Women and Alcohol National Institute on Alcohol Abuse and Alcoholism NIAAA

Prenatal alcohol exposure can cause children to experience physical, cognitive, and behavioral problems, any of which can be components of fetal alcohol spectrum disorders. When Gillian Tietz began drinking in graduate school, she found a glass of wine helped ease her stress. Anxiety kept her up at night, she says, and she started having suicidal thoughts. Cooper says enrolling in a 90-day residential treatment program in 2018 drastically changed her own perception of who is affected by addiction.

Harvard Health Publishing

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. “For us to address issues with alcohol, we also need to address these pervasive issues with mental health,” White says. 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. Alcohol has slid along a similar trajectory, with the industry assuring women that all they need to get through the day is a glass of something. In the 1970s, women’s magazines advised readers that wine could be part of an “Anti-Tension Diet,” as the journalist Gabrielle Glaser writes in Her Best-Kept Secret.

Physical differences in drinking

In both cohorts, heavy drinking among Black women was lower than that of White and Hispanic women. The authors attribute the increased heavy drinking frequency of younger White and Hispanic women to changes in women’s social roles and norms across recent decades, including higher education attainment and rates of employment outside the home, as well as later age at first marriage and childbearing. These increased rates of alcohol misuse among women are of considerable concern since women experience the harmful health and behavioral consequences of drinking sooner and at lower levels of alcohol exposure than men (Foster et al, 2014). We know that there are sex-specific differences in the pharmacokinetics and pharmacodynamics of alcohol (Thomasson, 1995). Women are generally smaller than men and have relatively less total body water and more total body fat. As a result, alcohol is more concentrated in a woman’s body; blood alcohol concentration rises faster and stays elevated longer in women than men.

Women can reduce the amount of alcohol they drink to reduce their risk of harms. 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. More than a decade ago, when Holly Whitaker worked a director-level job at a Silicon Valley start-up, insecurities haunted her. “There was just an inability to be with myself,” she told me, “and that manifested as fear.” She often sought comfort in alcohol.

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. This trend parallels the rise in mental health concerns among young women, and researchers worry that the long-term effects of the COVID-19 pandemic could amplify both patterns. In addition, certain individuals should avoid alcohol completely, particularly those who experience facial flushing and dizziness when drinking 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.

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? Problem drinking has risen fastest among women in their 30s and 40s, the age at which many are squeezed between careers, motherhood, and aging parents. Overwhelmingly, high-income, highly educated women are the ones who drink.

She moved back home and was soon taking a shot or two of vodka each morning before heading to the office for her finance job, followed by two more drinks at lunch. Victoria Cooper thought her drinking habits in college were just like everyone else’s. Sure, she got more refills than some and missed classes while nursing hangovers, but she couldn’t have a problem, she thought. Kaiser Health News is a national, editorially independent newsroom and program of the Kaiser Family Foundation. “Because of what my picture of alcoholism was — old men who brown-bagged it in a parking lot — I thought I was fine,” says Cooper, now sober and living in Chapel Hill, N.C. A .gov website belongs to an official government organization in the United States.

1. Overwhelmingly, high-income, highly educated women are the ones who drink.
2. 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.
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4. In addition, women had similar levels of inflammatory cytokines but elevated levels of liver inflammation suggesting immunological differences that may contribute to more rapid and severe progression of alcohol-related liver damage in women.
5. Research from Sugarman’s colleagues found that women with alcohol use disorder had better outcomes when they were in women-only treatment groups, which included a focus on mental health and trauma, as well as education about gender-specific elements of addiction.

The Endocrine System and Alcohol Drinking in Females

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 harbor house sober living Prozac to help women handle the double workday. So, you know, ‘Alert at work, able to do the stuff at home,’” Herzberg says.

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Gender-specific results from the 2015 National Survey on Drug Use and Health (NSDUH) suggested that among persons with AUD in the past year, only 7.4% of men and 5.4% of women received treatment (SAMHSA, 2015). Thus, women with alcohol disorders appear to be under-represented in specialty alcohol and drug treatment facilities, despite having a shorter interval between drinking initiation and treatment entry (Alvanzo et al, 2014). In part, this may reflect that women are more likely to seek care in non-substance abuse settings, particularly primary care and mental health settings, where their drinking problems may not be recognized (Brienza and Stein, 2002).

Alcohol and Your Pregnancy AI/AN

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. “That’s when I got scared, when I tried to not drink and only made it two days,” says Cooper, now 30. 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.

The relief would start even as she anticipated drinking; at the first sip, she began to feel warm and right; numb, but also energized. Dr. Schneekloth conducts research in the field of addiction psychiatry, particularly alcoholism research and transplant psychiatry. 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.

One study found alcohol-related visits to the emergency room from 2006 to 2014 increased 70% for women, compared with 58% for men. Another paper reported that the rate of alcohol-related cirrhosis from 2009 to 2015 rose 50% for women, compared with 30% for men. For nearly a century, women have been closing the gender gap in alcohol consumption, binge-drinking and alcohol use disorder.

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. They highlight the critical importance of the NIH mandate to include women in research and, more importantly, to enroll sufficient women to permit adequately powered analyses of sex differences and similarities. Importantly, they point to large gaps in information that urgently need research attention as rates of alcohol use by women steven tyler health problems increase and converge with those of men. 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.