex differences
on many of the personality dimensions they
investigate. For example, Miller et a1. (1973)
found that female addicts value such attri-
butes as "clean-liness" and "self-respect"
more than male addicts; and Olson's results
(1964) suggest that male addicts are more
guarded and overtly wary than female addicts.
Such findings do not, however, indicate that
among addicts, one sex is more pathological
or “sicker" than the other.

Nevertheless, there are several studies which
do reach the general conclusion that female
drug abusers are more psychologically dis-
turbed than male drug abusers. Table 25
describes, in a broad manner, how the stud-
ies reviewed here deal with this issue. As
may be seen in this table, one-third of the
studies reviewed conclude that female drug
abusers function, psychologically, more poorly
than male drug abusers; there are no studies

which report the opposite conclusion. Those
studies which did not utilize a male compari-
son group nevertheless also reported signifi—
cant pyschological difficulties on the part of
the female addicts who were studied. The
largest group of studies (40 percent of those
under consideration here) do not report

broad male/female differences, although each
notes some psychological difficulty in both
male and female drug abusers. One study
(Miller et al. 1973) concludes that the differ-
ences found merely reflect the societal differ-
ences between all males and females, rather
than between male and female drug abusers.

 

34

Si

Table 22

'I'RFAMZNT SI‘UDIES

 

 

 

 

SAM- SAMPLE RACE/ MARITAL EIZUCA- CURRFNT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE EWICITY STATUS TIONAL DRUG USE HISTORY JUSTICE ORDER
SIZE 95 2. 9. STATUS 95 9s % HISTORY % 1;
1/ Chain, Gerard, 20 Patients A11 F Range= Black—SS First Use of @iates:
Lee, and admitted to 17-20 Write—25
Rosenfeld treatment in Puerto Age Range: 14-19
(1964) New York City Median= Rican-lS Age Median: 16
Hospital; 18 . 5 Other- 5
85% were 45% had used other
addicted to drugs prior to heroin
heroin at
entry 100% did not purchase
first heroin
g," Poplar 90 Registered M=2 $41.7 Black—7 1 yr college-19 Drug of choice was Addicted
196-9) nurse F=98 Write-93 2 yr college- 8 Demerol nurses did
patients Range= 3 yr diploma-64 not appear
at the NIMI-I 23-63 BA- 9 to be
Clinical typical of
Center in other
Lexington, Ky. addicts

 

 

 

 

 

 

 

 

 

 

 

 

 

95

Table 22

TREATMENT STUDIES

 

 

 

(continued)
SAM- SAMPLE RACE/ MARITAL EIUCA- CURREU CRIMINAL
S’IUDY PLE DESCRIPTION SEX AGE Ell-NICITY STATUS TIONAL DRUG USE DRUG USE JUSTICE OTHER
SIZE % is is STATUS is 96 HISTORY 15 HISIDRY % 2
3/ Chambers, 168 Subjects All F $34.8 Black-66 B W* B W Heroin Heroin use: B W Employment status
Hinesley, were 168 White-34 M 9 55 < HS 67 61 use at 1 6 months prior to
and consecutively glack S 82 13 HS 24 23 admission: Ever used 1 93 37 admission:
Maldestad admitted X=30.4 Bk.M 9 32 > HS 9 16 First drug 1 89 32 .
(1970) female Black-35 Preferred drug 81 37 B W
patients at White White-B8 Most erquent
the NINH $37.0 *M-mrried HS-high 1Diff drug 93 33 Legally
Clinical S-single school 5i 3:22; anployed 16 23
Center in Bk.M-broken tgn < 001 1
Lexington, marriage a p. ' ‘ mrthana ever used: Illegally
Ky. employed 68 32
Black--68
White-{59 Dependent 16 45
Initial exposure to
narcotic use: Reared in broken
B w home:
Peer-Social 89 42 Blade-72
Medical 3 45 White-46
Family 8 13

 

 

 

 

 

 

 

 

 

1Difference significant

at p. < ,001.

Source of drugs :

Pusher
Doctor
Drugstore
Theft

U1

‘0
Ombt-J

44
33
19

 

 

 

 

LS

lele 22
'I'REA'I‘MENT STUDIES

 

 

 

 

 

 

 

(continued)
SAM- SAMPLE RACE/ MARITAL EIlJCA- CURRENT DRUG USE CRIMINAL
SIUDY PLE DESCRIPTION SEX AGE EHNICITY STATUS TIMAL DRUG USE HISTORY JUSTICE
SIZE % % it SFAIUS ii I. 1. HISTORY Is
4/ Williams 172 Patients at All F 5934.9 Black--34
" and Hates the NIMH Ranges White--66
(1970) Clinical 17-70
Center in
Lexington,
Ky.
S/ Brown, 218 Clients of M=83 I=Y= 28.6 B 0* M S 0* YNumber of Basis of Initial illegal act:
_ Gauvey, the Narcotics F=l7 .4 grades completed decision to
Meyers, Treatment II=X: 27.4 I 89 11 I 33 44 23 withdraw l) Occurred before
and Administration _ from drugs: first heroin use:
Stark in Washington, III=X: 17.2 II 95 5 II 22 44 34 I - 10.3
(1971) D.C., classified 11 . 10.4 I-Change life I--74
into 3 groups: 111 96 4 III 4 96 0 III - 9.5 11—40
II-Drug- III--78
related
I-Adult male ‘B-Black *M—married physical 2) Occurred in order
addicts 0-Other S-single problem to obtain drugs:
(N=105) O-other
III-Change life I--18
II-Adult female II--33
III--14

 

 

addicts (N=36)

111 -Juvenile mle
addicts (N=7 7)

 

 

 

 

 

Basis of failure
of first with-
drawal attenpt:

I ‘Continued
phys ical
need

I I - Cont imed
phys ical
need

I I I -Cont inued
phys ical
need

3) Arrested before
first heroin use:

I--53
II--20
III--55

 

 

 

Table 22
'I'REAWEVT STUDIES

 

 

 

8E

 

(continued)
SAM- SAMPLE RACE/ MARITAL EWCA- CURRENT DRUG USE CRIMINAL
Sl'UDY PLE DESCRIPTION EHRITICY STATUS TIONAL DRUG USE HISTORY JUSTICE OTHER
SIZE 3; is STATUS % 2 1, HISIDRY ’3 3
6_/ Cuskey, 457 Patients at 1961 1961' 1961 1967 (onlz) B Primary source of
' Moffett, the NIH-i support
and Clinical B-47 B W B W Heroin ever used 94
Clifford Center in h— 53 Marihuana ever used 88 1961
(1971) Lexington, 15-19 M 30 51 < HS 75 55 Other drugs ever used 6 66
Ky.; divided 20-24 m, s 36 16 HS 23 29 B W
into two 25-29 BM 34 33 >HS Z 15
groups: 30-34 8-49 1967 1967 Work 24 53
35-39 “-51 ‘B W T W Source: B W Dependent 40 37
1961: a sample 40-44 Illegal
of fenales > 44 M 33 39 < HS 64 47 Pusher 94 49 Acts 36 10
admitted S 25 101 HS 30 33 Other 5 51
to Br.“ 42 51 > HS 6 20 1967
Lexington
in 1961 15-19 B W
20-24 12 18
1967: a sample 25—29 1 . HS-hi h school Work
of females 30-34 glffemce g Dependent 21 51
admitted 35-39 1:619:11] Illegal
to 40-44 1967 si _ Acts 67 31
Lexington > 44 . . g
in 1967 n1f1cant at
p. < .05.
‘M-mrried
S-single
BrM-broken
marriage

 

 

 

 

 

 

 

 

 

 

 

 

6E

Table 22

IREAIMENI SIUDIES

 

 

 

(continued)
SAM SAMPLE RACE/ MARITAL EUJGA- CURRBU DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE ETHNICITY STATUS TIONAL DRUG USE HISTORY JUSTICE OTHER
SIZE % is 1; STATUS ’5 % % HISTORY % t
7/ Gottschalk, 113 New patients I: M-28
— Bates, Fox, - coming into F-7Z Use of psychoactive
and James two types of drugs at contact:
(1971) clinics: II: M=35
F=65 1: MISC
1--Mental F-72
health
(N865) II: M-65
F=6S
II--Genera1
medical
(N=48)
y Weppner 738 Patients at M=77 Black I 66 Groups I and 11--
and the NINH F-ZS White = 34 Drug used as imnediate
Agar Clinical precursor to heroin:
(1971) Center in I: M=74
Lexington, F=26 I M F
Ky. divided
into two 11: M=79 M F Mariluafa 46 49
groups: F=21 Alcohol 39 23
B 54 17 Other than alco-
I--Those W 20 9 hol/marihuana 27 15
addicted
to heroin 74 26
giggiedamn: 1Difference significant
11 at p. < .01.
II-—Those
addicted M F
to another
.drug before B 50 13
heroin W 28 9
78 22

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0?

Table 22

TREATMENT STUDIES

 

 

 

 

 

(continued)
SAM— SAMPLE RACE/ MARITAL EDUCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE E'IT‘NICITY STATUS TKNAL DRUG USE HISIDRY JUSTICE OTHER
SIZE % t z STATUS % % % HISTORY % 8
2/ Driscoll 100 Consecutive A11 F X'= 25 Black - Z6 M = 19* < HS-wSS Arrests Attempted suicide:
and admissions White = 74 S = 46 HS--Z6
Barr at a private Range= O - 35 > HS-—19 Never-—31 Yes--46
(1972) drug treat- 15.58 Once--11 No-—54
ment facility *M-married > 1--58
over a 15- S-single
month period O-other
19/ Heller 67 Young, non- M = 63
and addicted F = 37
Mordkoff drug abusers No M-F differences
(1972) in a non- on NMPI
residential
W081?!“ .
ll/ Levi and 414 Entire popu- A11 F I II
Seborg lation of
(1972) the women's Black 20 47
unit of a White 60 18
State reha- Mexican
bilitation American 20 35
center for
drug treatment;
divided into
two groups:

 

 

I--Literates
(Ns335)

II-~I]1iterates
(N=79)

 

 

 

 

 

 

 

 

 

 

 

IV

Table 22
mm SIUDIES

 

 

 

(continued)
SAM- SAMPLE RACE/ MARITAL EIMCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIP'I‘Im SEX AGE E'U'NICITY STATUS TIWAL BRIE USE HISTORY JUSTICE OTHER
SIZE 8 8 % STATUS % 2 % HIS‘IURY % t
12/ Miller, 274 Patients at M - 75 Black White The Rokeach Value
_ Sensenig, the NIH! F - 25 Ranking Task was
Stocker , Cl inical M 50 28 administered:
and Center in Females reported
Campbell Lexington, F 12 10 valuing the follow-
(1973) Ky. ing significantly
62 38 more than males--

 

 

 

 

 

 

 

 

 

 

 

happiness, self-
respect, inner
harmony, true
friendship, being
clan, and being
forgiving; males
reported valuing
the following
significantly more
than femles--being
ambitious, self-
controlled, logical,
and intellectual.

