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For example, compared with men, substance abuse problems among women, particularly older women (National Center on Addiction and Substance Abuse 1998), are less likely to be identified in health care settings (Brienza and Stein 2002).

Women also experience shorter intervals between first loss of control over drinking and onset of their most severe drinking-related consequences, and shorter intervals between onset of regular drunkenness and treatment-seeking (Randall et al. Women report more severe problems and experience more health-related consequences from substance use (Bradley et al.

Women also tend to seek care in mental health or primary care settings rather than in specialized treatment programs, which may contribute to poorer treatment outcomes.

H., is a senior investigator at the Center for Health Research, Kaiser Permanente Northwest, and a clinical associate professor in the Department of Public Health and Preventive Medicine and the Department of Psychiatry at Oregon Health & Science University, both positions in Portland, are more likely than men to face multiple barriers to accessing substance abuse treatment and are less likely to seek treatment.

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Identification of a problem is the first step toward treatment, whether by the person needing treatment, or by a family member, health care professional, employer, or government agency.