Alcohol-dependent women progress faster from onset of alcohol drinking to entry into treatment, experiencing an earlier onset (i.e., "telescoping") of alcohol-related complications. This phenomenon also appears to be evident in drug-dependent women, though the data available to support telescoping in drug dependence is less abundant. To evaluate gender effects on progression to treatment entry and on the frequency, severity and related complications of DSM-III-R drug and alcohol dependence among 271 substance-dependent patients (mean age: 32.6 years; 156 women). Multivariate and univariate ANCOVA was used to compare age at onset of regular use of cocaine, opioids, cannabis and alcohol and time elapsed between initiation of regular use of each substance and entry into an index or current substance abuse treatment. Scores on the Addiction Severity Index (ASI) were also examined. There was no gender difference among patients in the age at onset of regular use of any substance. Women experienced fewer years of regular use of opioids and cannabis, and fewer years of regular alcohol drinking before entering treatment. Although the severity of drug and alcohol dependence did not differ by gender, women reported more severe psychiatric, medical and employment complications. These findings support the notion of an accelerated progression to treatment entry among opioid-, cannabis- and alcohol-dependent women, and suggest that there exists a gender-based vulnerability to the adverse consequences of these disorders.