 

 

 

2‘7

Table 12

TRERWT STUDIES

 

 

 

 

 

 

 

 

 

 

 

 

Volunteered for
treatment: 1

M F

Never 62 47
Once 23 25
> 1 15 28

 

1Difference signi-

ficant at p. < .001.

How was habit
supported?

Vice--9
Forgery- -42
Ooming- -14
Sex-49
Narcotics- -69
Robbery--6
Theft- -48
Work-S

(F only)

 

h'as spoxllse
addict?

Yes No
M 39 61
F 83 17

1Difference
signifi-
cant at
p. < .001.

(continued)
SAM- SAMPLE RACE,’ MARITAL EDIK‘A- CURRENT IRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE EHNICITY STATUS % TICNAL DRUG USE HISTORY JUSIICE OTHER
SIZE 1 ’5 STATUS 15 % % HISTORY t g
13/ Rosenbaum 360 Clients M I 50 (F only) Black-17 M F Time between first Occupation
_ (1973) at the F - 50 % White-65 use and addiction of father
California a w c T 01— married 84 94 to heroin:1 (1: only)
Rehabilita- cans-18 Not Married 16 6
tion Center < 19 0 15 12 12 M F 3 H C
for Drug 20-24 27 53 37 46
Addiction; 25-29 20 21 24 22 < 4 mos. 23 47 White
matched > 30 53 11 27 21 4-12 nos 44 22 00118,- 43 46 24
male and > 12 nos. 33 31
£31319 Blue
samples B-Bleck lnifmmce Sim. Collar 50 so 64
“W“ t“ t t 001
C-Chicana man a p. < . . None 7 4 12
T-Total

 

 

 

Table 22

TREATMENT STUDIES

 

 

£17

 

 

(continued)
SAM— SAMPLE RACE/ MARITAL EIlJCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTIW SEX AGE ETHNICITY STATUS TIONAL DRUG USE HISTORY JUSTICE OTHEI
SIZE % 95 % STATUS % ’a % HISTORY 9s 2
fl/ Campbell 3,583 Patients M - 80 M: $27.0 M F T Married: YNumber YAge at YAge at
a at the _ of grades first first
Freeland NIH! F . 20 F: X-26.7 B 52 11 63 M = 71 completed: use: arrest:
(1974) Clinical W 28 9 37 F = 82
Center in X M I 10.7 M = 19.0 M '- 17.1
Lexington. M F F ' 10.4 F = 19.7 F - 18.6
Ky. M-Mnle M F
B 27.4 27.2 F-Femle X Y
W 26.2 26.0 T-Total B 74 84 X M F M F
W 67 80 M F
B 19.0 19.9 B 17.0 18.5
B—Black B 10.5 10.0 W 18.9 19.4 W 17.0 18.7
w-White W 11.0 10.9
F-Fexmle
M-hhle
Q/ Coughlan 69 Residents A11 F Range: 13-17 Black-38 At entry 58% The majority of
and of a White-38 were primary the residents
Gold residential Pue'rto heroin users; were from
(1974) drug Rican—24 the renaming severely dis-
treaunent 42% used pi115, mrbed families
program mrihuana, LSD,
inhalants, and
alcohol

 

 

 

 

 

 

 

 

 

 

 

 

 

W

Table 22

TREAWT STUDIES

 

 

 

 

(continued) .
SAM- SAMPLE RACE/ MRITAL EIUCA- GJRRENT DRlX} USE CRIMINAL
S'IUDY PLE DESCRIPTION SEX AGE EIHNICI'IY STATUS TIONAL DRUG USE HISTORY JUSTICE OTHER
SIZE % % is STATUS % 35 HISTORY 1s %
16/ DeLeon 206 Residents M = 71 M: Y=21.1 M F T Y Mnrber Addicted to X Age at Females (on the Beck
_ (1974) of a __ of grades heroin: addiction: Depression ‘lnventory and
therapeutic F = 29 F: X=21.0 B 27 12 39 completed: MAACL Depression and
community W 32 10 42 M=8Z M = 17.1 Anxiety Scales and
0 13 6 19 M = 10.5 F = 17.8 Shortened mnifest Anxiety
F = 10.7 F=90 Scale) were significantly
more likely than males to
B-Black evidence depression and
W—White anxiety.
0-0ther
M-Vale
F-Fenale
T-Total
g/ Gioia 67 Subjects M = 58 M: $31.3 M F T High Heroin use Employed:
and were heroin school prior to
Byrne users fmn F - 42 F: $29.9 B 39 33 72 diplom: admission: M = 59
(1975) an Illinois W 16 6 22
drug abuser S 3 3 6 M=41 M=90 F = 4
program F=29 F=93
B-Black Methadone:
w—White
S-Spanish M=80
F=68

 

 

 

 

 

 

 

 

 

 

 

 

 

Table 22
TREATMENT STUDIES

 

 

Si?

 

 

 

 

(continued)
SAM- SAMPLE RACE/ WITAL EDJCA- CURRENT DRUG USE CRIMINAL
STUDY PLI; DESCRIPTIW SEX AGE E'ITNICITY STATUS TICNAL DRUG USE HISTORY JUSTICE OTHER
SIZE 1; % is STATUS % % it HISIURY % z
18/ Kiln'ann 84 Residents All F $25.6 White-73 Married-27 Administration of the Personal
_ (1974b) of the Orientation Inventory indicated
California Range= Other—27 Single-36 that drug abusers in this
Rehabilita- 18-34 sample. when compared with 158
tion Center Divorced-13 nonabusing adults, were a) less
efficient in their use of time;
Separated-19 b) less satisfied with their
' lives; c) skeptical of humn
Widowed-5 goodness; d) more sensitive
toward their own needs and . .
feelings; 6) more spontaneous
in expressing feelings; and
f) better able to develop
meaningful relationships
with others.
19/ Lett and 429 Subjects were M = 66 M F T Number of years from first use of illicit drug
'_ Ingram all narcotics F = 34 to first use of heroin:
(1974) addicts pre— B 44 23 67
senting at a W 23 10 33 BF MM WP M F I’M-Black male
Dallas metha- BF-Black female
done clinic < l 17 26 34 45 23 32 VM-Hhite male
for evaluation 1-4 33 39 38 32 35 37 WF-White fanale
and treatment 4<7 18 15 20 14 19 15 M-Male
during an 18- 7-10 11 5 6 S 12 S _F-Fenale
month period > 10 21 15 2 4 11 12

 

 

 

 

 

 

 

 

 

 

 

Table 22
TREATMENT STUDIES

 

 

91'

 

(continued)
SAM- SAMPLE RACE/ MARITAL EWCA- CRIMINAL
PLE DESCRIPTKN SEX EIHNICI'I'Y STATUS TKNAL JUSTICE O'I‘HER
SIZE % % % STATUS % HISTORY %
130 Staff (n=34) Staff Residents and staff gave their
and residents M = 74 perceptions of the major problems
(n=96) in a F - 26 of drug addicts; the major M-F
therapwtic resident differences: mles
comnmity Residents exceeded femles in perceiving
M - 76 being prejudiced against: females
F = 24 exceeded males in perceiving

 

 

 

 

 

 

 

 

 

 

 

childishness, suicide attempts,
dependency, bad feelings concern-
ing one's body, and inability to
express feelings as major prob-
lems of drug addicts.

 

 

L?

Table 22
TREATMENT STUDIES

 

 

 

 

 

addicted during
1969
(N = 264)

II--Transition era
addicts, addicted
during 1969
(N = 169)

III--New era addicts,
addicted after
1971
(N = 128)

 

 

 

 

 

 

 

 

(continued)
SAM— SAMPLE RACE/ MARITAL EDUCA- CURRB‘IT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE ETHNICITY STATUS TIONAL DRUG USE HISTORY JUSTICE
SIZE 95 % % STATUS 95 % % HISTORY %
21/ Newmeyer Sbl Clients seen at the M = 69
_ (1974) drug detoxification F = 31
project of a free
medical clinic were H F
divided into three
groups: I 78 22
II 62 38
I--01d style addicts, III 60 40

 

 

 

8f

TINe 22
mm STUDIES

 

 

 

 

 

 

(contimed)
SAM- SAM’LE RACE/ MARITAL EllJCA- QIRRENT DRUG USE CRIMINAP
S1UDY PLE DFSCRIP’I‘IW SEX AGE EDNICITY SI‘A‘IUS TImAL DRUG USE HISIORY JUST 1C): ONE!
SIZE % t % smus t 1 1 IIISIDRY 1. s
g/ PeterSen 1,127 Patients M - 42 (F only) Black - 33 (F only) was the present
(1974) treated for White - 67 contact a mi—
acute drug F - 58 % Number of sub- cide attaupt?
reactions M F statues abused:
in a a w1 1 Black White1
hospital 3 13 20 Black White
anergency 14-17 22 12 H 29 38 Yes 32 45
man 18-24 44 38 l 86 71 No 68 55
25-34 23 22
35-49 9 19 > 1 14 29
> ‘9 2 9 1Difference
1 . significant at
1 Difference significant p. < .01
Difference at p. <
significant
at p. < .001. ------------
Alcohol-drug use in
conbinatian:
Black White
Yes 8 11
No 92 89
g/ Ross 395 Patients at A11 F Y = 32.7 Black and Admission MI results sug-
and . the gum other --38 type: gested that famle
Berzms Clinical White --62 addicts are active,
(1974) Center, Voletary: aggressive. and
WWW“: 59 immune
KY- personalities.
Involun.:
41

 

 

 

 

 

 

 

 

 

 

 

 

69

Table 22

TREATMENT STUDIES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(continued)
SAM- SAMPLE RACE/ MARITAL EIIICA- CURRBJT DRUG USE CRIMINAL
SIUDY PLE IESCRIP'I'ION SH AGE Ell-NICITY STATUS TKNAL DRUG USE HISIORY JUSTICE (”HER
SIZE 8 8 8 STATUS % t % HISIURY % i
y] Barr 864 Residents of M - 73 Median M F 0 M F Suicidal thoughts:
(1976) a therapeutic
cummityand F-27 M-26 8646765 Married 17 22 M-27
clients from 0 36 33 35 Single 40 49 F = 41
a timber of F - 25 Other 43 29
methadone Suicide attaipts:
maintenance B-Black
programs 0-0ther M - 10
F I 27
Raised by
M F
Both
Parents 58 40
Single
Parent 32 40
Relatives 9 16
Foster
Hane/
Orphanage 1 4

