Etienne Maffli Swiss Institute for the Prevention of Alcohol and other Drug Problems Lausanne,...

Etienne Maffli

Swiss Institute for the Prevention of Alcoholand other Drug Problems

Lausanne, Switzerland

Characteristics of male and female outpatients

with drug-related problems: The situation in Switzerland

between 1995 and 2003

Data13’585 treatment episodes monitored by SAMBAD between 1995 and 2003 (survey at intake)

(statistics of the ambulatory services for alcohol or drug problems in Switzerland)

• Admissions with opiates, cocaine, stimulants, benzodiazepines, hallucinogens, inhalants or cannabis as main substance of abuse

• Centralised methadone programs and heroin prescription programmes not included

• Inpatients programmes not included

• Free participation of the services

Registered clients at intake

465

688

901969

1083

1368

1622

1420

1252

157269310

405441564621561

489

0

200

400

600

800

1000

1200

1400

1600

1800

1995 1996 1997 1998 1999 2000 2001 2002 2003

male (N=9768) female (N=3817)

N

0

1020

30

40

1995 1996 1997 1998 1999 2000 2001 2002 2003

%

Proportion of female clients in %

28.9 29.525.6

28.1 25.228.1 28.3 27.7 29.2

(overall proportion: 28.1%)

Primary drug: opiates and cocaine

0

10

20

30

40

50

60

70

80

90

100

1995 1996 1997 1998 1999 2000 2001 2002 2003

opiates (male) opiates (female) cocaine (female) cocaine (male)

%

opiates

cocaine

F

M

FM

(male: N=9768; female: N=3817)

Primary drug: cannabis and benzodiazepines

0

10

20

30

40

50

60

70

80

90

100

1995 1996 1997 1998 1999 2000 2001 2002 2003

cannabis (male) cannabis (female) benzos (male) benzos (female)

%

cannabis

benzosF

M

MF

(male: N=9768; female: N=3817)

Primary drug: hallucinogens and stimulants

0

10

20

30

40

50

60

70

80

90

100

1995 1996 1997 1998 1999 2000 2001 2002 2003

hallucinogens (male) hallucinogens (female)

stimulants (female) stimulants (male)

%

hallucinogensstimulants

F

FMM

(male: N=9768; female: N=3817)

Mean age at intake

30.530.3

27.3

28.7

27.9

2726.8

2626.3

29.5

28.728.3

28.6

28.6

28.128

27.6

27

25

26

27

28

29

30

31

32

1995 1996 1997 1998 1999 2000 2001 2002 2003

mean age (female) mean age (male)

age

N=3565 N=9290

Living status (with whom)(1995-2003)

10.9

4.8

8

21.9

5.9

24.5

23.9

12.6

5.1

5.9

15.2

29.4

31.5

0.2

0 10 20 30 40

other

with friends

with partner and child(ren)

with partner (alone)

alone with child

with parents

alone

female (N=3745) male (N=9522)

%

Living status (where)(1995-2003)

6.9

6.6

86.5

8.0

8.2

83.9

0 20 40 60 80 100

in institutions

unstableaccommodation

stableaccommodation

female (N=3742) male (N=9569)

%

Nationality(1995-2003)

4.2

15

80.8

8.8

22.2

69.1

0 20 40 60 80 100

other

EU

swiss

female (N=3707) male (N=9478)

%

4.7

43.0

47.7

4.5

6.0

51.8

38.8

3.4

0 10 20 30 40 50 60

higher level

secondary level

primary level

nevercompleted

primary school

female (N=3479) male (N=8985)

%

Highest educational level completed(1995-2003)

Labor status: regular employment and training

0

5

10

15

20

25

30

35

40

45

50

1995 1996 1997 1998 1999 2000 2001 2002 2003

regular employment (male) regular employment (female)

pupil/student (female) pupil/student (male)

%

regular employment

pupil/student

F

F

M

M

(male: N=9582; female: N=3735)

Labor status: unemployment and economical inactivity

0

5

10

15

20

25

30

35

40

45

50

1995 1996 1997 1998 1999 2000 2001 2002 2003

unemployed (male) unemployed (female)

econ. inactive (female) econ. inactive (male)

%

economical inactivity

unemployed

M

F

F

M

(male: N=9582; female: N=3735)

Source of referral (1995-2003)

