1. 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)

2. 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

3. 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)

4. 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)

5. Proportion of males and females in the general population (2003) %

6. Total treatment demand by gender and by country (2003) %

7. First treatment demand by gender and by country (2003) %

8. NetherlandsAustriaSwitzerlandGreece Czech Republic Opiates 3,73,03,55,12,2 Cocaïne 4,2n.a.2,44,00,9 Stimulants 2,7n.a.0,32,71,7 Cannabis 4,2n.a.4,25,32,8 Other Substances 1,1n.a1,02,84,1 Total 3,73,02,95,02,0 Male to female ratio by primary drug and by country (first treatment demand, 2003)

9. Drug related deaths by gender and by country according to age groups (2003) Age < 20Age 20 - 39Age > 39All age groups mff%mf mf mf Austria 1 15525 %972118 %21416 %1333018 % Czech Republic 2 7436 %621317 %647253 %1338941 % Greece 2 1218 %197157 %3313 %242177 % Netherlands 2 02100%441424 %35920 %792524 % Switzerland 3 3350 %1013123 %432133 %1475527 % 1) Federal Ministry for Health and Women – calculations by Austrian Health Institute; 2) EMCDDA Statistical Table 5; 3) Swiss Federal Statistical Office

10. Drug-related police notifications by substance and gender in Austria, Switzerland and The Netherlands (2003) OpiatesCocaineCannabisOther drugs mff%mf mf mf Austria353566616%178933216%7698131315 %344867116% Switzerland92019818%140817111%24622138 %2053214% The Netherlands 63617422%168640119%132031519 %37120135%

11. Drug-related police notifications by substance and gender in Austria, Switzerland and The Netherlands, age<20 (2003) Age<20 OpiatesCocaineCannabisOther drugs mff%mf mf mf Austria95620518%3138121%304263217 %80125624% Switzerland30923%247125%529316 %16420% The Netherlands 500%43816%851313 %25824%

12. Drug-related police notifications by substance and gender in Austria, Switzerland and The Netherlands, age 20-39 (2003) Age 20-39 OpiatesCocaineCannabisOther drugs mff%mf mf mf Austria240143715%127722615%428362113 %240538214% Switzerland73715818%101312711%16901538 %1562413% The Netherlands 861817%4344910%222198 %6069%

13. Drug-related police notifications by substance and gender in Austria, Switzerland and The Netherlands, age >39 (2003) Age >39 OpiatesCocaineCannabisOther drugs mff%mf mf mf Austria1782412%1992511%3736014 %2423312% Switzerland1533117%1483218%2432911 %33411% The Netherlands 60913%811112%1600 %7330%

14. Drug-related police notifications by substance and gender in Austria, Switzerland and The Netherlands, age >39 (2003) Age >39 OpiatesCocaineCannabisOther drugs mff%mf mf mf Austria1782412%1992511%3736014 %2423312% Switzerland1533117%1483218%2432911 %33411% The Netherlands 60913%811112%1600 %7330%

15. Propoption of females in drug-related first and all treatments, drug-related deaths and police notifications by country (2003)

16. Gender distribution according to age groups in drug-related first treatments by country (2003) Age < 20Age 20 - 39Age > 39 All age groups mff%mf mf mf Austria 1176636 %52014422 %541825 %69122825 % Czech Republic 105674841 %164358026 %632125 %2762134933 % Greece 1705926 %124823916 %1672011 %158531820 % Switzerland 682829 %1414424 %18625 %2277826 % The Netherlands 55717324 %280968820 %64723026 %4013109121 %

17. Primary drug at first treatment by gender and by country (2003)

18. Most important source of referral among first treatment patients by gender and country - primary drug: opiates (2003) CZGR CHNL

19. Most important source of referral among first treatment patients by gender and country – primary drug: stimulants (2003) Czech RepublicThe Netherlands

20. Most important source of referral among first treatment patients by gender and country – primary drug: cannabis (2003) CZ GR NLCH % % %

21. Opiates StimulantsCannabis Age Mean age at first use among male and female clients (first treatment) by primary drug and country (2003)

22. Time lag between first use and first treatment among male and female clients by primary drug and country (2003) OpiatesCannabisStimulants years

23. 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

24. 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