 

 

09

TINCZZ
TREATMENT STUDIES

 

 

 

 

 

 

 

 

 

 

 

 

 

(continued)
SAM— SAMPLE RACE/ MARITAL EDUCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE ETHNICITY STATUS TIONAL DRUG USE HISTORY JUSTICE
SIZE % $ % % STATUS % % % HISTORY %
g§j Eldred and 158 Clients M = 50 M: X = 25.0 B W M S 0 Y Number 7 age at first Referred to
Washington of the F = 50 F: X = 24.9 of grades heroin use: treatment
(1976) Narcotics M 89 11 M 23 64 14 completed: from
Treatment M: 20-29=71% F 97 3 F 12 54 33 M = 19.6 Criminal
Administra- M = 10.7 F = 20 7 Justice
tion in F: 20-29=49%1 F = 10.6 ------- System:
Washington, B—Black M-Married _
D.C. W-White S-Single Percent who X years of M = 42
lDifference 0-Other aizdgiteS‘ herein use: F = 32
significant g ' _
at < 02 M ' 5'6
P' ' ‘ M = 37 F = 4.7
F = 39 -------
Who introduced
you to heroin?
M F1
Same sex 59 29
(nunsite
sex 5 41
Both sexes 30 19
Client
sought 5 11
1Difference
significant at
p. < .001.

With whom did you
usually use drugs?

MFZ
Alone 42 46
Same Sex 38 27
Opposite
sex 4 28
Both Sexes 37 52
2 .
Difference

significant at
p. < .005.

 

 

 

IS

Table 22
TREATMENT STUDIES

 

 

 

 

 

 

(continued)
SAM- SAMPLE RACE/ MARITAL EWCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE ETHNICITY STATUS TIONAL DRUG USE HISTORY JUSTICE O'IHER
SIZE % 2 % % STATUS % is % HISIDRY % %
Eldred and lbw did you support
Washington your habit?
(1976) 3 .
(contimed) M F
Work 61 49
Parents 14 13
Spouse 3 l3
Free/others 4 21
Illegal acts 66 59
3Difference significant
at p. < .01.
26/ Klinge, 143 Patients in M = 57 M = Y: 15.7 M F r between age at admis— IQ:
— Vaziri, an inpatient F = 43 _ sion and duration
and adolescent F = X: 15.3 M 70 80 of abuse: M F
Lennox psychiatric H 53 62
(1976) facility; S 49 60 M = .157 Verbal 105.9 105.1
the subjects N 38 35 F = .351 Perform-
were not D 23 38 ance 105.8 105.6
diagnosed This indicates that
as drug M-marihuana females had begun abus- "' ' ' ’ ’ ' " ‘ ' ‘ ‘
abusers but H—hallucino- ing drugs chronologi— Living arrangement
were identi- gens cally earlier than prior to admission:
fied as such S-stinulants mles.
by self— N—narcotics ----------- M F
report and D-depressants
urinalysis Source of drugs: Parents 90 82

 

 

 

No significant
drug use dif—
ferences were
fcund on indi-
vidual drug us
or use of two
or more drugs

 

 

 

 

 

M F

Friends] 32 as
Dealer 2 36 26
e pushing 12 3
Stealing 14 2
Other 6 16

 

1Difference significant
at p. < 5.

2Difference significant
at p. < .01. I

Relative l 9

School/

Institu-

tion 5 6
Friends 4 3

 

 

 

25

Table 22

TREATMENT STUDIES

 

 

 

(continued)
SAM- SAMPLE RACE/ MARITAL EIIJCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE ETHNICITY STATUS TImAL DRUG USE HISTORY JUSTICE
SIZE % % it STATUS % % % HISTORY %
fl/ Sacher, 100 An accidental = 78 Drug Use Initiation
Brown, sample of = 22 (Percentage)
Greene, clients of the Sex of Initiator
Narcotics
DuPont Treatment M F
Administration
in Washington, . M 99 1
D.C. F 50 50

 

 

 

 

 

 

 

 

 

 

 

 

 

£9

Title 23

MNI'REA'DENI‘ STUDIES

 

 

 

 

SAM- SAMPLE MARITAL EDUCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTICN SEX AGE STATUS TIONAL DRUG USE HISI‘ORY JUSTICE OTHER
SIZE 1 z STATUS % 2 2 HISTORY 3 2
lg/ Kleber 27S Arrestees, M = 85 Connecticut addicts,
(1969) 133 of whom F = 15 identified during a
were arrested ---------- 3-year period
for heroin Heroin
use and 142 arrestees: M F
arrested for
mtitmana use M = 82 1963-64 so 20
(covered the F = 18 1954-55 34 15
city of New ---------- 1965-66 83 17
Haven 1964- mfihuana
67) artestees:
M = 89
F = ll
gry Mitchell, 71 College M = 48 M: X = 19.3 Qu‘rent— M F Females more Source of drug
Kirkby and Under— F = 52 _ 1y in likely (p < .001)
Mitchell graduates F: X = 18.9 college Barb. 3 11 than males to Doctor Mother
(1970) Bromide 0 24 have used a
Tranq. 12 22 "decrement- M F M F
producing" (i.e., Barb. 100 100 -- --
barbiturate. Bran. -_ 34 __ 13
bromide. or tran- Tranq. 75 so -- 18

 

 

 

 

 

 

 

 

 

 

quilizer) drug,
but no more

likely to have
used an "increment-
producing: (i.e.,
amphetamine,
hallucinogen, or
narcotic) drug

7 Age at first use:

Barb. 18.0 15.5
Bromide -- 16.5
Tranq. 18.3 17.3

 

 

 

Table 23

Mommm'r STUDIES

 

 

VS

 

 

(continued)
SAM- SAMPLE ' RACE/ MARITAL ERICA- CURRINI‘ DRIXS USE CRIMINAL
STUDY PLE DESCRIPTION EIHNICITY STATUS TIONAL DRUG USE HISIORY JUSTICE OTHER
SIZE % 9; STATUS ’5 % 9‘ HISIURY % ’5
fl/Baldiner, 120 Four groups of 30 Group I consistently
Goldsmith, subjects each were differed from all
Capel and constituted. others on the follow-
Stewart Their composition ing value issues:
(1972) was as follows: religion. law/justice,
I-College marihuana economics, race, sex.
users education. Marihuana
II-College nondrug is not seen as a
users casual agent of these
III-Noncollege heroin views but as a symbol
users of nontraditional and
IV-Noncollege nondrug less conservative
users attitudes.
The subjects were
obtained from the
population of a
miversity, a
comunity action
program, and a
methadone
maintenance clinic.
gry Scott 58 Subjects were M - 43 Age at
(1972) former drug F = 57 first drug
abusers of use:
high school
age. M F
11-12 4 11

 

 

 

 

 

 

 

 

 

13-14 40 60
15-16 56 29

Length of time

using drugs:

M F
6 mo. 4 9
6-12 mo 44 23
>12 mo 52 68

 

 

 

 

59

Table 23
”TREATMENT SIUDIES

 

 

 

 

 

users on a
self-report
basis.

 

 

 

 

 

 

None
users

23

Non-
users

33

60

Users
In
College 21
Before
College 71
Not Used 8
Total 100
Alcohol use--
Users
In
College 11
Before
College 89
Not Used 0

Total 100

 

100

 

 

(continued)
SAM- SAMPLE RACE/ MARITAL ERIC!» CURRENT [RUG USE CRIMlNAL
STUDY PLE DESCRIPTION SH AGE E'fl-NICITY STA'IUS TIONAL DRUG USE HISTORY JUSTICE OTHER
SIZE % t % SX‘ATUS % 95 HISTORY % 1.-
fl/ Steffenhagen, 131 College under- All F Currently Initiation
McAree and graduates, 93 under- into:
Nixon (1972) of whom were graduate
classified as students Cigarette use--

 

 

9S

lele 23
NONI'REA’n-fl-ZNT SIUDIES

 

 

 

 

 

 

(continued)
SAM- SAMPLE RACE/ MARITAL ENCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE EITNICITY S‘l‘A’IUS TICNAL DRUG USE HISTORY JUSTICE OTHER
SIZE % s s STATUS % S t HISIORY % 8
fl/ McDonald, 411 College under- All F Currently In the "extrene
Walls, and graduates under— groups analysis,"
LeBlanc classified as users graduate drug users (I)
(1973) and nonusers on a students and mriluana—
self-report basis only users (111)
and, for the pur- did not differ
pose of "extreme significantly
groups analysis," from each other,
further classified but these groups
as: combined differed
I-users of 2 or more significantly from
drugs (n - Z3); nomsers in con-
II-rmdomly selected formity, social
nomsers (n = 23) participation, and
III-marijuana users use of cigarettes,
only (11 = 8). beer, and hard‘liquor.
7_N/ Climent, 66 Subjects were A11 F I:Z=25 3
Raynes, selected fran a II'XIZQ 5 I 11 Born in urban area:
Rollins, fanale prison popu- Married 20 13
and lation and divided I II Single 61 50 I - 34
Plutchik into two groups: 8 % Divorced 7 25 II — 22
(1974) 1 Separated 10 8
I--Heroin users < 20 40 17 Widowed 2 4 Live in urban area:
(N=42) 20-25 31 37
II-—Nonheroin >25 29 46 1Difference significant I; : 3(1)
users (N-Z4) IDifference at p ('05'
significant Suicidal tlmghts:
at p< .05 I _ 76
II - 54
Suicide attenpts:
I - 62
II - 46

 

 

 

 

 

 

 

 

 

 

 

Table 23
NONTREATMENT STUDIES

 

 

LS

 

(continued)
SAM- SAMPLE RACE/ MARITAL EDUCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE ETHNICITY STATUS TIONAL DRUG USE HISTORY JUSTICE OTHER
SIZE % % % STATUS % % % HISTORY % '
SN/ File, 227 Female A11 F B1ack=721 Ever arrested for the following
—~ McCahill arrestees offenses:

and classified White=28

Savitz as ”nar— Black White Other

1974 cotics 1 .

