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Gender differences among treatment patients of some European countries (Austria, Czech Republic, Greece, Switzerland, The Netherlands). Martin Bush (A), Katerina Kontogeorgiou & Maria Pouloudi (GR), Etienne Maffli (CH), Ton Ouwehan & Wil Kuijpers (NL), Bela Studnickova (CZ) - PowerPoint PPT Presentation
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Martin Bush (A), Katerina Kontogeorgiou & Maria Pouloudi (GR), Etienne Maffli (CH), Ton Ouwehan & Wil Kuijpers (NL),
Bela Studnickova (CZ)
Coordination: Linda Montanari, Paul Griffiths, Colin Taylor (EMCDDA)
TDI 2006 Annual expert meeting, 25-26 September 2006, Lisbon
Gender differences among treatment patients of some
European countries(Austria, Czech Republic, Greece, Switzerland, The Netherlands)
General aims
• assessing gender differences among treatment patients with drug-related problems in 5 European countries by means of TDI data
• comparing the resulting figures with external indicators (general population, drug-related death, police notifications, treatment organisation)
• drawing conclusions about possible differences between male and female clients, particularly with regard to the access to treatment, taking possible country-related disparities into account
Topics investigated with treatment data
overall gender distribution in treatment population (new clients, all clients), and by primary drug
gender distribution by age groups (new clients)
source of referral by primary drug and gender (new clients)
age at first use by primary drug and gender (new clients)
time lag between first use and first treatment by primary drug and gender (new clients)
External indicators
gender distribution in the total population (2003)
drug-related death (DRD) by age and gender (2003)
notifications by the police by age, gender and substance (2003)
share of treatment units participating in the monitoring system offering gender specific intervention (2003)
Proportion of males and females in the general population (2003)
0 50 100
The Netherlands
Switzerland
Greece
Czech Republic
Austria
females males
%
Total treatment demandby gender and by country (2003)
16.6%
17.7%
29.3%
26.3%
31.1%
0 25 50 75 100
The Netherlands
Switzerland
Greece
Czech Republic
Austria
females males
%
First treatment demandby gender and by country (2003)
16.7%
21.4%
24.8%
25.6%
32.8%
0 25 50 75 100
The Netherlands
Switzerland
Greece
Czech Republic
Austria
females males Barres 3 Barres 4 Barres 5 Barres 6
%
Netherlands Austria Switzerland GreeceCzech
Republic
Opiates 3,7 3,0 3,5 5,1 2,2
Cocaïne 4,2 n.a. 2,4 4,0 0,9
Stimulants 2,7 n.a. 0,3 2,7 1,7
Cannabis 4,2 n.a. 4,2 5,3 2,8
Other Substances 1,1 n.a 1,0 2,8 4,1
Total 3,7 3,0 2,9 5,0 2,0
Male to female ratio by primary drug and by country (first treatment demand, 2003)
Drug related deaths by gender and by country according to age groups (2003)
Age < 20 Age 20 - 39 Age > 39 All age groups
m f f% m f f% m f f% m f f%
Austria1 15 5 25 % 97 21 18 % 21 4 16 % 133 30 18 %
Czech Republic2
7 4 36 % 62 13 17 % 64 72 53 % 133 89 41 %
Greece2 12 1 8 % 197 15 7 % 33 1 3 % 242 17 7 %
Netherlands2 0 2 100% 44 14 24 % 35 9 20 % 79 25 24 %
Switzerland3 3 3 50 % 101 31 23 % 43 21 33 % 147 55 27 %
1) Federal Ministry for Health and Women – calculations by Austrian Health Institute; 2) EMCDDA Statistical Table 5; 3) Swiss Federal Statistical Office
Drug-related police notifications by substance and gender in Austria, Switzerland and The
Netherlands (2003)
Opiates Cocaine Cannabis Other drugs
m f f% m f f% m f f% m f f%
