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Whether similar convergence has occurred in the proportion of substance\u2010related acute care encounters involving alcohol remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective longitudinal cohort study using national administrative claims from the Merative MarketScan Commercial and Multi\u2010State Medicaid databases (January 2016 to December 2023). Individuals aged 16\u201364\u2009years with at least one emergency department (ED) or inpatient encounter involving a non\u2010nicotine substance\u2010related diagnosis (ICD\u201010\u2010CM F10\u2010F19, excluding F17) were included. Alcohol involvement was defined using multiple classifications: any alcohol\u2010related diagnosis, alcohol\u2010only encounters, inpatient admissions with alcohol as the primary diagnosis, and acute alcohol\u2010related morbidity identified using CDC external cause codes. We estimated monthly sex\u2010specific trends in the proportion of substance\u2010related encounters involving alcohol using generalized estimating equation models with quadratic time terms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort comprised 1,355,161 individuals (54.7% male, 45.3% female) with 5,190,680 substance\u2010related ED and inpatient encounters. Among individuals with substance\u2010related encounters, alcohol involvement was more common among males than females (61.5% vs. 43.2%). Across all alcohol\u2010related outcomes, models demonstrated accelerating convergence in the sex gap over time (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). From 2016 to 2023, the male\u2013female gap in the proportion of substance\u2010related encounters involving alcohol narrowed by 6.0 percentage points (95% CI, 4.9\u20137.1), 4.7 points (95% CI, 3.6\u20135.8) for alcohol\u2010only encounters, and 4.9 points (95% CI, 4.0\u20135.8) for inpatient admissions with alcohol as the primary diagnosis. Trends in total substance\u2010related encounter volume did not differ by sex.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>From 2016 to 2023, alcohol accounted for an increasing proportional share of substance\u2010related acute care encounters among women relative to men, independent of changes in overall substance\u2010related healthcare utilization volume.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70279","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T01:24:13Z","timestamp":1773710653000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Narrowing differences in the rate of alcohol\u2010related acute care admissions in the\n                    <scp>United States<\/scp>\n                    between women versus men, 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