( ) involved" lef‘t’r'tme Prostitution 49 20 41

51gn1f1cant Drug Sales or
at p (‘001' Possession 71 84 81

Larceny 51 31 4S
Burglary 20 22 21
Forgery/Fraud 9 8 9
Robbery 17 S 13
Assault 14 9 12
Weapons 12 8 11
Homicide 3 2 2
Gambling 9 2 7
Liquor 4 ll 6
Other1 42 36 40

X Number of arrests by category:
Black White Other

Prostitution 2.6 1.0 2.1

Drug Sales or

Possession. 1.8 1.5 1.7
Property

Offenses 1.9 1.1 1.7
Personal

Offenses .4 .2 .3
Other 1.1 .7 1.0

 

lIncludes contempt of court, Violation
of probation or parole, failure to
appear in court. j

 

 

 

 

 

 

 

 

 

 

 

 

 

89

Table 23

NON'I'REATMENT STUDIES

 

 

 

(continued)
SAW SAMPLE RACE/ MARITAL EIIJCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE ETHNICITY STATUS TIONAL DRUG USE HISTORY JUSTICE OTHER
SITE “2 % % STATUS % % % HISTORY % %
91/ Krug and 563 Subjects were M=53 M: X Age at
_ Henry entering freshmen F=47 F : initial drug
(1974) at a junior experience:
college (N=285) H
and a graduating M X=14 l
senior class
{N'=278) at a high I‘ X=15. 5

 

 

 

' school--both in

the Southern U . S .

 

 

 

 

 

 

 

 

 

 

 

 

 

69

Table 23

NON'I'REATMENT STUDIES

 

 

 

(continued)
SAM- SAMPLE RACE/ MARITAL EDUCA-
S'IUDY PLE DESCRIPTION SEX AGE E'I‘HN'ICITY STATUS TIONAL wRRENT DRUG USE DRLC USE HISI'ORY“
SIZE 35 is STA'IUS % is 75
lON/ Rosenberg 8 700 Subjects were Year I: Year I: n - n u u
— K351, and’ ’ Students in —— — w 131613531
Berberian grades 7-12 in M=49 Black — 8 Year I: Year I'
(1974) New England. F=Sl White - 92 '
Data were M F . _ _
collected in Year II: Year II: GRADES' 7 9 10 12
two consecutive Nbrihuana 18 16 M F M F
years: M=49 Black - 10 Hashish 13 11
F=51 White - 90 Amphetamines 4 4 .
(71) Year I: Barbiturates 3 3 Era)??? 18 16 44 39
N=4 427 Glue 1 1 5 15 . 11 9 32 28
’ Mescaline 4 3 Amphetamines S 6 16 17
(72) Year 11: LSD 3 2 Barbiturates S 5 14 14
N=4,273 Cocaine 1 1 Glue . 1° 5 1° 7
Heroin 1 .1 Mescalme 4 2 14 11
LSD 3 3 14 9
Cocaine 1 1 5 3
Year II: Heroin 1 .4 5 1
M F Year 11:
Mar'] 20 18 GRADES: 7-9 10-12
Phshish 14 11
Amphetamines 3 4 M F M F
gigmrates i : Marin mm 24 22 52 48
Mescaline 3 3 Phshish 13 11 36 31
LSD 2 2 Amphetamines S S 18 19
Cocaine l 1 Barbiturates S 7 12 12
Heroin 1 4 Glue 14 13 13 7
' Mescaline 4 4 16 14
LSD 3 4 16 13
Cocaine 2 2 6 6
Heroin 1 1 5 2

 

 

 

 

 

 

 

 

 

 

*Columns CRIMINAL JUSTICE HIS'mRY and OTHER were (mitted.

 

09

Table 23

NONTREATMENT STUDIES

 

 

 

(continued)
SAM- SAWPLE RACE/ MARITAL EIlJCA- CURRENT DRUG USE CRIMINAL
STUDY PLE DESCRIPTION SEX AGE ETHNICITY STATUS TIONAL DRUG USE HISTORY JUSTICE OTHER
SIZE % % ‘t STATUS 95 ‘3 % HISI‘ORY % %
ifl/ Streit, 1,050 Secondary school NSF, no Currently No consistent M-F
Hulsted, smdents divided breakdown secondary differences in
and into drug users given school perception of parental
Pascale and nondrug users students behavior; differences
(1974) on the basis of were found between

 

 

number of times
they reported
using marihuana,
LSD, barbiturates,
or amphetamines.

 

 

 

 

 

 

 

 

 

users and nonusers
(both M and F) concern-
ing perception of
parental love and
hostility.

 

 

Table 24
REVIEW OF STUDIES NOTING PSYCHOLOGICAL CHARACTERISTICS OF FEMALE DRUG ABUSERS

 

 

STUDY SAMPLE IMJOR FINDINGS CONCERNING PSYCHOLOGICAL CHARACTERISTICS OF FEMALE
DRUG ABUSERS
Olson (1964) 20 hospitalized male and female hflPl profiles suggested that male addicts were significantly more guarded
heroin addicts and overtly wary than female addicts but that females felt more exposed
and vulnerable to their current situation. On this basis it was posited
n of 60 males that the females in this study may have had less well-developed ego
n of 60 females defenses and tended to demonstrate more pessimism and low morale while

19

Chein (1964)

utilizing projective and obsessive—conpulsive defenses. Additionally.
females scored significantly higher on the Depression and Paranoia scales.
The author suggests that this indicates a lack of self-confidence, poor
morale, and more worry and dissatisfaction with their current situation:
along with the use of paranoid defense mechanisms. A primary elevation on
the psychopathic deviate and secondary elevation on the hypomania scales
was noted with both sexes and is suggested to be representative of narcotic
addicts in general.

52 hospitalized male and female Psychiatric diagnoses of male and female addicts were not significantly
opiate addicts different. The only difference of note was in the categorization of
subtypes of the diagnosis of character disorder. TWO subtypes used to
n of 32 males describe the male addict were "pseudopsychopathic delinquent” and "oral
n of 20 females character": both these subtypes were described as defining their lives

"in terms of aggression and hostility experienced as pleasurable or as
justified reaction to mistreatment or frustration (p. 311). These sub—
types were not described for females. It was suggested that females did
not employ the facade of "joy in battle” of the male ”pseudopsychopathic
delinquent” but did experience anxiety and reproach following episodes of
rage or anxiety, a characteristic not reported among the male subtype of
"oral character.” Both males and females were considered to be "seriously
maladjusted" prior to addiction.

 

29

Table 24

REVIEW OF STUDIES NOTING PSYCI-DLOGICAL CHARACTERISTICS OF FEMALE DRUG ABUSERS

(continued)

 

STUDY

SAMPLE

MAJOR FINDINGS CONCERNING PSYCHOLOGICAL CHARACTERISTICS OF FEMALE
DRUG ABUSERS

 

Ellinwood, Smith
and Vaillant
(1966)

111 male and female admissions to
the USPHS Narcotics Hospital at
Lexington

n of 81 males
n of 30 females

Review of psychiatric examinations revealed that, "diagnostically,
women were more often seen as neurotic and psychotic, while males
were more often seen as having personality disorders and being
sociopathic” (p. 37). The authors note, however, that “there may be
a judgmental and diagnostic bias here since different psychiatrists
examined the males and the females" (p. 37). The diagnostic
classifications were:

Diagnostic Classification M F
(n = 81) (n = 30)
Percent
Organic Diagnosis 1 0
Psychosis 0 7
Neurosis 1 10
Psychophysiologic 3 0
Personality Disorder 77 66
Sociopathic l7 3
Drug Abuse Only 0 14

 

d'Orban (1970)

66 imprisoned female heroin addicts

Seventeen percent of this addict sample had a history of psychiatric
inpatient treatment prior to addiction; 50 percent had a history of
psychiatric hospitalization since addiction. There were no psychotic
diagnoses; the most frequent diagnosis was personality disorder, usually
precipitated by a suicidal gesture or transient amphetamine psychosis.
The author reports the most striking finding to be "disturbed psycho-
sexual development" among the sample as evidenced by 48 percent
reporting themselves to be homosexual, with few expressions of conflict
concerning this. The author concludes that ”the women in this study
showed more severe psychiatric abnornality" than a similar sample of
male addicts obtained in another study.

 

£9

REVIEW OF STUDIES NOTING PSYCI-DLOGICAL CHARACTERISTICS OF FEMALE DRUG ABUSERS
(continued)

 

STUDY

Heller and
Mordkoff
[1972)

Waddell, Snith,
and Stewart
(1972)

Sutker and
Moan (1972)

SAMPLE

67 young male and female nonaddicted
polydrug abusers in a nonresidential
treannent program

n of 42 males
n of 25 females

31 black methadone maintenance
clients

n of 13 males
n of 8 females

59 fenales in three groups:

a. Prisoners with a history of
heroin addiction (n = 17)

MAJOR FINDINGS CONCERNING PSYCPDLOGICAL CHARACTERISTICS OF FEMALE
DRUG ABUSERS

The group form of the NWWI was administered and scored for 14 standard
and the following special scales: Welsh's first and second factor,
manifest anxiety, ego strength, and dominance. No significant
differences were found among these scores.

Form R of the IWPI was administered upon admission to a methadone
maintenance program and again 5 months later. Both males and females
showed an elevation of the Hypomania scale after methadone. The
authors interpret this as a suggestion that methadone maintenance
causes a further increase in the overt behavior and restlessness of

the addict. Sex differences were noted on two scales. First, the
Hypochondriasis scale, where females showed a marked increase between
the two testing periods, whereas the mean score for males decreased
slightly. This finding was interpreted as suggesting that the side
effects of methadone may persist longer in fenales than males, causing
them some difficulty in coping with bodily functions. The second scale
in which sex differences were noted was the Paranoia scale where fenales
scored consistently higher than the males. This was interpreted to
indicate that females showed 'touchy,‘ more sensitive responses to
their environment” (p. 436).

