C Timko, Center for Health Care Evaluation; EG Connell, Center for Health Care Evaluation; RH Moos, Center for Health Care Evaluation

Objectives: The purpose of this study was to compare initially untreated women and men problem drinkers on (1) the type and amount of help they received over an 8-year follow-up period; (2) associations between type of help and 8-year drinking and functioning outcomes; and (3) associations between amounts of help and outcomes at 8 years.

Methods: Study participants were 466 (49% women) problem drinkers who had not received prior formal treatment for problem drinking and were followed at 1 year and 8 years. Primary outcomes were drinking patterns and problems and functioning. Participants' reports placed them into one of four groups at 8 years: no-help; help from AA only; help from formal treatment only; and help from formal treatment plus AA.

Results: There were few differences between women and men during Year 1 or Years 2-8 on the proportions who sought formal inpatient or outpatient care or participated in AA, or on how much help they received in any modality. Although women were worse off than men at baseline on drinking and functioning, at 1 and 8 years (when baseline status was accounted for), women were better off (e.g., were more likely to be abstinent and to have no drinking-related or legal problems). Interactions of gender by type or amount of help on outcomes were generally not significant.

Conclusions: Women demonstrated better drinking and functioning outcomes over 8 years than did men, despite findings that women and men differed little on the types and amounts of help they received. Women and men were comparable on the extent to which they benefitted from AA only, formal treatment only, or formal treatment plus AA, or improved without any help.

Impact: These findings suggest that problem drinking women and men do not benefit differentially from the various kinds or levels of services we examined. They indicate that factors outside of treatment, such as ongoing family and work contexts and personal factors, may influence women and men's drinking and functioning outcomes and should be considered in evaluations of the course of substance abuse.