1	Gender Differences Among Adolescents in Substance Abuse Treatment: Implications for Developing Gender-Responsive Treatment Approaches Christine Grella, Ph.D. UCLA Integrated Substance Abuse Programs
2	Questions How do adolescent males & females differ from adults regarding substance use and associated problems? What do we know about gender differences in substance use among adolescents? What are the implications of gender differences among adolescents related to substance use for developing gender-responsive treatment?
3	Data Sources Population-based epidemiological studies Providers in national treatment system Treatment outcome and clinical studies Studies of youth not in treatment (e.g. homeless youth, JJS, mental health, child welfare) Effective Adolescent Treatment (EAT) Project
4	Treatment for Adolescents Needs to Address Issues Specific to their Development Alcohol and drug use patterns type of substance acute vs. chronic use Pathways into treatment Trauma/abuse exposure & mental health Family, school, peers Social roles and developmental tasks
5	Gender Distribution of Adolescents in AOD Treatment 1992-2002 (TEDS, 2004)
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8	Gender-Responsive Treatment for Youth Addresses gender-specific experiences and their relation to substance use: family background & relationships abuse & trauma exposure criminal involvement mental health physical health peer and social influences sexuality/HIV risk educational status developmentally appropriate tasks & goals
9	Suicidality Among Adolescents in DATOS
10	Comorbid Disorders Among Adolescents in DATOS
11	Types of Abuse Reported by Adolescents in DATOS
12	Depressive Disorder Among Adolescents in DATOS by Gender and Abuse Status
13	ADHD Among Adolescents in DATOS by Gender and Abuse Status
14	Conduct Disorder Among Adolescents in DATOS by Gender and Abuse Status
15	PTSD Among Youth in Drug Treatment (Deykin & Baka, 1997)
16	Gender Differences in Substance Abuse, Mental & Physical Health, and HIV Risk Behavior (Stevens et al., 2003) Among youth in 4 treatment programs, females reported greater problem severity related to: Substance use (lifetime and past year problems) Mental health (general mental distress, depression, somatic symptoms, suicidality, anxiety) HIV risk (health distress, sexual activity, condom use) Health problems (worry about health, pain, breathing problems)
17	Risk Behaviors Among Street Youth in Northern California (Clements et al., 1997) Males and females were equally likely to use injection and non-injection drugs Females were: more likely to be sexually active more likely to have had an STD less likely to use condoms consistently
18	AOD Disorders Among Youth in Juvenile Detention (Teplin et al., 2002)
19	Any AOD Disorder Among Youth in Juvenile Detention (Teplin et al., 2002)
20	Girls Have “Double Dose” of Symptoms (Dakof, 2004) Boys and girls had similar levels of externalizing behaviors, but girls had higher levels of depression and family dysfunction more family conflict less family cohesion
21	Gender and Comorbidity Among Adolescent Drug Users (Rowe et al., 2004)
22	Indicators of Greater Severity Among Girls in CSAT EAT Projects
23	Indicators of Greater Severity Among Girls in CSAT EAT Projects, Continued
24	Delinquent Behavior Among Girls (Ages 12-17)¹ (NSDUH, 2004)
25	Delinquent Behavior Among Girls (Ages 12-17), 2002-2003 (NSDUH, 2004)
26	Is the Gender Gap Among Adolescents Narrowing? Tobacco use among girls is increasing faster than among boys Age of drug use initiation is decreasing among girls Involvement in delinquent and criminal behavior is increasing among girls Conduct and externalizing problems are equally prevalent among girls and boys who are in treatment
27	Gender Paradox Among Adolescents Boys who engage in substance use and other delinquent behaviors are far more numerous in the general population, in treatment, and in the juvenile justice system Girls who enter into treatment or the juvenile justice system, although less numerous, appear to be more severe
28	Acknowledgement . This presentation was supported by analytic runs provided Substance Abuse and Mental Health Services Administration's (SAMHSA's) Center for Substance Abuse Treatment (CSAT) under Contracts 207-98-7047, 277-00-6500, and 270-2003-00006 using data provided by the following grantees: (TI11320, TI11324, TI11317, TI11321, TI11323, TI11874, TI11424, TI11894, TI11871, TI11433, TI11423, TI11432, TI11422, TI11892, TI11888, TI013313, TI013309, TI013344, TI013354, TI013356, TI013305, TI013340, TI130022, TI03345, TI012208, TI013323, TI14376, TI14261, TI14189,TI14252, TI14315, TI14283, TI14267, TI14188, TI14103, TI14272, TI14090, TI14271, TI14355, TI14196, TI14214, TI14254, TI14311, TI15678, TI15670, TI15486, TI15511, TI15433, TI15479, TI15682, TI15483, TI15674, TI15467, TI15686, TI15481, TI15461, TI15475, TI15413, TI15562, TI15514, TI15672, TI15478, TI15447, TI15545, TI15671). Any opinions about this data are those of the authors and do not reflect official positions of the government or individual grantees