Gender differences among prisoners in drug treatment

https://doi.org/10.1016/S0899-3289(01)00083-9Get rights and content

Abstract

Purpose: Nearly all prison-based substance abuse treatment programs have been designed with male prisoners in mind. Administering these male-oriented programs to women prisoners has been the standard correctional practice. Recently, this practice has received considerable criticism. Critics argue that female prisoners have special needs that are not met by programs originally designed for male prisoners. However, most of the empirical support for the existence of such special needs rely on two inappropriate samples: prisoners who are not in treatment and treatment participants who are not incarcerated. Findings from these two different groups may not be generalizable to the population of prisoners in treatment. Methods: This paper directly addresses this generalizability problem with an examination of gender differences among 1326 male and 318 female federal prisoners who were enrolled in a substance abuse treatment program. Results: Women used drugs more frequently, used harder drugs, and used them for different reasons than men. Women also confronted more difficulties than men in areas linked to substance abuse such as educational background, childhood family environment, adult social environment, mental health, and physical health. Conclusion: We find support for the argument that substance abuse treatment programs which were originally designed for men may be inappropriate for the treatment of women.

Introduction

Recent years have seen new policies designed to improve substance abuse treatment for incarcerated women (e.g., PaceCom, 1999). These efforts are based on the prevalent belief that female prisoners have special needs, which have not been met by programs that were originally designed for men Chandler & Kassebaum, 1994, Lockwood et al., 1995, Mactas, 1998, Miller, 1984, Wellisch et al., 1991, Wellisch et al., 1993. While women may indeed have special needs, much of the empirical research cited in support is based on samples of nonincarcerated substance users in treatment or, alternatively, on prisoners who are not in treatment. Findings from these two different groups may not be generalizable to the population of prisoners in treatment since the complex and poorly understood processes by which people are selected into prison and into treatment may differ. Indeed, prior research on treatment relevant gender differences has yielded a number of inconsistencies with regard to the seriousness of drug use American Correctional Association, 1990, Chandler & Kassebaum, 1994, Kassebaum & Chandler, 1994, Weisner, 1993, childhood physical and sexual abuse Lake, 1995, Snell & Morton, 1994, the prevalence of mental illness Griffin et al., 1989, Maden et al., 1994, Panton, 1974, and whether work histories and educational levels are equivalent Anglin et al., 1987, Snell & Morton, 1994. These inconsistent findings are noted both in samples of nonincarcerated substance users in treatment programs and in samples of prison and jail inmates.

To our knowledge, there is only one other published study of gender differences among incarcerated treatment participants (Peters, Strozier, Murrin, & Kearns, 1997). The Peters et al. study surveyed 435 female and 1220 male inmates in a Florida county jail. Subjects in that study were all admitted to a substance abuse treatment program. The 6-week program was residential for male inmates, but female participants were mixed with the general population. Overall, men and women were demographically similar. Peters et al. found that women were substantially more impaired than men. Women reported more recent, more frequent, and more chronic drug use than the men. Women also preferred harder drugs, indicating a greater preference for cocaine (74% of women compared with 49% of men). In contrast, the men indicated a greater preference for the softer drug marijuana (there was no difference in preference for heroin). Among those who used cocaine, women reported a preference for smoking it, while men preferred intranasal administration.

Peters et al. examined several other dimensions thought to have an impact on treatment. They found women were more impaired psychologically. Women were more likely to have taken medication for psychological problems, had experienced higher rates of lifetime depression, and had attempted suicide more often than men. The study's authors speculated that these differences may be associated with the greater frequency with which women reported being victims of childhood physical, emotional, and sexual abuse. Their research also found potential relapse risks for women in the form of greater obstacles to employment. Despite the fact that the women and men in their sample had comparable educational levels, fewer women worked prior to incarceration, women earned less, and were less likely to report having a skill or a trade. The authors speculated that women may turn to illicit substances to ease the pain of poverty associated with their poor employment prospects. Alternatively, women may return to substance use in the face of involuntary idleness resulting from their higher levels of unemployment. Whatever the pathways, it is important to note that this research revealed a pattern of disadvantages and deprivations that supercede simple drug use. Women confronted more serious problems than men in several areas associated with substance abuse. Indeed, Peters et al. found that the only area where women were less impaired than men was alcohol use.