Austria 3535 666 16% 1789 332 16% 7698 1313 15 % 3448 671 16%
Switzerland 920 198 18% 1408 171 11% 2462 213 8 % 205 32 14%
The Netherlands
636 174 22% 1686 401 19% 1320 315 19 % 371 201 35%
Drug-related police notifications by substance and gender in Austria, Switzerland and The
Netherlands, age<20 (2003)
Age<20
Opiates Cocaine Cannabis Other drugs
m f f% m f f% m f f% m f f%
Austria 956 205 18% 313 81 21% 3042 632 17 % 801 256 24%
Switzerland 30 9 23% 247 12 5% 529 31 6 % 16 4 20%
The Netherlands
5 0 0% 43 8 16% 85 13 13 % 25 8 24%
Drug-related police notifications by substance and gender in Austria, Switzerland and The
Netherlands, age 20-39 (2003)
Age 20-39
Opiates Cocaine Cannabis Other drugs
m f f% m f f% m f f% m f f%
Austria 2401 437 15% 1277 226 15% 4283 621 13 % 2405 382 14%
Switzerland 737 158 18% 1013 127 11% 1690 153 8 % 156 24 13%
The Netherlands
86 18 17% 434 49 10% 222 19 8 % 60 6 9%
Drug-related police notifications by substance and gender in Austria, Switzerland and The
Netherlands, age >39 (2003)
Age >39
Opiates Cocaine Cannabis Other drugs
m f f% m f f% m f f% m f f%
Austria 178 24 12% 199 25 11% 373 60 14 % 242 33 12%
Switzerland 153 31 17% 148 32 18% 243 29 11 % 33 4 11%
The Netherlands
60 9 13% 81 11 12% 16 0 0 % 7 3 30%
Drug-related police notifications by substance and gender in Austria, Switzerland and The
Netherlands, age >39 (2003)
Age >39
Opiates Cocaine Cannabis Other drugs
m f f% m f f% m f f% m f f%
Austria 178 24 12% 199 25 11% 373 60 14 % 242 33 12%
Switzerland 153 31 17% 148 32 18% 243 29 11 % 33 4 11%
The Netherlands
60 9 13% 81 11 12% 16 0 0 % 7 3 30%
Propoption of females in drug-related first and all treatments, drug-related deaths
and police notifications by country (2003)
25%
33%
17%
26%
21%
29%31%
17%
26%
18%18%
41%
7%
27%
24%
16%
12%
24%
0%
10%
20%
30%
40%
50%
Austria CzechRepublic
Greece Switzerland TheNetherlands
first treatments all treatments drug-related deaths police notifications
Gender distribution according to age groups in
drug-related first treatments by country (2003)
Age < 20 Age 20 - 39 Age > 39 All age groups
m f f% m f f% m f f% m f f%
Austria 117 66 36 % 520 144 22 % 54 18 25 % 691 228 25 %
Czech
Republic1056 748 41 % 1643 580 26 % 63 21 25 % 2762 1349 33 %
Greece 170 59 26 % 1248 239 16 % 167 20 11 % 1585 318 20 %
Switzerland 68 28 29 % 141 44 24 % 18 6 25 % 227 78 26 %
The Netherlands 557 173 24 % 2809 688 20 % 647 230 26 % 4013 1091 21 %
Primary drug at first treatment by gender and by country (2003)
15.9
15.8
28.6
33.5
83.3
84.7
14.7
16.3
36.9
42
26
20.7
0.6
0.3
8.9
6.5
7.8
0.9
62.6
52.1
28.9
32.9
29.9
42.3
11
11.8
19
26
9.4
2.8
7.7
2.6
3.2
1.7
3.1
5.3
1.6
1.3
0.9
0.5
0% 20% 40% 60% 80% 100%
female
male
female
male
female
male
female
male
Th
eN
eth
erl
an
ds
Sw
itze
rla
nd
G
ree
ce
Cze
chR
ep
ub
lic
Opiates Cocaine Stimulants Cannabis Others
Most important source of referral among first treatment patients by gender and country - primary drug: opiates
(2003)
3.6
5.2
0.5
4.6
2.1
7.2
10.8
66
4.1
5.7
0.5
1.6
5.4
9.5
70.7
2.5
0 20 40 60 80
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=194) male (N=441)
CZ GR
4.5
0.8
1.9
1.9
2.3
7.9
56.2
24.5
6.9
1.1
1.4
2
7.1
57.5
22.2
1.7
0 20 40 60 80
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=265) male (N=1324)
0
20
10
5
15.0
0.0
20
30
4.1
11
5.5
8.2
6.8
13.7
35.6
15.1
0 20 40 60 80
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=20) male (N=73)
CH
9.6
9.6
0.9
4.4
5.3
16.7
3.5
50
7
22
1.5
3.5
10.5
2.4
45.8
7.4
0 20 40 60 80
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=114) male (N=459)
NL
