The Influence of Gender On Perceived Treatment Need Among a Community Sample of Substance Users

Background and Purpose: Most individuals do not perceive a need for substance use treatment despite encountering problems due to their substance use and meeting diagnostic criteria for substance use disorders. This is a challenge at the local, national, and global level because these individuals are least likely to pursue treatment and their ongoing problematic substance use has larger societal costs and implications. There are also those who perceive a need for treatment and yet do not pursue it. This study aimed to understand which factors increase the likelihood of perceiving a need for treatment for community-based adults who meet diagnostic criteria for substance use disorders in the hopes to better assist with more targeted efforts for treatment recruitment and retention. In particular, it examined the influence of substance use problem severity upon perceived treatment need and the role of gender on this relationship.  The central hypothesis of the study was that gender moderates the relationship between substance use problem severity and perceived treatment need, so that women would be more likely than men to perceive a need for treatment as substance use problem severity increased. This was grounded in the fact that women are more likely than men to hold positive beliefs about seeking help (professional or otherwise) for their problems (Courtenay, 2000a). It is also reflected in the steadily increasing rate at which they have been entering substance use treatment for the past decade as the barriers to care are reduced (SAMHSA, 2010a). Method: The study was a secondary data analysis of the 2010 National Survey on Drug Use and Health (NSDUH) using logistic regression. The weighted sample consisted of a total 20,077,235 subjects. Results of the logistic regression were verified using Relogit software for rare events logistic regression due to the rare event of perceived treatment need among subjects in the sample (<5%) (King & Zeng, 2001a; 2001b). Results indicated that there was a statistically significant main effect of substance use problem severity upon perceived need for treatment, so that as substance use problem severity increased, subjects were more likely to perceive a need for treatment. A statistically significant main effect of female gender upon perceived need for treatment was found, indicating that women in the sample were 1.5 times more likely to perceive a need for treatment. However, the moderating effect of female gender upon the relationship between substance use problem severity and perceived treatment need was not found and men were, in fact, more likely to perceive a need for treatment as problem severity increased. This model was tested while controlling for predisposing and enabling factors such as race/ethnicity, socioeconomic status, and others which could impact perceived need. Conclusions and Implications: This study aimed to contribute to understanding the gender-specific factors leading to perceiving a need for treatment among community substance users in hopes of contributing to the development of gender-specific outreach and recruitment for treatment, as well as targeted messages for public health and prevention.