Author: Alex Thompson

Why Women Are Drinking More

Researchers concluded men were 2.88 times more likely to die than women and that alcohol-related deaths were trending upward for both men and women. Some 29.5 million Americans are thought to have an alcohol use disorder. Seven percent of men but just four percent of women are diagnosed annually. But most of the deaths reflect the toll from longer-term consumption, Karaye says, including from its eventual impact on the liver, the pancreas, or heart.

Among teens and young adults, however, there’s an overall decline in drinking. By the time Victoria Cooper enrolled in an alcohol treatment program in 2018, she was “drinking for survival,” not pleasure, she says — multiple vodka shots in the morning, at lunchtime and beyond. In the treatment program, she saw other women in their 20s struggling with alcohol and other drugs. “It was the first time in a very long time that I had not felt alone,” she says. Cute terms like mommy juice or liquid courage belie the reality that even small amounts of wine, beer, or cocktails endanger health.

The authors suggested that these trends might be a sign that women who binge-drink even when they are pregnant are more likely to have an alcohol use disorder than other binge-drinkers. Thus, elevated levels of alcohol exposure in women give rise to a variety of negative health consequences. For example, there is more damage and inflammation in the female brain during alcohol withdrawal (Hashimoto and Wiren, 2008). Women also are at increased risk of alcohol-related heart disease, as well as immune and infectious diseases. In one study, there was a 12% increase in breast cancer risk per 1 drink/day increase in average alcohol consumption. We know that alcohol induces widespread alterations in estrogen receptor physiology and function that in turn affect sensitivity and risk of estrogen positive breast cancer.

Sure, she got more refills than some and missed classes while nursing hangovers, but she couldn’t have a problem, she thought. Women can reduce the amount of alcohol they drink to reduce their risk of harms. All of these factors point to women absorbing more alcohol, and therefore having a higher blood alcohol content than men with a comparable dose of alcohol. Terry D. Schneekloth, M.D., a Mayo Clinic psychiatrist with expertise in alcoholism and addiction, helps break down some of the differences. Women’s deaths began rising 15 percent annually, versus a 12.5 percent increase for men.

1. Kaiser Health News is a national, editorially independent newsroom and program of the Kaiser Family Foundation.
2. Anxiety kept her up at night, she says, and she started having suicidal thoughts.
3. Although the gender gap in alcohol consumption is narrowing among all ages, the reasons differ.

As Karaye’s study notes, though, these drugs—like many others—have primarily been studied in men, so it is uncertain how much they improve the health or mortality of women. Federal guidelines recommend that women who want to drink consume no more than one serving a day (two for men). But from a health perspective, less—or none—is a better target, Patel suggests. In 2014, the head of the National Institute on Alcohol Abuse and Alcoholism promised an executive at the Distilled Spirits Council that it would not fund research on the relationship between alcohol advertising and underage drinking.

How ultra-processed food harms the body and brain

Sometimes, she would start drinking in the morning and go until she passed out. “Anytime I felt anything I didn’t want to feel, I used outside things to manage that, and alcohol was very effective,” she said. The next day, she would feel shaky and even more stressed—and still be facing the demons she drank to avoid. Perhaps most concerning is that the rising gender equality in alcohol use doesn’t extend to the recognition or treatment of alcohol disorders, Sugarman says. So even as some women drink more, they’re often less likely to get the help they need. “It’s not only that we’re seeing women drinking more, but that they’re really being affected by this physically and mental health-wise,” says Dawn Sugarman, a research psychologist at McLean Hospital in Massachusetts, who has studied addiction in women.

Deaths from alcohol can occur swiftly, such as the sudden heart or liver failure of alcohol poisoning, or the car accidents, falls, or drownings after drinking too much. It can be tempting to shut down any anti-alcohol message with the argument that women should be allowed to drink heavily if they want to. Johnston told me she doesn’t travel to college campuses anymore; she gets too much pushback from students who say they have a right to drink, and no one’s going to tell them otherwise. Just as the addictive dangers of Valium became unignorable, Eli Lilly invented Prozac. Though the blockbuster antidepressant was marketed toward both genders, “there were some explicitly gendered Prozac ads that had to do with pitching Prozac to help women handle the double workday.

