A Research Agenda for Gender and Substance Use Disorders in the Emergency Department

Choo, Esther K.; Beauchamp, Gillian A.; Beaudoin, Francesca L.; Bernstein, Edward; Bernstein, Judith; Bernstein, Steven; Broderick, Kerryann B.; Cannon, Robert D.; D’Onofrio, Gail; Greenberg, Marna Rayl; Hawk, Kathryn; Hayes, Rashelle B.; Jacquet, Gabrielle A.; Lippmann, Melanie J.; Rhodes, Karin V.; Watts, Susan; Boudreaux, Edwin D.

doi:10.1111/acem.12534

Cited by 11 publications

(15 citation statements)

References 88 publications

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“…9 Apart from this study, little is known about sex-specific differences in the patterns of substance use and need for interventions among ED patients. This knowledge deficit about substance use related to sex was highlighted as a research priority at the 2014 Academic Emergency Medicine consensus conference “Gender-Specific Research in Emergency Care.” 10 …”

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confidence: 99%

Sex Differences in Substance Use Among Adult Emergency Department Patients: Prevalence, Severity, and Need for Intervention

Beaudoin

Baird

Liu

et al. 2015

Academic Emergency Medicine

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Background Substance use is prevalent among emergency department (ED) patients, and sex has been implicated as an important factor in the etiology, pathophysiology, sequelae, and treatment of substance use disorders. However, additional information is needed about the epidemiology of substance use as it relates to sex among ED patients. Objectives This study examined sex differences in the prevalence and severity of self-reported tobacco, alcohol, and drug use among adult ED patients. Methods A random sample of English- or Spanish-speaking, non–critically ill or injured, 18- to 64-year-old patients was approached at two urban EDs and asked to self-report their lifetime and past 3-month tobacco, alcohol, and drug use. Participants completed the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) using an audio computer-assisted self-interview. Participants were categorized by their substance severity (ASSIST score) and need for a brief or more intensive intervention per World Health Organization recommendations. Substance misuse prevalence, frequency, severity, and need for interventions were compared between sexes by substance category. Multivariable logistic regression models were used to examine the association between sexes and the need for intervention after adjusting for sociodemographic characteristics. Results Of the 6,432 participants in the study, the median age was 37 years (interquartile range = 26 to 48 years), and 56.6% were female. Overall, lifetime, and past 3-month use was higher for men across all substances (tobacco, alcohol, and drugs). Among those reporting past 3-month use, the frequency of use was similar between sexes for tobacco and all drugs, but men reported more frequent alcohol use. Men had higher mean ASSIST scores compared to women, 30.3 (standard error [SE] ± 0.8) vs. 21.1 (SE ± 0.5); mean difference 9.2 (95% confidence interval [CI] = 7.4 to 10.9). The need for any intervention (brief or intensive) was similar between sexes for tobacco and drugs. After sociodemographic factors were adjusted for, women were less likely than men to need any intervention for alcohol (odds ratio [OR] = 0.6; 95% CI = 0.4 to 0.8), but not other substances: tobacco (OR = 0.9; 95% CI = 0.6 to 1.3), marijuana (OR = 0.8; 95% CI = 0.6 to 1.1), or other drugs (OR = 1.1; 95% CI = 0.7 to 1.7). Conclusions Although men have a higher overall prevalence of substance use, the frequency and severity of use were similar for men and women for most substances. After other characteristics were adjusted for, sex appears associated with the need for interventions for alcohol, but not tobacco, marijuana, or other drugs.

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confidence: 99%

Sex Differences in Substance Use Among Adult Emergency Department Patients: Prevalence, Severity, and Need for Intervention

Beaudoin

Baird

Liu

et al. 2015

Academic Emergency Medicine

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“…Although many screening, brief intervention, and referral to treatment studies have been completed in the ED, this novel intervention acknowledges the complex interplay between IPV and drug use for women with substance use disorders. Because programs for targeted, at-risk populations have little precedent in the acute care setting (Choo, Beauchamp, et al, 2014), in-depth interviews with participants were a critical component of selecting the content and format of the intervention and, working within the planned theoretical framework, strengthening the aspects of the intervention that the women themselves prioritized.…”

Section: Discussionmentioning

confidence: 99%

“I Need to Hear From Women Who Have ‘Been There’”: Developing a Woman-Focused Intervention for Drug Use and Partner Violence in the Emergency Department

et al. 2016

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Objective Addressing violence and linking women to community services in parallel with drug change goals is critical for women with coexisting intimate partner violence (IPV) and substance use disorders (SUD). Our objective was to develop a Web-based intervention to address violence and drug use among women patients in the ED. Methods The intervention was developed in a five-step process: 1) Initial intervention development based on selected theoretical frameworks; 2) In-depth interviews with the target population; 3) Intervention adaptation, with iterative feedback from further interviews; 4) Beta testing and review by an advisory committee of domestic violence advocates; 5) Acceptability and feasibility testing in a small open trial. Results Themes supported the selection of MI and empowerment models but also guided major adaptations to the intervention, including the introduction of videos and a more robust booster phone call. Participants in the open trial reported high scores for satisfaction, usability, and consistency with essential elements of motivational interviewing. Conclusions This qualitative work with our target population of women in the ED with SUD experiencing IPV underscored the importance of connection to peers and empathetic human contact. We developed an acceptable and feasible intervention distinct from prior ED-based brief interventions for substance-using populations.

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“…This last step departs from the procedure for the Gender and Substance Use Disorders paper, as there was not sufficient time for participants to vote for the violence subset in person. 6 The final voting was on a scale of 1 (low priority), 2 (moderate priority) or 3 (high priority); and all questions with average scores greater than 2 were included.…”

Section: Consensus Processmentioning

confidence: 99%

“…Given the complexity of the relationships between gender, substance use, and violence, this breakout session decided to dedicate a separate discussion and set of research questions specifically examining these interrelated topics, rather than integrating them with the other substance use and gender manuscript. 6 …”

Section: Introductionmentioning

confidence: 99%

The Intersecting Roles of Violence, Gender, and Substance Use in the Emergency Department: A Research Agenda

et al. 2014

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The relationship between gender, violence, and substance use in the emergency department (ED) is complex. This paper examines the role of gender in the intersection of substance use and three types of violence: peer violence, intimate partner violence, and firearm violence. Current approaches to treatment of substance abuse and violence are similar across both genders; however, as patterns of violence and substance abuse differ by gender, interventions may be more effective if they are designed with a specific gender focus.

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A Research Agenda for Gender and Substance Use Disorders in the Emergency Department

Cited by 11 publications

References 88 publications

Sex Differences in Substance Use Among Adult Emergency Department Patients: Prevalence, Severity, and Need for Intervention

Sex Differences in Substance Use Among Adult Emergency Department Patients: Prevalence, Severity, and Need for Intervention

“I Need to Hear From Women Who Have ‘Been There’”: Developing a Woman-Focused Intervention for Drug Use and Partner Violence in the Emergency Department

The Intersecting Roles of Violence, Gender, and Substance Use in the Emergency Department: A Research Agenda

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