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Alcohol Consumption Among Women Is on the Rise

pouring wine

July 18, 2018 -- Laura McKowen says she enjoyed drinking alcohol before she became a mother and would imbibe a few times a week as part of a successful advertising career and active social life. But she says her problem drinking really started after she gave birth to a daughter in 2009.

“The drinking changed for me then,” she says. “I was struggling really hard to adjust to things: being a new mom, a cross-country move, losing my job. My nerves were shot, so I drank more, thinking it would help me sleep, help me cope, but it made me worse.”

McKowen, who lives in North Shore, MA, says as time went on, her drinking started earlier in the day and booze would be part of play dates. She and her friends would do yoga and then go out and drink wine. Her book club was all moms in their 30s, drinking like they did in their 20s. And alcohol even started to show up at birthday parties for 1- and 2-year-olds.

“It didn’t matter that I had to go and breastfeed or parent when I got home. It didn’t stop anything,” she recalls.

McKowen didn’t realize it at the time, but she had joined an unenviable -- and growing -- group: Women with alcohol disorders. Recent research has shown the gap between men and women with drinking problems is shrinking. Female alcohol use disorder in the United States more than doubled from 2002 to 2013, according to the National Institute on Alcohol Abuse and Alcoholism.

Even though she didn’t drink all day, every day, McKowen says alcohol was a daily habit and she knew she relied on it too much. Hangovers were common. So was blacking out for hours at night after putting her daughter to bed and self-medicating by combining wine with the sleep medication Ambien. “I didn’t know how to be in my own skin without drinking,” she explains.

She separated from her husband, got a DUI, and knew she was headed down a bad path. But she says she didn’t start to consider getting sober until an incident with her daughter. She got drunk and blacked out at a wedding, and her family had to step in to watch over her child.

“I put her in danger at the wedding. I left her unattended for a long period of time. She was 4,” McKowen says. “I knew eventually, I would lose custody of my daughter if I kept drinking. It was inevitable. I knew I would lose pretty much everything.”

Even so, it took McKowen a year to get serious about sobriety. She eventually started going to AA meetings, returned to the practice of yoga, and began chronicling her recovery on a blogand podcast that connected her to other moms going through the same thing. She now has nearly 30,000 followers on Instagram and has become an advocate for changing a culture she believes encourages moms, and women in general, to drink.

“It’s so socially acceptable. Even if you drink a lot, it’s not seen as weird,” McKowen says. “People just say -- of course you drink. We do too. Moms need it. Cheers.”

The Rise in Drinking Among Women

The data on the rise of alcohol consumption and abuse by women are staggering. Historically, men have been the ones to drink far more alcohol, but numerous studies show that is changing on a variety of fronts: alcohol use, binge drinking, alcohol use disorders, driving under the influence of alcohol, and more. Studies differ on the percentage increase, but all support a clear and troubling trend of more alcohol consumption among women:

  • Female alcohol use disorder in the United States increased by 83.7% between 2002 and 2013, according to a 2017 study sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
  • High-risk drinking, defined as more than three drinks in a day or seven in a week for women, is on the rise among women by about 58%, according to a 2017 study comparing habits from 2001-2002 and 2012-2013.
  • A 2018 study found a steep rise in the rate of alcohol-related ER visits between 2006 and 2014, and increases were larger for women than men.
  • Death from liver cirrhosis rose in women from 2000 to 2013.

“Males still consume more alcohol, but the differences between men and women are diminishing,” says Aaron White, PhD, senior scientific advisor to the director of the NIAAA.

Female drinking is starting earlier, too.

Another 2017 study, funded by the National Institute on Drug Abuse, found narrowing gender gaps as early as high school and middle school. Male drinking used to far surpass female drinking at all levels from eighth through 12th grades, but that’s changed dramatically over the last 20 years.

“Now, by eighth grade, more females than males are drinking. Females are now, for the first time in history, more likely to drink in 10th grade than males; and by 12th grade, where there used to be a big gap 10 or 15 years ago, it’s now dead even,” White says .

This isn’t just a U.S. problem. A 2016 publication by Australian researchers who pooled  information from 68 studies in 36 countries with a total sample size of more than 4 million men and women found similar results.

Their analysis showed that while men born in 1891 were almost 2 ½ times more likely than women to drink alcohol, men and women born in 1991 were almost equally likely to drink. And of the 42 studies that showed converging alcohol use, most reported this was driven by higher rates of female drinking.

“This matters because often, the focus in the media and public debate is on young men and alcohol,” says lead author Tim Slade, PhD, an associate professor at the National Drug and Alcohol Research Centre in Sydney, Australia. “It matters because, while women seek treatment for almost every other physical and mental health problem at higher rates than men, women who experience problems related to alcohol generally don’t seek treatment.”

The NIAAA says evidence of rising female alcohol use is also concerning because women are more likely than men to have a variety of alcohol-related health effects, including liver inflammation, cardiovascular disease, neurotoxicity, and cancer, says Deidra Roach, MD, medical project officer of the NIAAA Division of Treatment and Recovery Research. She says they are statistically more likely to black out from drinking too.

“Women are generally smaller than men and have less total body water and more total body fat,” Roach explains. “Blood alcohol level rises more quickly and stay elevated longer in women, so the harmful effects of alcohol, even if a man and woman drink same amount, will show up sooner in the women.”

“This is a very serious issue for women,” she says. “We need to do more in terms of getting this message out to young women and medical providers who work with young people. Because once you end up on the slippery slope of harmful drinking, it becomes difficult to reverse.”

