Background Few studies have focused on Asian Americans and Pacific Islanders (AAPIs), despite indications of increasing substance abuse among AAPIs in recent years. Objectives This prospective longitudinal study examined gender differences among AAPIs in treatment. Methods The study included 567 (177 women, 390 men) AAPI patients drawn from two prior studies, one with 32 community treatment programs in 13 California counties (CalTOP, 3, 9months), and another project including 36 treatment sites in 5 California counties (TSI, 3, 12 months). Baseline and follow-up assessments utilized the Addiction Severity Index (ASI). A subset of patients was assessed at 3 and 9 /12 months (n=106). Results Significant gender-related differences were observed at baseline: fewer women than men were employed or never married. More women were living with someone having alcohol and drug problems. Methamphetamine was the primary drug for women and men, followed by alcohol and heroin. Compared to AAPI men, AAPI women reported greater problem severity in family/social relationships (0.18 vs. 0.11, p<.001), employment (0.68 vs. 0.56, p<0.001), and mental health (0.19 vs. 0.14, p<0.01). Relative to women, AAPI men reported greater treatment satisfaction at the 3-month follow-up. Significant improvements at follow-up were observed in family, alcohol, drug, and legal domains for both genders, and in mental health for men only. Compared to AAPI men, AAPI women demonstrated significantly greater improvements in drug problems (ΔASI=0.07, p<0.05). Conclusions Gender differences revealed in this study suggest a need for a greater treatment focus on psychiatric problems for AAPI women and drug use problems for AAPI men.

Objective To determine mental health service utilization patterns among women treated for substance use disorders (SUD) and identify factors associated with patterns of high mental health service use. Methods Data were provided by 4,447 women treated for SUD in California during 2000–2002 for whom mental health services utilization records were acquired. A latent class model was fitted to women’s high use of services (≥6 services/year over 8 years). Multinomial logistic regression was used to identify predisposing, enabling, and need factors associated with utilization patterns. Results In 8 years after initiating SUD treatment, 50% of women utilized mental health services. High use probability was consistently low for most women (76.9%); for others, however, it decreased immediately following SUD treatment and then increased over time (9.3%), increased immediately following SUD treatment and then decreased (8.7%), or remained consistently high (5.1%). Consistently high services use was negatively associated with marriage (OR 0.60, p<0.05) and employment (OR 0.53, p<0.05) and positively associated with older age (OR 1.04, p<0.001), homelessness (OR 1.68, p<0.05), public assistance (OR 1.76, p<0.01), outpatient SUD treatment (OR 3.69, p<0.01), longer SUD treatment retention (OR 1.00, p<0.01), treatment desire (ORs 1.46, p<0.001), and co-occurring disorder diagnosis (ORs 2.89–44.93, p<0.001). Up to 29% of women with co-occurring mental health disorders at SUD treatment entry did not receive any mental health treatment in the subsequent 8 years. Conclusions Mental health services utilization patterns among women treated for SUD are hetereogeneous and dynamic. Understanding factors related to women’s utilization patterns may aid efforts to optimize care and ensure appropriate use of mental health services.

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