Because of biological differences between men and women, the same quantity of alcohol consumed over the same time period produces higher blood alcohol levels (BALs) in women than in men. Some alcohol researchers have proposed that quantity and volume measures of alcohol consumption (e.g. usual number of drinks per drinking day and overall amount of alcohol consumed) should be adjusted to reflect these biological differences. To date, no standard adjustment for biological gender differences has been adopted. In this paper, we review the literature on biological and behavioral differences related to alcohol consumption and effects and discuss the implications of these differences in terms of adjusting alcohol consumption measures. Our review suggests that adjusting measures of alcohol consumption to compensate for biological sex differences is most appropriate for research or policy applications involving the short and long-term physiological effects of alcohol in contexts where gender differences in how alcohol is consumed can be assumed to be minimal. In other circumstances, non-biological gender differences relating to alcohol use, such as pace of drinking, may moderate the relationship between alcohol consumption and biological gender differences, making an adjustment less defensible. We also identify areas where more knowledge is needed not only to address the issue of adjusting alcohol measures for gender differences but also to understand better the relationship between alcohol consumption and effects.

This paper reports the findings of a retrospective study designed, primarily, to investigate the predictive accuracy of the Rapid Risk Assessment for Sexual Offence Recidivism (RRASOR); the Static 99 and two models developed in Western Australia, namely the Violent Offender Treatment Program Risk Assessment Scale (VOTPRAS) and the 3-Predictor model on a Western Australian sample of violent and nonviolent sexual offenders. A secondary aim was to establish whether the instruments are equally valid for Indigenous and non-Indigenous, and violent and nonviolent sexual offenders. The data of 538 convicted sexual offenders, who were assessed by the Sex Offender Treatment Program of the Western Australian Department of Justice from 1987 to 2002, were used. The predictor variables were the total scores obtained for each instrument and the outcome variable a conviction in a court for a further sexual offence and, in the case of the VOTPRAS, also a further violent offence. In general the predictive accuracy of the 3-Predictor model was the best, followed by the Static 99, the RRASOR and last, the VOTPRAS. The study provides tentative support for the argument that risk assessment tools that were developed overseas should not be used with Indigenous people without further research and that different assessment tools should be developed for violent and nonviolent sexual offenders respectively.

Survey on Drug Use and Health [2]) are based on household samples that exclude prison and jail inmates, populations known to have high rates of substance use disorders. To estimate the effect of excluding inmates, we present estimates of alcohol and drug use disorders for household and inmate populations and calculate the change in the overall prevalence of substance use disorder when these two populations are pooled.Prevalence estimates for the combined U.S. household and inmate population are weighted averages of the survey-weighted prevalence estimates for the household population, state prison population, federal prison population, and jail population (1,3-5). As seen in Table 1, details about interviewing and how weighted averages and standard errors were calculated are reported (also see the data supplement accompanying the online version of this letter).Including inmates increased overall projected estimates of the number of persons in the United States aged ≥18 years with an alcohol use disorder by 877,000, from 17,580,000 to 18,457,000, a 5.0% increase over the base. Estimates of the number with an illicit drug use disorder increased by 1,043,000, from 4,159,000 to 5,202,000, a 25.1% increase. Overall prevalence of the specific alcohol abuse and dependence disorders increased over the base by 4.2% and 5.9% respectively, and illicit drug abuse and dependence increased by 12.0% and 53.8%.High rates of DSM-IV substance use disorders among inmates combined with a large inmate population means that many persons with alcohol and drug use disorders are missed by major U.S. national general population surveys. The undercount for both alcohol and illicit drug disorders is significant, but proportionately the undercount for alcohol disorders is modest while the proportionate undercount for illicit drug disorders, particularly illicit drug dependence (i.e., addiction), is large. These results likely would be accentuated for substances such as cocaine, methamphetamine, and heroin, which are rare in the household population (2) but common among inmates (4-5). In addition, prevalence rates may be particularly underestimated for men and for those minority populations that are overrepresented in the inmate population. To improve accuracy and cover the full range of cases, the U.S. surveillance system may need to be modified. In addition, further investigation of the effect of incarceration on estimates for specific subpopulations is warranted.

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