All 55 were administered a large battery of psychological tests
including the group form of the Nhfld. Fourteen NBPI scales were
scored; the 10 standard clinical scales. 3 validity scales, and
the Welsh A scale. Among the 3 groups, prison addicts and

 

{,9

Table 24

REVIBV 0F STUDIES WING PSYGDLOGICAL GiARACI'ERIS‘l‘ICS 0F FEMLE DRUG ABUSERS

(continued)

 

SIUDY

SAMPLE

MAJOR FINDINGS CONCERNING PSYCHOLOGICAL G‘IARACI'ERISTICS OF FEMALE
DRUG ABUSERS

 

Sutker and
Moan (1972)
(continued)

Prisoners with no history of
heroin addiction (n = 23)

Street addicts applying to the
Narcotic Addict Rehabilitation
Act Program (NARA) (n = 19)

NARA heroin addicts responded on the PMPI in a more deviant fashion on every major
clinical scale. Their elevations were particularly dramatic on the F, Psychopathic
deviate, and Hypomania scales. Classification of the 55 on the basis of WWI

profile types suggested that while 48 percent of the nonaddicts were "normal," only
18 percent and 21 percent of the prison and NARA addicts, respectively, could be so
labeled. It was suggested that the addict profiles reflected "pronounced acting out
potential, disregard for cultural norms, a tendency toward irrational expression of
unwlses, as well as marked sociopathy" (p. 112). It was noted that these antisocial
features were well documented as features in the personality of male heroin addicts.
Finally, it was pointed out that the imprisoned heroin addicts, for all their
potential for social deviance, were incarcerated for relatively minor offenses in
comparison to the nonaddict prison group. It was suggested that tendencies of
addicted women toward "extreme forms of behavior deviance . . . are likely diverted,
redirected and tempered by a ccmplex interaction of subgroup pressures" (p. 112).
Reasons suggested for this relative lack of extreme behavior deviance are that the
behavior of the female addict is often determined by the male addict, who is expected
to carry out the violence, the effects of the narcotics themselves, and the existence
of other outlets for social deviance such as sexual promiscuity (especially
prostitution), fighting, and arguing with other female addicts and vicarious
participation in violence by provocation of the male partner.

 

99

Table 24

REVIEW OF STUDIES NOTING PSYCHOLOGICAL CHARACTERISTICS OF FEMALE DRUG ABUSERS

(continued)

 

 

STUDY SAMPLE MAJOR FINDINGS CONCERNING PSYCHOLOGICAL CHARACTERISTICS OF FEMALE
DRUG ABUSERS
Miller, 274 male and female consecutive Rokeach's value ranking task (Value Survey) was administered;
Sensenig, analysis of sex differences obtained indicated that males placed
Stocker and n of 212 males more emphasis upon values related to achievement and competence
Campbell n of 62 females while females place more emphasis upon values related to
(1973) interpersonal and intrapersonal sensitivities. On this basis

the authors suggest that . . . “In sum, differences in values be-
tween male and female addicts more directly reflect differences
found between the sexes generally rather than reflecting
differences attributable to the drug abuse experience" (p. 596).
A difference was found, however, on the values "cleanliness”

and “self-respect,” both of which females valued more highly
than males. The authors interpret this in the context of the
”common life experiences of female drug addicts" where feelings
of "dirtiness and worthlessness" may be engendered by the female
addict's "activities which are particularly inconsistent with
female role definition in our culture."

 

Cryns (1974)

70 male and female methadone
maintenance clients

n of 51 males
n of 19 females

The Shostrom Personal Orientation Inventory (P01), 3 measure of
positive mental health rather than of clinical defect, was
administered. No real differences in personality profile were
found between males and females, with the exception that females
were significantly more "sensitive anotionally" than males.

 

Kilmann
(1974a)

84 hospitalized female heroin
addicts and 176 "normal" females

The Adjective Check List, 300 commonly used adjectives forming
24 scales and based upon Murray's need trait system, was
administered to both the addict and the "normal" groups.

The addict group described themselves as being less defen-
sive, self-controlled, personally adjusted, oriented to

 

99

Table 24

REVIEW OF STUDIES NOTING PSYCHOLOGICAL CHARACTERISTICS OF FEMALE DRUG ABUSERS

(continued)

 

STUDY

SAMPLE

MAJOR FINDINGS CONCERNING PSYCHDUJGICAL CHARACTERISTICS OF FEMALE
DRUG ABUSERS

 

Kilmann
(1974a)
(continued)

achievement, dominant, enduring, orderly, nurturant and deferent
and more unfavorable, labile, heterosexual, exhibitionistic.
autonomous, aggressive, succorant, and attracted to novel
experiences than the control group. These results are collectively
interpreted to suggest that ". . . the female addict engaged in
nmnature social interactions . . . their reported competitiveness,
aggressiveness, indifference to the concerns of others and lack of
control over hostile impulses coupled with their self-centered
orientation suggests that the addict's problens in living can be
attributed to the impersonal and immature quality of their
interpersonal interactions” (p. 486).

 

 

Kilmann
(1974b)

84 hospitalized female heroin
addicts

The Personal Orientation Inventory was administered to measure
personality characteristics associated with "positive mental
health." Compared with a ”normal” sample (obtained in another

1 study) the addicts were found to be less effective in their use

of time, less satisfied with their lives and selves, more skeptical
of man's goodness, their feelings, and better able to develop
meaningful relationships with others than the control grOLp.

 

DeLeon
(1974)

208 male and female residents of a
drug free residential program

148 males
60 females

Five instruments (seven scales) were selected to assess psycho-
pathology and administered: Internationalization—Externalization
(I-E), Schizophrenia Scale (55), Beck Depression Inventory (BDI),
Manifest Anxiety Scale (MAS), and three Miltiple Affect Adjective
Checklists (Anxiety, Depression, and Hostility). Both male and
female mean scores were comparable with psychopathological groups
reported in the literature. However, with one exception

 

L9

Table 24

REVIEW OF STUDIES NOTING PSYCHOLOGICAL CHARACTERISTICS OF FEMALE DRUG ABUSERS

(continued)

 

STUDY

SAMPLE

MAJOR FINDINGS CONCERNING PSYCPDLOGICAL CHARACTERISTICS OF FEMALE
DRUG ABUSERS

 

DeLeon (1974)
(continued)

(Hostility), mean scale scores for females were higher than those
of males and significantly so for four of these scales (BDI, MAS,
and Anxiety and Depression). Further, the author notes that "the
fanale data point to the possibility that for women, especially
white and Spanish, addiction may relate to or express a more
serious and complex psychological disturbance” (p. 150). Females'
scores were consistently elevated in comparison to males at every
stage of time spent in the program, although a significant decrease
in psychopathological signs with time spent in residence was found
for both males and females.

 

Ross and
Berzins
(1974)

395 female patients at the NIMH
Clinical Research Center

The Lexington Personality Inventory, a questionnaire consisting of
a) 600 true/false statements describing various facets of the addict
personality and b) the clinical and validity scales of the bIPI,
was administered. All mean profiles showed considerable elevation.
with only the Hypochondriasis scale consistently below a t score of
60 and the Psychopathic deviate score consistently equal to or
greater than a t score of 70. These high Pd scale scores were
interpreted to reflect anger, rebelliousness and resenUnent on the
part of these women; other indicators of Wnore severe pathology"
were seen in high scale scores on Depression, Schizophrenia, and
Psychasthenia (t scores over 65) as well as discontent with

current levels of functioning (F greater than K). The results of
the study suggests that"the mean.NWPI profile of female narcotics
addicts at the Lexington Clinical Reserach Center . . . indicates
an active, aggressive, immature type of personality which is also
associated with heavy drinking or abuse of drugs" (p. 783).

 

Table 24

REVIEW OF STUDIES NOTING PSYCfDLOGICAL CHARACTERISTICS OF FEMALE DRUG ABUSERS

 

 

89

(continued)
STUDY SAMPLE MAJOR FINDINGS CONCERNING PSYCHOIDGICAL CHARACTERISTICS OF FEMALE
DRUG ABUSERS
Arnon, 61 male and female Methadone Witkin's Rod and Frame Test, a measure of field dependence, was
Kleimman and Maintenance Clients administered. Both field—dependent and field-independent cognitive
Kissin (1974) styles are hypothesized to be associated with separate clusters of
30 males personality characteristics. For example, field-dependent
31 females individuals are thought to "depend on their surrounding environment
for structure and support, . . . have difficulty dealing analytically
with the world around them and characteristically react to it in a
passive manner . . . have a poor sense of separate identity, a

relatively primitive, undifferentiated body image, poor control
over impulses, and a tendency to use more primitive defenses such
as denial and repression" (p. 152). Alternatively, field
independence is considered to be "characterized by activity and
independence . . . better impulse control, higher self-esteem,

a more mature body image with a well developed sense of separate
identity and more differentiated defenses based on isolation and
intellectualization" (p. 152). Results indicated that the total
addict group, including males and females, was significantly more
field dependent than a group oanormal" subjects in another study.
Comparison of male and female addicts indicated that females were
significantly more field dependent than males. Female addicts
were also significantly more field dependent than the female
control group; the male addict and male control group did not
significantly differ on field dependence.

 

Gossop (1976) 55 male and female drug dependent Self-ideal discrepancy scores, a measure of self—esteem, was
clients of a London Drug Dependence administered to the addict experimental group and a small,
Unit nonaddict, control group comprised of 8 males and 8 females.

There was no difference between male and female controls

 

69

Table 24

REVIEW OF STUDIES NOTING PSYCI-DIDGICAL CHARACTERISTICS OF FINALE DRUG ABUSERS

 

 

(continued)
STUDY SAMPLE MAJOR FINDINGS CONCERNING PSYCIDIDGICAL CHARACTERISTICS OF FEMALE
DRUG ABUSERS
Gossop (1976) 32 males on self—esteem; female addicts, however. tended to evaluate themselves
(continued) 23 females

less favorably in relation to their ideal selves than male addicts.
This finding is interpreted as providing some support for the View
that female addicts may be more generally disturbed than male addicts.

02.

Table 25

GENERAL CONCLUSIONS REGARDIMS OVERALL PSYCHOMXHCAL FUNCTIONING OF
FEMALE vs. MALE DRUG ABUSERS

 

 

FEW DIFFERENCES FEMALES FUNCTION FEMALES FUNCTION
BEIWEEN MALE AND FEMALE “DRSE THAN BETTER THAN NO MALE/FINALE
1"UI‘KITI01NIIING1 MALES MALES (DMPARISON
Olson (1964) d'Orban Sutker and Moan
(1970) (1972)
Chein (1964) Waddell et a1. Kilmann
(1972) (1974a)
Ellinwood et al. DeLeon Kilmann
(1966) (1974) (1974b)
Heller and Mordkoff Arnon et a1. Ross and Berzins
(1972) (1974) (1974)
Miller et al. Gossop
(1973) (1976)

Cryns (1974)

 

1This category includes those studies in which males and females may have different diagnoses or NMPI elevations but do not essentially
differ in their overall functioning, although both may be functioning poorly.

4. Conclusions

This report on the characteristics of female
drug abusers is based on a structured effort
to identify, collect, and assess all of the
available data sources on drug use patterns,
demographic descriptors as reflected in
national and local drug treatment data sys-
tems, treatment and nontreatment studies,
and psychological descriptions from published
and unpublished literature.

