Sex-based differences in multidimensional clinical assessments of early-abstinence crack cocaine users

• Published in: PloS one 2019-06, Vol.14 (6), p.e0218334
• Main Authors: Sanvicente-Vieira, Breno, Rovaris, Diego Luiz, Ornell, Felipe, Sordi, Anne, Rothmann, Leonardo Melo, Niederauer, João Paulo Ottolia, Schuch, Jaqueline Bohrer, von Diemen, Lisia, Kessler, Felix Henrique Paim, Grassi-Oliveira, Rodrigo
• Format: Article
• Language: English
• Subjects: Abstinence; Addictions; Adult; Alcohol; Alcohol use; Alcoholic beverages; Alcoholism; Alcohols; Analysis; Biology and Life Sciences; Brain research; Child care; Cocaine; Cocaine-Related Disorders - epidemiology; Cocaine-Related Disorders - psychology; Cocaine-Related Disorders - rehabilitation; Comorbidity; Crack (Drug); Crack Cocaine - adverse effects; Crime; Domains; Drug abuse; Drug use; Epidemiology; Female; Females; Gender aspects; Gender differences; Health aspects; Health sciences; HIV; HIV infections; Hospital patients; Hospitalization; Human immunodeficiency virus; Humans; Linear Models; Male; Males; Medical research; Medicine and Health Sciences; Mental disorders; Narcotics; Neurosciences; Physical Sciences; Psychiatry; Regression analysis; Sex; Sex Characteristics; Sex differences; Sex differences (Biology); Sexual behavior; Sexually transmitted diseases; Social interactions; Social Sciences; Social support; STD; Substance abuse; Substance abuse treatment; Trauma; Women
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0218334

Crack cocaine use disorder (CUD) has been related to sex differences. This work aimed to compare the severity of drug use and the severity of other negative related outcomes in males and females with CUD. A total of 1344 inpatients (798 males and 546 females) with crack cocaine use disorder (CUD) were evaluated by a detailed multidimensional clinical assessment, including addiction severity and trauma exposure. Linear regression predicted higher drug use severity (β = 0.273, p < 0.001) and more problems in domains related to childcare issues (β = 0.321), criminal involvement (β = 0.108), work-related problems (β = 0.281) and social support impairments (β = 0.142) for females, all with p < 0.001. Alcohol problems were predicted to be higher in males (β = -0.206, P < 0.001). Females had higher rates of other mental disorders, particularly trauma and stress-related disorders (OR: 3.206, CI: 2.22, 4.61). Important sex differences also emerged in trauma history and HIV infection prevalence. CUD has a more severe clinical presentation among females facing early abstinence. Sex differences in the CUD course indicate the need for consideration of sex-specific interventions and research.