• Participants were recruited from 6 drug free, psychosocial
treatment (PT) and 5 methadone maintenance (MM) programs
(N = 628) participating in a NIDA Clinical Trials Network (CTN)
randomized clinical trial (RCT) of an employment intervention.
• All subjects completed Addiction Severity Index (Lite) as part
of baseline.
• Males and females with and without physical and sexual abuse
(lifetime) were compared on a variety of medical & psychiatric
measures with chi-square analyses.
• Inclusion criteria:
- 18 years of age or older
- Met DSM-IV criteria for Substance Abuse/Dependence
(lifetime)
- Reported unemployment or < 20 hrs work in any week of
prior month
- Completed at least 30 days of treatment at baseline
assessment
Introduction
Reported Lifetime Abuse
References
Acknowledgements
Method
Substance Use Disorders (N = 628)
Discussion
•Unemployment is a chronic problem in drug dependentindividuals.1,2,3
•Job Seekers’ Workshop (JSW) program was developedspecifically for drug dependent individuals and has demonstratedefficacy across several well-designed studies1,2,3
•Through the NIDA CTN, the efficacy of JSW was studied in amuch larger and more heterogeneous sample of drug dependentindividuals.
•Since rates of physical and sexual abuse in persons withSubstance Use Disorders (SUD) vary greatly across studies, thisstudy offers a large, relevant sample to examine.
1Hall, SM, Loeb, P, Coyne, K, et al. (1981). Increasing employment
in ex-heroin addicts I: Criminal justice sample. Behavior Therapy,
12, 443-452.
2Hall, SM, Loeb, P, LeVois, M, et al. (1981). Increasing employment
in ex-heroin addicts II: Methadone maintenance sample. Behavior
Therapy, 12, 453-460.
3Hall, SM, Loeb, P, and Norton, J. (1977). Improving vocational
placement in drug treatment clients: A pilot study. Addictive
Behaviors, 2, 227-234.
This research was supported by a grant from the NationalInstitute on Drug Abuse (NIDA) Clinical Trials Network(CTN) (Mid-Atlantic Node).
Purpose
Demographics (N = 628)
Inclusion Criteria
• To examine prevalence rates in a diverse sample of men and
women with SUDs and their medical/psychiatric correlates with
the goal of informing clinical practice.
Gender Differences in Physical/Sexual Abuse in Outpatients with SUDs:Correlates with Medical and Psychiatric Symptoms
L. Islam1, A. Sepulveda1, A. Alvanzo2, L. Keyser-Marcus1, T. Reickman3, M. Stitzer2, and D. Svikis1
1Virginia Commonwealth University, Richmond, VA; 2Johns Hopkins School of Medicine, Baltimore, MD;3Oregon Health and Science University, Portland, OR
• Women with SUDs report physical and sexual abuse at rates
double those of men with SUDs.
• History of physical and sexual abuse was associated with
increased rates of depression and trouble controlling violence in
both genders.
• Men with physical abuse were more likely to present for
treatment with a chronic medical problem.
• The constellation of problems suggests both men and women
with histories of abuse would benefit from psychiatric evaluation
and ancillary intervention services.
Variable
PT
(N=327)
MM
(N=301)
p-value
Gender
(% female)
46.2
60.8
0.01
Race
(% white)
54.7
25.9
0.01
Age
(mean yrs)
38.8
43.7
0.01
Disability
(%)
8.6
23.3
0.01
Variable
PT
(N=327)
MM
(N=301)
p-value
Alcohol
83.8
54.5
0.01
Marijuana
64.5
41.2
0.01
Stimulants
33.0
10.3
0.01
Opiates
39.5
96.4
0.01
Statistical Summary
• Women reported higher rates of physical (60.9%) and sexual
(47.9%) abuse (lifetime) than men (24.7% and 12.5%,
respectively, both p<.001).
• Men and women with physical abuse were more likely to
report recent depression (.008<p<.001); lifetime depression
(.002<p<.001) and trouble controlling violent behavior
(lifetime) (p<.001).
• Men with physical abuse were more likely to report chronic
medical problems (73%) than men without abuse (51%)
(p<.001).
• Chronic medical problem rates were comparable for women
with and without abuse.
• Similar patterns were seen for men and women with and
without a sexual abuse history. Those with sexual abuse
reported higher rates of recent and lifetime depression and
trouble controlling violence (lifetime).
• Rates of chronic medical problems were comparable for
all groups.
Chronic Medical Problems