6

5.1

7.9

9.4

10.4

9.9

22.3

64.8

6.3

9.6

6.6

6.2

8.9

22

66.2

9.8

0 20 40 60 80

other

court / probation / police

social services

hospital / other medical source

general practitioner

other centre

family / friends

self-referred

female (N=3817) male (N=9768)

%

multiple responses allowed

Ever previously treated

60.362.158.466.4

69 70.1

66.366.7

66.7

57.860.862.1

68.967.4

65.8

69.6

67.567.3

0

10

20

30

40

50

60

70

80

1995 1996 1997 1998 1999 2000 2001 2002 2003

female (N=3672) male (N=9374)

%

Already receiving substitutional treatment

29.728.2

34.437.236.337.8

32.5

37.4

27.32525.3

31.7

37.1

32.131.429.8

37.2

28.6

0

5

10

15

20

25

30

35

40

45

50

1995 1996 1997 1998 1999 2000 2001 2002 2003

female male

%

(male: N=9095; female: N=3593)

Daily use of primary drug (1995-2003)

47.9

14.3

79.3

7.3

33

78

54.8

14.3

87.8

14.6

78.5

33.2

0 20 40 60 80 100

cannabis(N=867;265)

hallucinogens(N=7;7)

benzodiazepines(N=172;174)

stimulants(N=82;55)

cocaine(N=560;221)

opiates(N=5603;2163)

female male%

Age at first use of primary drug(1995-2003)

20.221.3

18.5

23.7

15

19.421.2

18.1

25.6

14.7

0

5

10

15

20

25

30

opiates(N=5823;2218)

cocaine(N=658;243)

stimulants(N=98;61)

benzodiazepines(N=148;143)

cannabis(N=861;261)

male female

mean age

Secondary drugs of clients with opiates as primary drug (1995-2003)

1.1

0.5

10.6

7.3

22.1

21.8

41.1

41.9

0.7

1

11.2

10.4

27.2

43

50.2

20.0

0 10 20 30 40 50 60

other

inhalants

stimulants

hallucinogens

benzodiazepines

alcohol

cocaine

cannabis

female (N=2799) male (N=7348)%

Multiple responses allowed

Secondary drugs of clients with cannabis as primary drug (1995-2003)

1.9

0.3

3.0

6

10.2

8.8

12.1

25.8

0.9

0.9

1.5

8.2

10.5

11.6

26.9

9.2

0 10 20 30 40 50 60

other

inhalants

benzodiazepines

hallucinogens

opiates

cocaine

stimulants

alcohol

female (N=364) male (N=1162)%

Multiple responses allowed

Secondary drugs of clients with cocaine as primary drug (1995-2003)

2.3

1.6

12.7

21.2

19.2

29

46.6

54.1

1.2

1.1

12.4

14.6

37.2

49.5

49.3

21.6

0 10 20 30 40 50 60

other

inhalants

hallucinogens

benzodiazepines

stimulants

alcohol

cannabis

opiates

female (N=307) male (N=893)%

Multiple responses allowed

Secondary drugs of clients with benzodiazepines as primary drug

(1995-2003)

8.6

0

1.6

3.3

10.7

19.3

38.7

29.6

1.5

0.5

5.3

5.3

33

44.2

58.3

25.2

0 10 20 30 40 50 60

other

inhalants

hallucinogens

stimulants

cocaine

cannabis

alcohol

opiates

female (N=243) male (N=206)%

Multiple responses allowed

Currently injecting drugs(past 30 days prior intake)

27.4

23.919.924.2

4037.7 38.3

30.7

35.9

21.422.822.3

30.531.732.1

36.736.635.5

0

10

20

30

40

50

60

1995 1996 1997 1998 1999 2000 2001 2002 2003

female (N=3453) male (N=8651)

%

Opiates or cocaine as primary drug: Injecting as usual route of administration

51.151.7

41.5

40.8

51.8 53.5 51.7 50.253.8

38.3

43.841.4

47.148.7

44.5

49.648.147.5

0

10

20

30

40

50

60

1995 1996 1997 1998 1999 2000 2001 2002 2003

female (N=2639) male (N=6838)

%

Conclusions

• The proportion of female clients (28%) is quite lower than that of male clients and remains stable over time

• Both educational level and socio-economical status are generally less favorable among female clients

• Female clients are more often living with partners and/or children than male clients

• Broadly similar patterns of substance use and route of administration prior treatment intake are observed among male and female clients

• The profile of male and female clients seeking help for benzodiazepine-related problems seems to differ, suggesting a different etiology