Most important source of referral among first treatment patients by gender and country – primary drug: stimulants
(2003)
10.1
2.6
3.7
2.3
2.4
2.8
22.2
54
8.4
4.1
1.6
0.9
2.5
13.2
67
2.3
0 20 40 60 80
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=794) male (N=1374)
Czech Republic
9.2
2.6
1.3
13.2
21.1
5.3
3.9
43.4
11
22.4
0.9
9.1
4.1
4.6
34.7
13.2
0 20 40 60 80
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=76) male (N=219)
The Netherlands
Most important source of referral among first treatment patients by gender and country – primary drug: cannabis
(2003)
CZ GR
10.6
1.6
3.3
1.6
4.1
0.8
37.6
40.4
10.6
4.1
3.1
2.2
2.2
34.7
37.8
5.4
0 10 20 30 40 50
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=245) male (N=688)
2.9
2.9
8.6
0
8.6
5.7
65.7
5.7
4.3
5.9
2.7
2.7
5.9
63.6
14.4
0.5
0 20 40 60 80
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=35) male (N=187)
23.8
0
4.8
14.3
0.0
4.8
28.6
23.8
15.4
15.4
9.9
9.9
5.5
33
9.9
1.1
0 10 20 30 40 50
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=21) male (N=91)
9.3
3.2
1.6
19
13.7
13.3
4.8
35.1
8.2
14
2
10.9
8.2
5.3
37.9
13.6
0 20 40 60 80
other
justice
social services
hospital /medical
GP
other centre
family / friends
self-referred
female (N=248) male (N=1046)
NLCH
%
% %
%
19.8
21.3 21.2
26.2
1919.9
20.7 20.6
12
14
16
18
20
22
24
26
28
CZ GR CH NL
Male Female
18.3
16
17.1 17
12
14
16
18
20
22
24
26
28
CZ GR CH NL
Male Female
15.516.2 16.3
14.815.5 15.6
12
14
16
18
20
22
24
26
28
CZ GR CH NL
Male Female
Opiates Stimulants Cannabis
Age Age Age
Mean age at first use among male and female clients (first treatment) by primary drug
and country (2003)
Time lag between first use and first treatment among male and female clients by primary
drug and country (2003)
4.4
7.4 7.7
11.4
4
5.9 5.7
14.7
0
2
4
6
8
10
12
14
16
CZ GR CH NL
Male Female
6.3
10.1
4.3
3.2
10.4
3.2
0
2
4
6
8
10
12
14
16
CZ GR CH NL
Male Female
3.6
8.1
2.5
6.6
0
2
4
6
8
10
12
14
16
CZ GR CH NL
Male Female
Opiates CannabisStimulants
years yearsyears
Preliminary conclusions I
Females are a minority of the treated population in the five countries, ranging from 16.7% in Greece to 32.8% in the Czech Republic.
The share of female clients is generally higher in low age groups than in older groups (except in The Netherlands), but still smaller than the share of male clients
The gender distribution seems also to vary according the primary drug: the highest share of female clients is observed among stimulant abusers whereas the lowest proportions are generally seen among opiate and cannabis abusers
No cross-cultural and overall gender-specific differences regarding the source of referrals of the clients monitored seem to prevail. The differences observed between the countries seem to be much more prominent than the differences related to the gender
Preliminary conclusions II
Female clients report generally an average younger age at first use than male clients do (except in The Netherlands among stimulant abusers). They are also generally younger at their first treatment demand than male clients
Compared with other sources of data (drug-related notifications and drug-related deaths), the proportion of females is often higher in the treatment data, suggesting that accessibility to treatment facilities is at least equal or even better for females than for males
Also the the observation that female clients generally show a shorter time lag between first use and first treatment than male clients (except for the Netherlands among opiate abusers) corroborates the assumption that access to treatment is not impaired for female substance abusers, compared with males