Original Article

Sex-Specific Substance Abuse Treatment for Female Healthcare Professionals: Implications

Authors: Erin Koos, MSW, Michael Brand, PhD, Julio Rojas, PhD, Ji Li, MS

Abstract

Objectives

Gender plays a significant role in the development and treatment of substance abuse disorders. Sex-specific treatment for girls and women has recurrently proven more effective, with better outcomes than traditional treatment. Research on impaired healthcare professionals (HCPs) has largely focused on men, garnering little attention for women and sex differences. With the increasing numbers of female HCPs, it is imperative to identify potential sex differences that may have implications for treatment. Our study compared a convenience sample of male and female HCPs with substance abuse disorders treated in an outpatient program to identify sex differences that may have implications for treatment.

Methods

Our sample consisted of 96 HCPs (54 men, 42 women) and 17 non–healthcare professional (N-HCP) women. All of the participants were evaluated using the program’s clinical interview and the Personality Assessment Inventory (PAI). Chart review data contained categorical variables, qualitative variables, diagnoses, and psychological test scores. A second analysis was conducted through two separate comparisons: the PAI results of comparing impaired female HCPs with impaired male HCPs and the PAI results of comparing impaired female HCPs with impaired female N-HCPs.

Results

Statistically significant differences indicated more male participants received prior treatment and more intensive treatment than female participants. More female subjects reported being diagnosed as having a comorbid psychiatric condition and taking psychotropic medications. Several statistically significant differences in the PAI scores were found. Among female HCPs, elevations were found in anxiety, depression, paranoia, and borderline personality disorder. Substantive differences, although not statistically significant, were elevations in somatic complaints and anxiety disorders in female HCPs. In the comparison of female HCPs and N-HCPs, the only statistically significant difference was the significantly higher anxiety score of N-HCPs.

Conclusions

The results indicate greater differences between female HCPs and male HCPs than between female HCPs and N-HCPs.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Grella CE. Gender-specific treatment for substance use disorders. , in Miller PM. (ed): Interventions for Addiction: Comprehensive Addictive Behaviors and Disorders. San Diego, CA, Academic Press, 2013; , pp 177–185.
 
2. Greenfield SF, Brooks AJ, Gordon SM, et al. Substance abuse treatment entry, retenion, and outcome in women: a review of the literature. Drug Alcohol Depend. 2007; 86: 1–21.
 
3. McGovern MP, Angres DH, Uziel-Miller ND, et al. Female physicians and substance abuse. Comparisons with male physicians presenting for assessment. J Subst Abuse Treat. 1998; 15: 525–533.
 
4. Nace EP, Davis CW, Hunter JH. A comparison of male and female physicians treated for substance use and psychiatric disorders. Am J Addict. 1995; 4: 156–162.
 
5. Wunsch MJ, Knisely JS, Cropsey KL, et al. Women physicians and addiction. J Addict Dis. 2007; 26: 35–43.
 
6. Baldisseri MR. Impaired healthcare professional. Crit Care Med. 2007; 35: S106–S116.
 
7. Cicala RS. Substance abuse among physicians: what you need to know. Hosp Physician. 2003; 39–46.
 
8. Gastfriend DR. Physician substance abuse and recovery: what does it mean for physicians—and everyone else? JAMA. 2005; 293: 1513–1515.
 
9. Rojas JI, Brand M, Fareed S, et al. Psychiatric comorbidity in health care professionals with substance use disorders. Addict Disord Their Treat. 2013; 12: 51–57.
 
10. Serry N, Ball JR, Bloch S. Substance abuse among medical practitioners. Drug Alcohol Rev. 1991; 10: 331–338.
 
11. Skipper GE. Treating the chemically dependent health professional. J Addict Dis. 1997; 16: 67–73.
 
12. Knight JR, Sanchez LT, Sherritt L, et al. Outcomes of a monitoring program for physicians with mental and behavioral health problems. J Psychiatr Pract. 2007; 13: 25–32.
 
13. McGovern MP, Angres DH, Shaw M, et al. Gender of physicians with substance use disorders: clinical characteristics, treatment utilization, and post-treatment functioning. Subst Use Misuse. 2003; 38: 993–1001.
 
14. Collins RL, Gollnisch G, Morsheimer ET. Substance use among a regional sample of female nurses. Drug Alcohol Depend. 1999; 55: 145–155.
 
15. Trinkoff AM, Zhou Q, Storr CL, et al. Workplace access, negative proscriptions, job strain, and substance use in registered nurses. Nurs Res. 2000; 49: 83–90.
 
16. Griffith J. Substance abuse disorders in nurses. Nurs Forum. 1999; : 34: 19–28.
 
17. Hotchkiss D, Early S. The differences in keeping both male and female physicians healthy. Health Care Manag (Frederick). 2009; : 28: 299–310.
 
18. Domino KB, Hornbein TF, Polissar NL, et al. Risk factors for relapse in health care professionals with substance use disorders. JAMA. 2005; 293: 1453–1460.
 
19. Marsh JC, Dingcai C, D’Aunno T. Gender differences in the impact of comprehensive services in substance abuse treatment. J Subst Abuse Treat. 2004; 27: 289–300.
 
20. Grella CE. From generic to gender-responsive treatment: changes in social policies, treatment services, and outcomes of women in substance abuse treatment. J Psychoactive Drugs. 2008; (Suppl 5): 327–343.Nov
 
21. Stasiewicz PR, Smith KE. Addictions in special treatment populations: treatment. In: Hersen M, Sledge W. (eds): Encyclopedia of Psychotherapy. New York, Academic Press, 2002; pp 9–14.
 
22. Wechsberg WM, Craddock GG, Hubbard RL. How are women who enter substance abuse treatment different than men? A gender comparison from the Drug Abuse Treatment Outcome Study (DATOS). Drugs Soc. 1998; 13: 97–115.
 
23. Spickard A, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA. 2002; 288: 1447–1450.
 
24. Brand M, Rojas J, Fareed S, et al. Execucare: outpatient treatment for impaired professionals. Addict Disorders Treat. 2013; 12: 11–18.
 
25. Morey L . The Personality Assessment Inventory Professional Manual. Odessa, FL: Psychological Assessment Resources, 1991; .
 
26. Green CA, Polen MR, Dickinson DM, et al. Gender differences in predictors of initiation, retention, and completion in an HMO-based substance abuse treatment program. J Subst Abuse Treat. 2002; 23: 285–295.
 
27. Brown ME, Trinkoff AM, Christen AG, et al. Impairment issues for health care professionals: review and recommendations. Subst Abus. 2002; 23: 155–165.