The present study replicates and expands on the Peters study with a description of gender differences among a sample of 1644 federal prisoners who volunteered for, and subsequently participated in a 9- or 12-month residential substance abuse treatment program. The sample studied here contrasts with the Peters sample in several ways. First, this sample is more geographically diverse since it is comprised of inmates who resided in all 50 states. This diversity insures that our data do not reflect the idiosyncratic patterns of drug use found in a single locale (e.g., National Institute of Justice, 2000). Second, the subjects in this sample of federal prisoners have likely committed more serious offenses than the county jail inmates in the Peters study, indicating that this sample is comprised of more difficult offenders. Finally, a large majority of the clients in the Peters sample had been sentenced by the court to complete the comparatively brief, 6-week program. In contrast, the clients in this federal sample volunteered to participate in the much longer, 9- or 12-month program. Taken together, results from these two studies cover a wide range of incarcerated clients and provide a greater empirical basis for determining whether or not women prisoners have special needs that are not met by programs originally designed for men. Identification of gender differences would suggest needed gender-specific treatment designs that, in turn, would increase treatment effectiveness, potentially resulting in improvements in outcomes such as program retention, relapse, and recidivism.

Section snippets

Methods

The data used in this paper come from a larger project to evaluate the effectiveness of the Federal Bureau of Prison's Drug and Alcohol Treatment Program (DAP). The DAP provides at least 500 hours of treatment over a 9-month period. Important components of this cognitive behavioral program include relapse prevention and addressing criminal lifestyle issues. Recent research shows that inmates who participated in the DAP had lower recidivism rates and postrelease drug use than a comparison group

Results

Table 1 presents descriptive statistics and bivariate tests for statistical significance for the variables included in the regressions. The top part of Table 1 presents results for 17 dependent variables, and the bottom part presents results for the five controls included in each model. These results show that men and women differ with respect to several of these controls. In particular, Table 1 shows a large difference by race. While two-thirds of the men were white, only half of the women

Discussion

The prevalent belief that women prisoners in treatment have special needs has led to policies supporting the development of new substance abuse treatment programs to address these special needs. However, much of the empirical evidence cited in support of this belief is inappropriate because it is based on two different groups: prisoners not in treatment and nonincarcerated treatment participants. We are aware of only one other published article that examined gender differences for a sample of

Acknowledgements

The authors would like to thank Miles Harer, Joyce O'Neil, Gerry Gaes, William Saylor, and the anonymous reviewers for their advice and assistance with this paper. Funding for this project has been provided by the National Institute on Drug Abuse and by the Federal Bureau of Prisons. Views expressed in this paper are those of the authors and do not necessarily represent the policies or opinions of the National Institute on Drug Abuse, the Federal Bureau of Prisons or the Department of Justice.

References (36)

  • R.H. Peters et al.

    Treatment of substance-abusing jail inmates: examination of gender differences

    Journal of Substance Abuse Treatment

    (1997)
  • P. Allison

    Multiple imputation for missing data: a cautionary tale

    Sociological Methods and Research

    (2000)
  • The female offender: what does the future hold?

    (1990)
  • Diagnostic and statistical manual of mental disorders

    (1987)
  • M.D. Anglin et al.

    Addicted women and crime

    Criminology

    (1987)
  • M.D. Anglin et al.

    Sex differences in addict careers

    American Journal of Drug and Alcohol Abuse

    (1987)
  • S.B. Blume

    Chemical dependency in women: important issues

    American Journal of Drug and Alcohol Abuse

    (1990)
  • S.M. Chandler et al.

    Drug–alcohol dependence of women prisoners in Hawaii

    Affilia

    (1994)
  • E.W. Flaherty et al.

    Frequency of heroin use and drug users' life style

    American Journal of Drug and Alcohol Abuse

    (1984)
  • M.L. Griffin et al.

    A comparison of male and female cocaine abusers

    Archives General Psychiatry

    (1989)
  • J.E. Helzer et al.

    A comparison of clinical and diagnostic interview schedule diagnoses

    Archives General Psychiatry

    (1985)
  • G. Kassebaum et al.

    Polydrug use and self control among men and women in prisons

    Journal of Drug Education

    (1994)
  • E.S. Lake

    Offenders' experiences of violence: a comparison of male and female inmates as victims

    Deviant Behavior

    (1995)
  • A. Laudet et al.

    Male partners of substance-abusing women in treatment: an exploratory study

    American Journal of Drug and Alcohol Abuse

    (1999)
  • R.J.A. Little et al.

    The analysis of social science data with missing values

    Sociological Methods and Research

    (1990)
  • Lockwood, D., McCorkel, J., Empson, G., & Surratt, H. L. (1995). Developing Appropriate Treatment for Women Within a TC...
  • D.J. Mactas

    Treatment of women with substance abuse problems

  • A. Maden et al.

    A criminological and psychiatric survey of women serving a prison sentence

    British Journal of Criminology

    (1994)
  • Cited by (0)

    View full text