Some problems manifest themselves differently for women than for men. Alcoholism is one of them. While both genders can suffer equally from the ravages of this disorder, women often abuse alcohol for different reasons, metabolize alcohol differently, and suffer unique health consequences. Approximately one-third of alcoholics in the US are women, and those with the most severe dependence tend to develop more serious problems. Women alcoholics may be treated more harshly by our society, carry more shame about their behavior, and show a more rapid progression of the disorder over time. Any woman who thinks she can “drink like a man” is mistaken, since this behavior exacts a heavy toll¹.
Here are some of the facts:
Women absorb and metabolize alcohol differently. Women have a higher proportion of body fat than men, and since fat cannot absorb alcohol, higher levels become concentrated in the blood. Women also have less of a gastric enzyme that breaks down alcohol before it enters the bloodstream. As a result, it is estimated that a woman will absorb almost 30% more alcohol than a man of the same weight and height¹.
Onset of alcohol abuse and dependence is related to a variety of factors. 40% of women (and men) who start drinking before age 15 will develop alcoholism in adulthood. Risk factors for alcoholism include a history of depression or childhood physical or sexual abuse; an inherited tendency; involvement with a partner who drinks excessively; and being able to “hold your liquor,” (i.e., having the ability to drink more than others without appearing inebriated). Most women’s drinking habits are similar to their peers, close friends, and partners. And while young women are the most likely to drink excessively at times, alcohol dependence is greatest among mid-life women (ages 34-49)¹.
Psychological factors impact women’s alcohol use. Low self-esteem is both a trigger for excessive drinking and a consequence of it. Women may abuse alcohol to relieve feelings of insecurity, depression, stress, or boredom; to address sexual inhibitions; or to cope with a recent crisis or loss, such as a divorce or miscarriage². Older women are more likely to abuse alcohol when facing loneliness, financial stress, or the death of a spouse. Alcohol abuse also places women at greater risk for domestic violence and sexual assault¹. A recent study concluded that binge drinking puts women at higher risk for engaging in risky sexual behaviors, unprotected sex, and acquiring sexually transmitted diseases³.
Health consequences of alcohol abuse also differ between the sexes. Once abuse progresses to dependence, women develop medical complications sooner than male alcoholics, despite consuming less alcohol, ounce for ounce, than men. They develop liver disease related to alcoholism after a shorter period of heavy drinking, and the percentage of women alcoholics who die from cirrhosis, suicides, circulatory disorders and accidents is greater than for men. In fact, the death rate among women alcoholics is 50-100% higher than for alcoholic men. Women also experience hormonal problems related to drinking, including impaired fertility, early-onset menopause, and fetal alcohol spectrum disorder in infants, which develops as a result of excessive drinking during pregnancy¹.
How can you tell if you or a loved one are dependent on alcohol? Some warning signs include:
- Craving alcohol
- Loss of control or being unable to stop once drinking has begun
- Physical withdrawal symptoms, such as shaking or sweating, when alcohol is discontinued after a period of heavy drinking
- Increased tolerance for alcohol—or the need for increased amounts of alcohol to feel the same effects
- Neglecting family, social, recreational, or work-related activities due to drinking
- Persistent use of alcohol, in spite of concerns of friends and family or awareness that physical or psychological problems are related to drinking
When symptoms of alcoholism persist, treatment is necessary. Women comprise approximately 25% of clients in alcohol treatment facilities in the United States. While most women try alcohol rehabilitation programs or Alcoholics Anonymous meetings, some opt for less traditional approaches, such as therapy or medical intervention from their physicians. Women are more likely to pursue treatment because of family problems, and are less likely than men to be referred by employee assistance programs or the courts. Women are most likely to avoid participating in treatment because of lack of child care, fear that they could have their children removed from them if the problem became public, and limited financial resources. Nevertheless, a recent study found that abstinence was higher for women than for men who completed treatment¹.
Alcoholism is a devastating problem for both women and men. It creates serious health risks, destroys family trust, and can put society at risk when a person drives while under the influence of alcohol. Assumptions that binge drinking is a rite of passage for adolescents and young adults ignores both the immediate dangers and the long-term consequences for those at risk for developing alcohol dependence. It is critical that individuals suffering from the effects of alcoholism receive the family and occupational support they need to find treatment.
References:
- National Institute on Alcohol Abuse and Alcoholism (NIAAA) www.niaaa.nih.gov
- National Center on Addiction and Substance Abuse www.casacolumbia.org
- Hutton, H., McCaul, M. Santora, P. & Erbelding, E.(2008). The relationship between recent alcohol use and sexual behaviors: gender differences among sexually transmitted disease clinic patients. Alcoholism, Clinical and Experimental Research, 32, 15.
Other resources:
- Alcohol use quiz: www.atgetfit.net/Alcohol/TestsAlcoholUseTest.aspx
- Alcoholics Anonymous (AA) World Services www.aa.org
- National Council on Alcoholism and Drug Dependence (NCADD) www.ncadd.org
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