Gender differences in problems and needs among chronic, high-risk crack abusers: Results of a randomized controlled trial (2005)

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Objective: Aims of the study were to assess, among clients receiving an outpatient treatment program (OTP), whether female crack abusers have more severe problems and/or different service needs than men. Methods: A total of 63 chronic crack abusers (34 women) participated in the study at baseline. Follow-up data were available for 33 subjects (21 women). Outcome measures included general condition at intake, and treatment compliance, outcome and satisfaction. Data were collected by means of monthly registrations, EuropAsi interviews and an evaluation form. OTP consisted of assertive outreach, a time-out provision, and intensive case management. Results: The vast majority of women were involved in street prostitution and were extremely vulnerable to deterioration. Compared to men, women who entered treatment had poorer physical health, higher rates of previous physical/sexual abuse, and more anxiety symptoms. Women reported a longer episode of cocaine abstinence than men. At discharge from OTP men reported a significantly better treatment outcome than women. Both genders gained most improvement in general living conditions. No gender differences emerged in treatment compliance. Although both men and women were satisfied with the service items offered by OTP, an outpatient walk-in service best served the needs of men, whereas women preferred a 24-hour care service including medical treatment and motivational outreach. Conclusions: Due to the harshness of street prostitution, treatment for female crack abusers should address areas of severe impairment. Integrated treatment services, tailored to the lifestyle of these women, are required to improve their general situation and safety. (Review' s abstract)