Women are less likely than men to seek treatment for substance abuse (alcohol and illicit drugs). In 2005, women comprised about 32% of all substance abusers seeking treatment (SAMHSA, 2005). One study found that 23% of men and 15.1% of women with alcohol abuse or dependence had ever received treatment, suggesting that a smaller proportion of substance abusing women receive treatment than substance abusing men (Greenfield et al., 2006). Reduced treatment-seeking among women may be due to an interaction of both external and internal barriers. External barriers are defined as socio-cultural or structural factors discouraging treatment attendance and internal barriers are defined as beliefs or feelings within a person, whether instilled by others or not, that discourage treatment attendance. One internal barrier to treatment, to be focused on in this study, is the negative social support women may perceive when seeking treatment (Xu et al., 2008, Xu et al., 2007, Green, 2006). Women often may not seek treatment because they are dissuaded to attend by those in their social circle (Xu et al., 2008, Green, 2006). In fact, women are more likely than men to have substance abusing loved ones who support and reinforce substance use (Green, 2006). This study examined past six month substance abuse treatment attendance among 1566 men and 767 women presented at two urban hospital emergency departments and screened as “at risk” substance users (using the ASSIST; WHO, 1998). Specifically, this study used descriptive statistics and chi square analyses to examine treatment-seeking behavior differences between men and women with and without support for recovery.