Exploring Gender-Based Differences in Hazardous Alcohol Use Outcomes Among Drug Treatment Court Participants: The Role of Health and Well-Being Across Multiple Dimensions.

BACKGROUND: In general populations, the prevalence of alcohol use has increased among women and remained constant among men. Little is known about the alcohol use patterns of women in drug treatment court (DTC) or how these behaviors are influenced by quality of life (QoL). This study examined whether multiple dimensions of QoL longitudinally predict subsequent hazardous alcohol use (AUDIT ≥ 8) outcomes and whether these associations varied by gender. METHODS: Data are from five waves (baseline to 12 months) of the Health Evaluation on the Results of Opioid Intervention Court (HEROIC). Participants' (N = 165) alcohol use (AUDIT) and QoL (RAND SF-36) were assessed every three months. Generalized estimating equations (GEEs) were used to examine associations between lagged QoL domains and subsequent hazardous alcohol use. Adjusted models examined gender and controlled for age, education, race/ethnicity, and treatment court setting. RESULTS: Hazardous alcohol use decreased over time across the sample. Lagged emotional well-being predicted hazardous alcohol use in full models, such that more emotional well-being was related to a lower likelihood of hazardous alcohol use. General health and social functioning were not longitudinally related to hazardous alcohol use. Previous associations did not differ by gender. CONCLUSION: In full models, emotional well-being predicted hazardous alcohol use, and there was a null effect of gender. General health and social functioning did not predict hazardous alcohol use, nor was gender significant in predicting problematic alcohol use. Emotional well-being may be a key QoL target for decreasing hazardous alcohol use among all DTC participants.