Gender disparity in utilization rates of substance abuse services among female ex-offenders: a population-based analysis.

BACKGROUND: The use and abuse of substances is common among offender populations. Although the female former offender population has risen substantially in recent decades, relatively little is known about their substance abuse treatment experiences. OBJECTIVE: This study examines disparities in substance abuse treatment utilization among the US population with special focus upon formerly incarcerated female offenders. METHODS: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, n = 43,093) collected in 2001-2002 and 2004-2005 the authors compared lifetime rates of substance abuse treatment utilization between female and male ex-offenders with the U.S. general population. The sample population covered inpatient and community based substance use treatment, detoxification and rehabilitation programs. It is a nationally representative sample of noninstitutionalized persons over the age of 18. Multinomial logistic regression was performed and likelihood of using substance use treatment and services was calculated using adjusted odds ratios (AOR). RESULTS: Compared to male ex-offenders, female ex-offenders were 52% less likely to use substance-abuse treatment services (AOR = 0.48, 95% CI = 0.26-0.89) and 51% less likely to use rehabilitation programs (AOR = 0.49, 95% CI = 0.26-0.93). Compared to females in the general population, female ex-offenders were 10 times more likely to use substance-abuse treatment services (AOR = 10.14, 95% CI = 5.71-18.00), 10.5 times more likely to use substance detoxification programs (AOR = 10. 45, 95% CI = 5.64-19.39); 8 times more likely to use inpatient wards (AOR = 8.05, 95% CI = 4.16-15.59); 9 times more likely to use outpatient wards (AOR = 9.06, 95% CI = 4.89-16.81), and 12 times more likely to use substance-abuse rehabilitation programs (AOR = 12.06, 95% CI = 6.55-22.22). CONCLUSIONS: While female ex-offenders were more likely to have used a range of substance abuse services when compared to the general population, they were less likely to use substance-abuse treatment services and rehabilitation programs than male ex-offenders.