Gender differences among Alaska Native people seeking alcohol withdrawal treatment

ABSTRACT

Background: Few studies focus on gender differences among patients who utilize detoxification services; even fewer focus on detoxification for Alaska Native people. This analysis focused on gender differences at admission among a sample of Alaska Native patients seeking alcohol withdrawal treatment. Methods: The sample included 383 adult Alaska Native patients admitted to an inpatient alcohol detoxification unit during 2006 and 2007. Logistic regression was used to estimate unadjusted and adjusted associations with gender. Results: Women were 88% more likely to have stable housing than men (odds ratio [OR] = 1.88, 95% confidence interval [CI] = 1.15, 3.05, P = .01). Women were 87% less likely to be seasonal workers (OR = 0.13, 95% CI = 0.03, 0.48, P = .003) and 50% less likely than men to be seeking employment (OR = 0.50, 95% CI = 0.29, 0.84, P = .01) at admission. Women had more than 5 times the odds of having children in the home at admission (OR = 5.64, 95% CI = 3.03, 10.56, P < .001) and almost 3 times the odds of experiencing physical abuse than men (OR = 2.96, 95% CI = 1.31, 6.66, P = .01). Additionally, women were 50% less likely to accept a referral to substance abuse treatment following detoxification (OR = 0.50, 95% CI = 0.30, 0.83, P = .01). Conclusions: The study found significant differences based upon gender. For instance, women are in need of services that accommodate women with children and services that address histories of physical abuse. Conversely, men are in need of housing and employment opportunities. Post detoxification follow-up, case management, and transition to care should include gender as a factor in treatment planning.

KEYWORDS:

• Alaska Native
• alcohol
• American Indian
• detoxification
• gender

Author contributions

Dr. Running Bear completed the statistical analysis with the direction and guidance of Drs. Beals and Novins. Dr. Running Bear wrote the first draft and Drs. Beals, Novins, and Manson assisted in content development and editing of the final manuscript. All authors contributed to and approved the final manuscript.

Funding

The National Institute for Minority Health and Health Disparities (P60 MD000507, S. M. Manson, Principal Investigator) provided the infrastructural support that facilitated the management and analyses of the data. The authors declare that they have no conflicts of interest.

Notes

^I Alaska Native is intended to include people who originate within the boundaries of Alaska and either identify as Alaska Native or American Indian