Health Topics: Women and Alcohol

And of course, women who drink while pregnant put their children at risk of physical, mental, and behavioral problems. As evidenced by the important findings reported in the recent papers included in this ACER virtual issue on women and alcohol, the field has made substantial progress incorporating a women’s focus across the full spectrum of research methodologies from preclinical to applied studies. But as rates of hazardous alcohol use by women and men converge, it is critical that we continue to frame our research questions with a focus on sex and gender similarities and differences. Taken together, the papers included in this virtual issue on women and alcohol highlight important new knowledge on sex differences in patterns of alcohol use, consequences of alcohol misuse, and approaches to identification and treatment.

Women generally have less body water, which dissolves alcohol, than men of the same weight. That means the same number of drinks leads them to have higher concentrations of alcohol in the blood, and their body tissues are exposed to more alcohol per drink. Now, as women approach parity in drinking habits, scientists are uncovering more about the unequal damage that alcohol causes to their bodies. What’s more, despite alcohol’s temporary calming properties, it can actually increase anxiety and depression, research suggests; some studies show it may lead to depression more quickly in women than in men. That common image of who is affected by alcohol disorders, echoed throughout pop culture, was misleading over a decade ago when Cooper was in college.

Those who frequently rely on alcohol to manage stress or who regularly experience symptoms of overconsumption—such as lethargy or foggy thinking—should talk to their primary care physician, Patel says. A doctor may recommend seeing a therapist to learn alternative stress-management techniques or joining a support group such as Alcoholics Anonymous. One reason may be that women don’t always recognize how much they’re drinking, Patel says. An official serving of wine is just five ounces, but today’s large stemware often holds 10 ounces or more. When two people polish off a bottle over dinner, they’ve each had two-and-a-half servings. Even when consuming the same amount of alcohol as men, women are more susceptible to its negative effects.

Short Takes With NIAAA: Do You Know the Facts About Women and Alcohol?

Also in this category are older adults, anyone planning to drive a vehicle or operate machinery, and individuals who participate in activities that require skill, coordination, and alertness. If you suspect that you or someone you know may have a drinking problem, consult with a health care provider. There are several warning signs of binge or excessive drinking, which in women, means having more than four drinks in one sitting and in men, having more than five drinks, according to the Centers for Disease Control and Prevention.

She found herself surrounded by other women in their 20s who also struggled with alcohol and other drugs. In Cooper’s teenage years, alcohol helped her overcome social anxiety, she says. “It’s hard to get out of that cycle of shame, drinking and abuse,” Cooper says. Similarly, a beer or two can, at least temporarily, help you tolerate a day on which day care is closed, work is nuts, your husband is playing video games, and an elderly relative is having a health scare. But what if you didn’t need the alcohol, because child care was ubiquitous and affordable, health care was cheap, and gender norms were more balanced? In her 2019 book, Quit Like a Woman, Whitaker describes drinking alone after a night out, feeling proud to have had “only” a bottle of wine in a day, and carrying airplane shots of liquor around in her purse.

So, you know, ‘Alert at work, able to do the stuff at home,’” Herzberg says. In the end, the gender ratio of antidepressant prescriptions was similar to that of Valium. In the early 2000s, Prozac’s makers repackaged the drug, literally, in a pink-and-purple capsule; rebranded it as Sarafem; and marketed it to women to treat PMS. As part of a research study, Sugarman and her colleagues gave women struggling with alcohol use information on how alcohol affects women differently from men.

The Role of Stress, Trauma, and Negative Affect in Alcohol Misuse and Alcohol Use Disorder in Women

Specifically, the prevalence of current drinking increased on average 1.6% per year among women ages 60+ compared with 0.7% per year among men ages 60+. Similarly, binge drinking increased on average 3.7% per year among women ages 60+ while remaining stable among men ages 60+. Countless studies show that males are more likely than females to be drinkers, and that among drinkers, males drink more heavily than females (Grant et al, 2015; Hasin et al, 2007). However, research suggests that this gender gap in alcohol use may be narrowing (Grant et al, 2017; Keyes et al, 2011; Slade et al, 2016). In a recent meta-analysis by Slade and colleagues (2016), temporal trends in alcohol use (any and problematic) and alcohol-related harms were analyzed by birth cohort using data derived from 68 studies (about 75% from the US or Europe). They reported a linear decrease over time in sex ratios for any and problematic alcohol use and alcohol-related problems, with ratios in younger cohorts (e.g., those born 1991–2000) being closer to equal compared to older cohorts (Slade et al, 2016).