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