The data on both female and male drug abus-
ers were examined to determine if there are
sex-specific drug use patterns, demographic
variables, and psychological characteristics;
to look at trends; and to permit further anal-
yses to explore significant differences be-
tween females and males. A summary of find-
ings identified by data source follows.

The national household surveys (Abelson and
Atkinson 1975; Abelson and Fishburne 1976)
indicate that for adults (18 and over):

0 For "current use of illicit drugs" there
are no significant differences between
males and females, except for marihuana
(current use for males is substantially
higher). The illicit drugs listed are her-
oin, cocaine, other opiates, hallucinogens,
inhalants, marihuana, and hashish:

o The prevalence (defined as "ever used")
of use of all of the illicit drugs is signifi-
cantly higher for males than for females.

For youth (12 to 17), the national survey indi—
cates:

0 Females and males report similar "current
use“ patterns of heroin, cocaine, mari-
huana, and hashish, but females report
significantly less use of inhalants than
males;

0 The prevalence of nonmedical use of psy-
chotherapeutic drugs between 1972 and
1976 indicates that the percentage of use
among females is increasing at the same
rate as it is among males.

The following are highlights of the treatment
data:

71

Within CODAP, there is a greater percent-
age of women in programs under age 25
than there are women in programs 26 and
older. No such differences are seen for
males;

For both males and females, there are sig—
nificantly more whites than blacks in treat-
ment (in CODAP, Polydrug, DAWN) with
the exception of the DARP data system
where the pattern is reversed;

Black females are more likely to be seen
in drug abuse treatment programs (CODAP,
DARP); and white females are more likely
to be seen in emergency services (DAWN-
emergency/crisis center);

In the over-30 age group, more females
than males report to emergency rooms and
crisis centers for treatment; yet for this
same age group, more males than females
are being treated in established drug treat—
ment programs (CODAP, DAWN);

More females than males had emergency
room contacts between April 1974 and April
1975 due to drug—related problems
associated with the use of barbiturates,
amphetamines, tranquilizers, alcohol,
nonbarbiturate sedatives and nonnarcotic
analgesics (DAWN);

Females were more than twice as likely to
come to emergency rooms because of crises
associated with the use of tranquilizers

than from difficulties associated with the
use of any other drug (DAWN);

Males under 30 are more likely than females
to report to hospital emergency and crisis
centers for problems associated with the
use of heroin, methadone, cocaine, alcohol,
and inhalants (DAWN);

Females under 30 are more likely than
males to report to hospital emergency rooms
and crisis centers for problems associated
with use of over-the-counter drugs
(DAWN);

Within the medical examiner facilities,
females 36 and older are more than twice

as likely as males of same ages to suffer
drug-related deaths (DAWN);

Males between ages 21 and 30 are more at
risk for drug—related deaths than females
of the same age;

The percentage of males using heroin ex-
ceeds the percentage of females using
heroin in all national data systems; how-
ever, reports of heroin use as a primary
drug may be increasing some-what more
rapidly for females than males in treatment
(e.g., CODAP reported female use of
heroin in 1974, 50 percent; 1976, 58 per-
cent; male use of heroin in 1974, 60 per-
cent; l976, 63 percent);

Exploring reports of marital status in indi-
vidual programs, i.e., in local systems,
both female and male clients are likely to

72

be single; with females more likely to be
separated than males;

There is little difference in the educa-

tional status of females and male clients--
the majority of both client groups have

not completed high school;

Consistently fewer female clients are
employed than male clients (across national
and local data systems);

Female clients are more likely to receive
welfare and be dependent on others than
are male clients who are more typically
receiving wages/salaries and engaged in
illegal activities;

Female clients are more likely than male
clients to have responsibility for depend-
ent children.

5. Discussion

The previous sections provide us with infor-
mation concerning the characteristics of female
and male drug abusers according to client
data in national and local drug information
systems, national household surveys, treat-
ment and nontreatment studies, and in some
additional studies of psychological character-
istics. It is clear that, although there is a
great deal of data available, there is still
much to be learned about the characteristics
of female drug abusers.

Drug program data show that men and women
have differing rates of entry into drug abuse
treatment and emergency treatment programs
and that those rates of entry will vary by
age within male and female groups.

Within the female treatment (CODA?) popula-
tion, there are significantly more women in
programs under age 26 than there are women
26 or older. The disparity in these numbers
suggests that either programs are better
geared to the younger female client or that
women's conditions change in some significant
way, limiting their availability for treatment
after age 25. The finding that women in treat-
ment are often responsible for dependent chil-
dren has obvious relevance for this latter
hypothesis. The woman aged 26 and older
then becomes of special concern. Why is
there the drop-off in women entering drug
abuse treatment programing in this age
group? What special programing may be re-
quired to meet this group's special needs?

In addition, the opiate-oriented drug treat-
ment environments would appear inappropriate
for large numbers of drug abusing women
who are seen at hospital emergency rooms
and crisis centers. It will be important to
assess the treatment needs of women over
age 30 who receive emergency' services for:
drug and drug-related problems since that
age group is over-represented in emergency
treatment relative to other female age group-
ings. What types of services are required
once these women are released from hospital
emergency rooms and crisis centers? Are
existing agencies capable of providing the
desired services to this population?

The available demographic data clearly sug-
gest that women generally have different

treatment needs. The employment and
primary source of support data imlicate .that
female clients in all but emergency rooms and
crisis centers are more likely than males to
be unemployed and/or dependent upon others
or welfare for their support. Females have
fewer and more restricted employment oppor-
tunities than males. The data cited here also
suggest a tendency for females to fall into
somewhat lower educational categories than
males. Moreover, females in treatment p10-
grams are more likely than males to be sepa-
rated or divorced, and to have responsibility
for dependent children.

It has been reported that female drug addicts
have more psychological difficulties than male
addicts. However, it should be observed
that methodological problems have been noted
in many of the psychological studies that have
been conducted. Thus, while studies do sug-
gest sex differences between male and female
clients on many of the personality dimensions
investigated, there is a need for more study
in this area to verify and understand differ-
ences.

Based on the data, it appeais that for.g'~“‘.z;,.‘.n
opiate-oriented treatment programs may not
be appropriate for some segment of the female
drug abusing population. It is possible that
more women would be encuui aged [3 pay-fier-
pate in the drug treatment service system if
these services were modified to meet their
needs.

Among the different variables that must be
considered in planning treatment for drug-
abusing women are the following:

1. Age seems to be an important factor to
consider, given the evidence that there
are differ ences between men and women
in drug use patterns and tzeatmeni; needs
at different age ranges.

2. Mental health services may be more appro—
priate for women who require emergency
medical treatment for drug problems.
For example, suicide attempts and ge..--
tures (using drugs) Would be more lil.ely
to require mental health services.

73

Treatment programs for females must put
more emphasis on such services as female-
oriented vocational training, child day
care facilities. assertiveness training.
increased educational support and oppor-
tunity, and social services. Every effort
should be made to assess the availability
of such services in the community.

Treatment programs should consider local atti-
tudes and conditions in attempting to

74

encourage female clients to seek treatment.
Drug treatment programs need to recognize
the particular stigma attached to female drug
abuse and develop innovative ways to serve
females. Appropriate referral strategies need
to be developed for older women who experi-
ence problems with psychotropic drugs. By
doing so, it is possible that greater numbers
of female abusers may feel more inclined to
seek treatment appropriate to their needs.

FOOTNOTES

CHAPTER 1

1The publications referenced did not report prevalence of illicit drug use separately by sex
except for marihuana. We are indebted to Ira Cisin, Ph.D., who provided special tabulations
of the 1975—76 data for use in this analysis.

2Statistical significance is here considered at the 0.05 level.

CHAPTER 2

1Statistical tests are also carried out in one national (Polydrug) and one local (University of
Miami [A]) data set with large n's. These tests are performed in order to demonstrate that,
even with a large number of observations, significant male/female differences are not often
found. Due to the large n's, however, the results of these tests should be regarded with
some caution.

2The DAWN Medical Examiner facilities are not, of course, treatment facilities and, as such, are
not included in the discussion of this table.

3"I‘he results of chi-square tests are: ASA--X =.7 0, d. f. =2, p < 0. 05; New Haven-~X =1. 2,
d..f=2, p.<005; M1arm(A)--X=02 df—Z p>0.05.

4The X2 test for NTA was invalid because the expected frequency was less than 5 for one cell.

5Data were collected on these groups only in the CODAP and DARP systems.

6The results of chi-quuare tests were: NTA--X =0. 032, d. f. =1, p > .05, ASA--X2=4.9, d.f.=?._.

p > 0. 05: Miami-~X2 =0. 9, d. f. =3, p > 0. 05; HERS--X =8. 5, d. f. =5, p > 0. 05; Polydrug--
X=0.8, d.f.=2, p>0.05.

7The chi-square test resuzlts were. NTA--X =2. 0, d. f. =1, p > x.9 0.5 ASA--X2=1. 2, d. f. =,1

p > 0. 05: New Haven--X =1. 4, d. f. =,1 p > 0. 05; Miami (A)-—X =25. 7, d. f. =4, p< 0.001;

HERS-—-X2 =8 4, d. f. =4, p > 0. 05; Polydrug--X =30. 8, d. f. =,4 p < 0. 001.

8Even these small differences may be accounted for by the indication, noted earlier (table 7),

that female clients may be younger than male clients. A greater percentage of females under

18 would tend to suppress the number of females even eligible (by virtue of age) to have com-

pleted 12 grades.

9The chi-square results 2were: NTA--Xz=2.0, d.f.=1, p > 9.05; ASA~-X2=7.0, d.f.=4,

p > 0. 052; Miami (A)—-X =10.8, d.f.=5, p > 0.05; HERS--X =23.5, d.f.=4, p < 0.001; Poly-

drug--X2 =0. 8, d. f. =3, p > 0.05.

1OIt should be noted that the DARP system collected data on several employment-related vari-
ables and reported them as an index entitled "employment record." Included are employment
history based upon type of work, past and present employment in the year previous to treat-
ment entry, and scurce of financial support. High scores on this index report reflect steady
employment in skilled positions, while low scores indicate very poor work histories.

”The results of chi-squart; tests are: NTA---x’=2, d.f.=1, p > 0.05; ASA--x'=o, d.f.=1,

p > O. 05; New Haven—-X2=4. 17, d. f. =1, p < 0.05; Miami (A)--X2=20.2, d.f.=1, p < 0.001.
7

1“The DARP system obtainedinformation regarding a variable entitled "criminal history" which

included, but was not limited to, arrest data.

