title: Gender differences in clinical outcomes for cocaine dependence: randomized clinical trials of behavioral therapy and disulfiram.
abstract: BACKGROUND
  Despite extensive research on gender differences in addiction, there are relatively few published reports comparing treatment outcomes for women versus men based on evidence-based treatments evaluated in randomized clinical trials.
  
  
  METHODS
  An aggregate sample comprised of data from five randomized clinical trials of treatment for cocaine dependence (N = 434) was evaluated for gender differences in clinical outcomes. Secondary analyses compared gender differences in outcome by medication condition (disulfiram versus no medication) and across multiple behavioral treatment conditions.
  
  
  RESULTS
  Women, compared with men, had poorer treatment outcomes on multiple measures of cocaine use during treatment and at post-treatment follow-up. These results appear to be primarily accounted for by disulfiram being less effective in women compared with men. There was no evidence of meaningful gender differences in outcome as a function of the behavioral therapies evaluated.
  
  
  CONCLUSIONS
  These findings suggest that women and men may benefit to similar degrees from some empirically validated behavioral treatments for addiction. Conversely, some addiction pharmacotherapies, such as disulfiram, may be associated with poorer outcomes among women relative to men and point to the need for careful assessment of pharmacological treatments in both sexes prior to widespread clinical implementation.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 1 Church Street, Suite 701, New Haven, CT 06510, United States. Electronic address: elise.devito@yale.edu.
authors.forename: Elise E
authors.initials: EE
authors.lastname: DeVito
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue, 151D, West Haven, CT 06516, United States.
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Babuscio
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue, 151D, West Haven, CT 06516, United States.
authors.forename: Charla
authors.initials: C
authors.lastname: Nich
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue, 151D, West Haven, CT 06516, United States; The APT Foundation, New Haven, CT 1 Long Wharf, New Haven, CT 06511, United States.
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Ball
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue, 151D, West Haven, CT 06516, United States.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Carroll
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D019970:Cocaine-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D004221:Disulfiram / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods; D012727:Sex Characteristics; D016896:Treatment Outcome
chemical_list: D004221:Disulfiram
keywords: CBT; Cocaine; Disulfiram; Gender; Psychotherapy; Sex