75

13

14

15
16

17

The chi-Square test results are:

drug--x’=96.1, d.f.=1, p < 0.001.

NTA-—x’=3.48, d.f.=l, p2) 0.05, ASA--x’=0.9, d.f.=1,
p > 0.05; Miami (A)—-x’=50.6, d.f.=l, p < 0.001; HERS-—X =106.8, d.f.=1, p < 0.001; Poly-

It should be noted that a "voluntary" admission is not necessarily voluntary in the sense that

it is an internally self-motivated act.

Legal or family pressure, for example, may result in a

client "volunteering" to enter treatment in the face of less desirable alternatives.

x’=7.9, d.f.=1, p < 0.005.

In 1975 and 1976 the CODAP clients were also asked to identify their tertiary problem drug.
These data, however, are considered by NIDA of insufficient validity to report.

The chi-square results comparing male versus female drug use (table 17) are as follows:

Drug

Heroin

Heroin

Heroin

Heroin

Illegal methadone
Illegal methadone
Illegal methadone
Barbiturates
Barbiturates
Barhiturates
Barbiturates
Amphetamines
Amphetamines
Amphetamines
Amphetamines
Cocaine

Cocaine

Cocaine

Cocaine
Marinuana

Me ”ihuana
Marihuana
Marihiurn
l-lallucinogens
Hallucinogens
Hallucinogens
Other drugs

   
  

Program
NTA

ASA

New Haven
Miami (A)
NTA

ASA

Miami (A)
NTA

ASA

New Haven
Miami (A)
NTA

ASA

New Haven
Miami (A)
NTA

ASA

New Haven
Miami (A)
NTA

ASA

New Haven
Miami (A)
NTA

ASA

Miami (A)
N'I‘A

76

E. d.f. 2

(expected frequency too small)

3.5 1 >.05
4.3 1 <.05
0.1 1 >.05
0.4 1 >.05
1.8 1 >.05
3.3 1 >.05
0.4 1 >.05
1.3 1 >.05
1.4 1 >.05
0.3 l >.05
0.3 1 >.05
0.6 1 >.05
0.3 1 >.05
0.4 1 >.05
0.6 1 >.05
1.1 1 >.05
0.1 1 >.05
4.3 1 >.05
.0 1 >.05
5.3 1 (.05
1.6 1 >.05
93.7 1 <.001
(expected frequency too small)
0.5 1 >.05
6.5 1 <.05

(expected frequency too small)

REFERENCES

Abelson, H., and Atkinson, R. Public Experience with Psychoactive Substances: A Nationwide
Study among Adults and Youth. Princeton, N.J.: Response Analysis Corp., 1975.

 

Abelson, H., and Fishburne, P. Nonmedical Use of Psychoactive Substances. 1975-76 Nationwide
Study among Youth and Adults. Princeton, N.J.: Response Analysis Corp., 1976.

 

 

Allport, G. Traits revisited. American Psychologist, 21:1-10, 1966.

Arnon, D.; Kleinman, M.; and Lissin, B. Psychological differentiation in heroin addicts. The
International Journal of the Addictions, 9(1):151-159, 1974.

Aron, W., and Daily, D. Graduates and splitees from therapeutic community drug treatment pro-
grams: A comparison. The International Journal of the Addictions, 11(1):1-18, 1976.

Baldinger, R.; Goldsmith, B.: Capel, W.C.; and Steward, G.T. Pot smokers, junkies and
squares: A comparative study of female values. The International Journal of the Addiction,
7(1):153-166, 1972.

Ball. J.C. Sex differences in criminality among drug abuse patients in the United States. In:
Gibbins, R.J., et al., eds. Research Advances in Alcohol and Drug Problems. Toronto:
John Wiley, 1976.

Ball, J.C.; Demaree, R.G.; Levine, B.K.; and Newman, J.F. Pretreatment criminality of male
and female drug abuse patients in the United States. Addictive Diseases: An International
Journal, l(4):481-489, 1975.

Barr, H. Memo dated February 21, 1976, “Some Data About Women." Eagleville, Pa.

Baughman, E.E., and Welsh, (3.5. Personality: A Behavioral Science. Englewood Cliffs, N.J.:
Prentice-Hall, 1962.

Bem, D.J., and Allen, A. On predicting some of the people some of the time: The search for
cross-situational consistencies in behavior. Psychological Review, 81:506-520. 1974.

Brown, 8.5.; Gauvey, S.K.; Meyers, M.B.; and Stark, S.D. In their own words: Addicts'
reasons for initiating and withdrawing from heroin. The International Journal of the Addic—
tions, 6(4):635-645, 1971.

Burt, M.R., et al. An Investigation of the Outcomes of Traditional Drug Treatment/Service
Programs. Washington, D.C.: U.S. Government Printing Office, 1977.

Butler, M. A Survey of the Prevalence of Drug Use in Eight North Central Texas Junior
and Senior High Schools. Fort Worth: Institute of Behavioral Research, 1975.

Calahan, 1).; Cisin, 1.11.; and Crossley, H..‘vi. America-.1 Drinking Practices: A National Survey
of Behaviors and Attitudes. Monograph No. 6. New Brunswick, N.J.: Rutgers Center of
Alcohol Studies, 1969.

 

 

Campbell. D.T., and Fiske, D.W. Convergent and discriminant validation by the multitrit-
multimethod matrix. Psycholrwical Bulletin, 56:81-105, 1959.

Campbell, R., and Freeland, J. Patterns of drug use. The International Journal of the Addic-
tions, 9(2):289-3$0, l9‘l‘4.

 

Chambers, C.; Hinesley, R.K.; and Moldmnad, M. Narcotic addiction in fen'nales: A race com-
pariscn. The International Journal of the Arhnctions, 5(20)2257-—278, 1970.

 

77

 

Chapman, L.J., and Chapman, J.P. Illusory correlations as an obstacle to the use of valid
psychodiagnostic signs. Journal of Abnormal Psychology, 74:271—287, 1969.

Chein, I. Narcotics use among juveniles. In: Cavan, R., ed. Readings in Juvenile Delin-
guency. New York: J.B. Lippincott, 1964.

Chein, 1.: Gerard, D.; Lee, R.: and Rosenfeld, E. The Road to H. New York: Basic Books,
1964.

Climent, D.E.; Raynes, A.; Rollins, A.; and Plutchik, R. Epidemiological studies of female
prisoners. II: Biological, psychological and social correlates of drug addiction. The
International Jounral of the Addictions, 9(2):345-350, 1974.

Cooperstock, R. Psychotropic drug use among women. Canadian Medical Association Journal,
115:760—763, 1976.

Cooperstock, R. , and Sims, M. Modifying drugs prescribed in a Canadian city: Hidden prob-
lems. American Journal of Public Health, 61:1007-1016, 1971.

Coughlan, A.J., and Gold, R. Self-destructive behavior in female adolescent addicts. American
Journal of Orthopsychiatry, 44(2):252-253, 1974.

Cronbach, L.J. Five decades of public controversy over mental testing. American Psychologist,
30:1-14, 1975. I

Cryns, A.G. Personality characteristics of heroin addicts in a methadone treatment program:
An exploratory study. The International Journal of the Addictions, 9(2):256—266, 1974.

Cuskey, W.; Moffett, A.; and Clifford, H. Comparison of female opiate addicts admitted to
Lexington Hospital in 1961 and 1967. HSMHA Health Remrts. 86(4):332-40, 1971.

Cuskey, W.; Premkumar, T.; and Sigel, L. Survey of opiate addiction among females in the
U.S. between 1850 and 1970. In: Cohen, 0.: Robinson, 5.: Smart, R.; et al. Psycho-
therapy and Drug Addiction. 1: Diagnosis and Treatment. New York: MSS Information,
1974.

DeLeon, G. Phoenix House: Psychopathological signs among male and female drug-free resi-
dents. Addictive Diseases: An International Journal, 1(2):l35-152, 1974.

d'Orban, P.T. Heroin dependence and delinquency in women--A study of heroin addicts in
Holloway Prison. British Journal of the Addictions, 65:67-75, 1970.

 

Driscoll, C., and Barr, H. "Comparative Study of Drug Dependent and Alcoholic Women."
Paper presented at the 23rd Annual Meeting of the Alcohol and Drug Problems Association
of North America, Atlanta, September 1972.

Duster, T. The Legislation of Morality: Law, Drugs and Moral Judgment. New York: Free
Press, 1970.

Eldred, C., and Washington, M. Interpersonal relationships in heroin use by men and women
and their role in treatment outcome. The International Journal of the Addictions, 11(1):
117—130, 1976.

 

Ellinwood, E.H.: Smith, W.G.; and Vaillant, G.E. Narcotic addiction in males and females: A
comparison. The International Journal of the Addictions, 1:33-35, 1966.

Fejer, D., and Smart, R. The use of psychoactive drugs by adults. Canadian Psychiatric
Association Journal, 1973. p. 18.

File, K.N. Sex roles and street roles. The International Journal of the Addictions, 11(2):263—
268, 1976.

File, K.N.; McCahill, T.; and Savitz, L. Narcotics involvement and female criminality. Addic-
tive Diseases: An International Journal, 1(2):177—-188, 1976.

78

Franks, V., and Vasanti, B., eds. Women in Therapy: New Psychotherapies. New York:
Brunner-Mazel, 1974.

Frederick, C.J.; Resnik, L.P.; and Wittlin, B.J. Self-destructive aspects of hard core heroin
addiction. Archives of General Psychiatry, 28:579-585. 1973.

Gay, G.R. Fifth Annual Conference on Methadone Treatment. Washington, D.C.. March 18,
1973. Journal of Drug Issues, 4(4):342-344, 1974.

Gioia, C., and Byrne, R. Distinctive problems of the female addict: Experiences at IDAP.
In: Senay, E., and Shorty, V., eds. Developments in the Field of Drug Abuse. Proceed-
ifls 1974 of the National Association for the Prevention of Addiction to Narcotics.
Cambridge, Mass.: Schenkman Publishing Co., 1975.

 

Glenn, W.A., and Richards, L.G. Recent Surveys of Nonmedical Drug Use: A Compendium of
Abstracts. Rockville, Md.: National Institute on Drug Abuse, 1974.

 

Gossop, M. Drug dependence and self-esteem. The International Journal of the Addictions,
11:741-753, 1976.

Gottschalk, L.; Bates, D.; Fox, R.: and James, J. Psychoactive drug use. Archives of

General Psychiatry, 25:395-397. 1971.
Guilford, J.P. Personality. New York: McGraw-Hill, 1959.

Harrison, J.A. Results of Administration of a Substance Abuse Questionnaire. Shianassee
County, Mich.: Commission on Alcohol and Drug Education. 1974.

Hays, J.R. The incidence of drug abuse among secondary school students in Houston, 1973.
St. Joseph Hospital Medical Surgical Journal, 9(1):12-17, 1974.

Heller, M. , and Mordkoff, A. Personality attributes of the young, non-addicted drug abuser.
The International Journal of the Addictions, 7(1):65-72, 1972.

Hurvitz, N. Psychotherapy as a means of social control. Journal of Consulting and Clinical
Psychology, 40:232-239. 1973.

Inciardi, J.A., and Chambers, C.D. Unreported criminal involvement of narcotic addicts.
Journal of Drug Issues, Z(2):57-64, 1972.

James, J. Prostitution and addiction: An interdisciplinary approach. Addictive Diseases: An
International Journal, 2(4):601-619, 1976.

James, I.P. Suicide and mortality amongst herion addicts in Britain. British Journal of the
Addictions, 62:391—398, 1967.

Jensen, A.R. Social class, race, and genetics: Implications for education. Harvard Educational
Review, 39:1-23, 1969.

Kamin, L. The Science and Politics of LQ. Potomac, Md.: L. Erlbaum Associates, 1974.
Kaplan, 8., ed. The Inner World of Mental Illness. New York: Harper and Row, 1964.

Kaubin, B.J. Sexism shades the lives and treatment of female addicts. Contemporary Drug
Problems, Winter 1974. pp. 471-484.

Krasner, L., and Ullmann, L.P. Behavior Influence and Personality. New York: Holt,
Rinehart, and Winston, 1973.

Kemp, W., ed. Drug Abuse: Current Concepts and Research. Springfield, 111.: Charles C
Thomas, 1975.

Kilmann, P.R. Self actualization of female narcotic drug addicts. Journal of Clinical Psychology,
30(3):308-310, 1974a.

79

Kilmann, P.R. Personality characteristics of female narcotic addicts. Psychological Reports,
35:485-486. 1974b.

Kleber, H.D. Narcotic addiction-~The current problem and treatment approaches. Connecticut
Medicine, 33(2):113-116, 1969.

Klinge, V.; Vaziri, 11.; and Lennox, K. Comparison of psychiatric inpatient male and female
adolescent drug abusers. The International Journal of the Addictions, 11(2):309-323, 1976.

Knudten, R.D., and Meade, A.C. Marijuana and social policy. Addictive Diseases: An Inter-
national Journal, 1(3):323-351, 1974.

Krug, 5.13., and Henry, T.J. Personality, motivation and adolescent drug patterns. Journal
of Counseling Psychology, 21(5):440-445, 1974.

Lett, C.R., and Ingram, C.R. Progression time to narcotic use in a southwestern addict popu-
lation. The International Journal of the Addictions, 9(2):351-354, 1974.

Levi, M., and Seborg, M. The study of I.Q. scores on verbal vs. academic achievement among
women drug addicts from different racial and ethnic groups. The International Journal of
the Addictions, 7(3):581-584, 1972.

Levine, J. The Nature and Extent of Psychotropic Drug Usage in the United States. Statement
before the Subcommittee on Monopoly of the Select Committee on Small Business, 1969.

Levy, S. , and Doyle, K. Attitudes toward women in a drug treatment program. Journal of
Drug Issues, 4(4):428-434, 1974.

Linder, R.L.: Lerner, 5.12.; and Burke, E.M. Drugs in the junior high school. Parts I and
II. Journal of Psychedelic Drugs, 6(1):43-49 (part I), 51-56 (part II), 1974.

 

Lindesmith, A.R. The Addict and the Law. Bloomington, Ind.: Indiana University Press,
1965.

MacDonald, A.; Walls, R.; and LeBlanc, R. College female drug abusers. Adolescence, 8:189-
196. 1973.

Manheimer, D.; Mellinger, G.; and Balter, M. Psychotherapeutic drug use among adults in
California. California Medicine, 109:445-451, 1968.

Marks, J.; Stauffacher, J.C.; and Lyle, C. Predicting outcome in schizophrenia. Journal of
Abnormal and Social Psychology, 66:117-127. 1963.

Mellinger, G.; Balter, M.; and Manheimer, D. Patterns of psychotherapeutic drug use among
adults in San Francisco. Archives of General Psychiatry, 25:385-394. 1971.

 

Michigan Department of Public Health. Alcohol and Other Drug Use and Abuse in the State of
Michigan. Silver Spring, Md.: Macro Systems, 1975.

Miller, J.S.; Sensenig, J.; Stocker, R.B.; and Campbell, R. Value patterns of drug addicts
as a function of race and sex. The International Journal of the Addictions, 8(4):589~598,
1973.

Mischel, W. Personality and Assessment. New York: John Wiley and Sons, 1968.

 

Mischel, W. Introduction to Personality, 2nd edition. New York: Holt, Rinehart, and Winston,
1976.

Mitchell, K.R.; Kirkby, R.J.; and Mitchell, D.M. Note on sex differences in student drug use.
Psychological Reports. 27:116. 1976.

Moseley, W.H., and Gerould, M.H. Sex and parole: A comparison of male and female parolees.
Journal of Criminal Justice, 3:47-58, 1975.

 

80

Moynihan, D.P. Comment: Jensen not "must reading" in the Nixon cabinet. Journal of Social
Issues, 26:191-192. 1970.

National Institute on Drug Abuse. Client Oriented Data Acquisition Process, National Manage-
ment Handbook. Rockville, Md.: the Institute, 1974.

Newmeyer, J.A. After the aquarian age: Observations on the changing face of heroin addiction
in a San Francisco clinic population. American Journal of Drug and Alcohol Abuse. 1(2):
199-206, 1974.

Olson, R.W. MMPI sex differences in narcotic addicts. The Journal of General Psychology,
71:257-266. 1964.

Parry, H.J. Patterns of psychotropic drug use among American adults. Journal of Drug
Issues, 1:269-273, 1971.

Parry, H.; Balter, M.; Mellinger, G.; Cisin, 1.; and Manheimer, D. National patterns of psy-
chotherapeutic drug use. Archives of General Psychiatry, 28:769-783, 1973.

Petersen, D. Acute drug reactions (overdoses) among females: A race comparison. Addictive
Diseases: An International Journal, 1(2):223-233, 1974.

Peterson, D.R. The Clinical Study of Social Behavior. New York: Appleton, Century, Crofts,
1968.

Poplar, J. Characteristics of nurse addicts. American Journal of Nursing, 69(1):117-119,
1969. ‘

Prather, J., and Fidell, L. Drug abuse among women: An overview. Journal of Drug Issues,
1977.

Raynes, A.E.; Climent, C.; Patch, V.D.; and Ervin, F. Factors related to imprisonment in
female heroin addicts. The International Journal of the Addictions, 9(1):145-150, 1974.

Rosenbaum, M. The World and Career of Women Heroin Addicts. San Fernando, Calif.:
Scientific Analysis Corp., 1973.

Rosenberg, J.; Kasl, 5.; and Berberian, R. Sex differences in adolescent drug use: Recent
trends. Addictive Diseases: An International Journal, 1(1):?3-96, 1974.

Ross, F., and Berzins, J.I. Personality characteristics of female narcotic addicts on the MMPI.
Psychological Reports, 35(2):?79-784, 1974.

Sacher, C.G.; Brown, 3.8.; Greene, M.H.; and DuPont, R.L. "Initiation into Heroin Use."
Unpublished manuscript. no date.

San Mateo County, California. Student Drug Use Survey. San Mateo: Department of Public
Health and Welfare, 1974.

Scott, E.M. The Adolescent Gap: Research Findings on Drug Using Teens. Springfield, 111.:
Charles C Thomas, 1972.

Simon, R.J. Women and Crime. Lexington: D.C. Health and Co., 1975.

Society for the Psychological Study of Social Issues. SPSSI on current I.Q. controversy:
Heredity versus environment. American Psychologist, 24:1039-1040, 1969.

Sowder, B.J., et al. An Investigation of Ways in Which the Treatment Process Affects Women
and Men Drug Abusers Differentially. Washington, D.C.: U.S. Government Printing Office,

1977.

Spencer, C., and Berecochea, J.E. Recidivism among Women Parolees: A Long Term Study.
Research Report No. 47. Sacramento, Calif.: California Department of Corrections, July
1972.

81 9

Steffenhagen, R.; McAree, C.: and Nixon. H. Drug use among college females: Socio-
demographic and social psychological correlates. The International Journal of the Addic-
tions, 7(2):285-303, 1972.

Streit, F.: Halsted, D.; and Pascale, P. Differences among youthful users and nonuserslof
drugs based on their perceptions of parental behavior. The International Journal of the
Addictions. 9(5):?49-755, 1975.

Sutker, P.B., and Moan, C.E. Personality characteristics of socially deviant women: Incarcer-
ated heroin addicts, street addicts, and non-addicted prisoners. In: Singh, J.M.;
Miller, L.; and Lal, H., eds. Drug Addiction: Clinical and Socio-Legal Aspects. Mount
Kisco. N.Y.: Futura Publishing Co., 1972. pp. 107-114.

Swanson, D.W.; Weddige. R.L.; and Morse, R.M. Abuse of prescription drugs. Mayo Clinic
Proceedings, 48(5):359-367, 1973.

Waddell, K.J.; Smith. R.K.; and Stewart, G.T. Changes in MMPI scores of black heroin ad-
dicts maintained on methadone. Proceedings, Fourth National Conference on Methadone
Treatment. New York: National Association for the Prevention of Addiction to Narcotics,
1972. pp. 435-438.

Weissman. J.C.; Katsampes, P.L.: and Giancinti, J.C. Opiate use and criminality among a
jail population. In: Senay. E.. and Shorty. V. , eds. Developments in the Field of Drug
Abuse. Proceedings 1974 of the National Association for the Prevention of Addiction to
Narcotics. Cambridge, Mass.: Schenkman Publishing Co., 1975.

Weppner, R., and Agar, M. Immediate precursors to heroin addiction. Journal of Health and
Social Behavior, 12:10-18, 1971.

Williams, J.E., and Bates, W.M. Some characteristics of female narcotic addicts. The Interna-
tional Journal of the Addictions, 5(2):Z45-256, 1970.

Zahn. M.A. The female homicide victim. Criminology. 13(3):400-415, 1975.

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ALOOHOL. DRUG ABUSE, AND
MENTAL HEALTH ADMINISTRATION
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DHEW Publication No. (ADM) 79-816
Printed 1979 ‘

 

 

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