A Cultural Shift?

The big question is: “Why?” What is behind the rise in women’s problem drinking? Roach says this isn’t fully understood, but she says some smaller studies and anecdotes show cultural norms around women’s drinking have changed dramatically over the past 100 years. “It’s gone from being taboo for women to drink at all to being expected in some settings, professional groups -- even to drink to intoxication,” she says.

Roach and other experts say high rates of depression and anxiety among women could play a role, as could violence against women.

“We know women drink more in response to negative emotions then men do,” she says. “Not all of them, but men as a group tend to drink for positive reinforcement and pleasure, and women tend to drink more in response to negative mood states.”

Women who’ve battled alcohol addiction also point to confusing societal messages. Pop culture seems to celebrate women who drink rather than warn against it. Movies like Bad Moms have become blockbusters at theaters. Advertising celebrates drinking and targets many alcohol campaigns directly to women.

Search online, and you’ll find hundreds of memes that joke about why women need a drink to get through the day or week -- whether it’s related to their kids or their job. There’s an endless supply of products around this topic -- like wine glasses emblazoned with the words “Mommy’s Little Helper.” A Facebook group called “Moms Who Need Wine” has more than 700,000 members. And #WineWednesday is often a trending topic on Twitter by midweek.

“We not only think it’s normal to drink as a parent, we celebrate it. There is a culture that says moms, this is your right. You have earned this. You actually need it,” says McKowen, the mom who realized she had a drinking problem.

In fact, McKowen says, she hears constantly from women who think they have a problem, even though many around them don’t.

“Moms carry so much shame around drinking,” she says. “A lot of women come to me and say people in their life don’t think they have a problem because it doesn’t show. And yet they are wrecked inside.”

Dana Bowman, a 40-something mother of two children, knows that feeling. She says she was an expert at hiding her problem. She has written about her journey to sobriety in two books -- Bottled: A Mom's Guide to Early Recovery and How To Be Perfect Like Me (coming out next month) -- and on her parenting blog, called Momsieblog. She wrote this to her followers when she first shared her struggle with alcohol:

“My affair with alcohol hit its lowest point when I had children,” she said. “And this is a common story, I think, amongst moms. The monotony, the chaos, the mess -- a glass of wine smoothed all that out and tucked my babies in just fine.”

Bowman, of Lindsborg, KS, now speaks openly about sobriety because she believes it’s important for women to recognize when they may need help -- something she doesn't think is always well-understood. 

“I have a chapter in my book called ‘I never dance on tables’ that women reference to me all the time. The story I keep getting from moms is, ‘We know better than being out, where we could get arrested, so we drink at home, by ourselves, at night after the baby goes to bed.’

“It’s really troubling and actually makes things worse. If I had been getting arrested or binge drinking or vomiting every night, it might have made me realize something was going on. But I had it controlled and managed, and so for a long time, I just didn’t admit that I had a problem. We buy into the lie that so much around us is driving us to drink.”

Pushing for Change

Advocates and researchers alike say this issue is slowly starting to get more attention, though few feel it’s enough. The NIAAA says in 2016, an estimated 5.4 million women over 18 could be considered as having an alcohol use disorder and needed treatment. But less than 1 in 10 (6.9%) actually got formal help.

Experts say treatment will be most successful if it’s more tailored to women -- addressing the mental health component of anxiety and depression, if it is there, and offering support if they are victims of violence or need family assistance because they are often primary caregivers of children. Many also stress that education campaigns addressing the harms of alcohol need to be designed to appeal to men and women and need to target adolescents, before drinking patterns become entrenched. 

Since she got help, McKowen understands she was drinking to mask the pain of postpartum depression, hormonal shifts, anxiety, and more. But now, almost 4 years sober, she says she has created a whole new life with her 9-year-old daughter. She left her corporate job and works for herself: handling a successful blog, teaching classes and retreats, and writing. She’s changed her social circle so it no longer revolves around drinking, and she says if there is one thing she has learned, it’s that sobriety is nothing like she feared when she was avoiding it for so long.

“I thought sobriety was going to be a terrible death sentence, and it is by far the best thing that has ever happened in my life.” McKowen says. “Now I have honest relationships. I am a far better mother, and I am doing work I actually love because I had the presence of mind to move to that. I am just living a more honest, joyful, and free life.”

WebMD Article Reviewed by Neha Pathak, MD on July 18, 2018

Sources

Dana Bowman, Lindsborg, KS.

Laura McKowen, North Shore, MA.

Deidra Roach, MD, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD.

Tim Slade, PhD, National Drug and Alcohol Research Centre, Sydney, Australia.

Aaron White, PhD, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD.

National Institute on Alcohol Abuse and Alcoholism Alcohol Fact Sheet. 

National Institute on Drug Abuse: “Monitoring the Future 2017 Survey Results.”

Alcoholism: Clinical and Experimental Research: “Trends in Alcohol-Related Emergency Department Visits in the United States: Results from the Nationwide Emergency Department Sample, 2006 to 2014,” “Converging Patterns of Alcohol Use and Related Outcomes Among Females and Males in the United States, 2002 to 2012.”

JAMA Psychiatry: “Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013.”

Results From the National Epidemiologic Survey on Alcohol and Related Conditions.”

BMJ Open: “Birth cohort trends in the global epidemiology of alcohol use and alcohol-related harms in men and women: systematic review and metaregression.”

JAMA Psychiatry, “Alcohol use, high-risk drinking increases in U.S. to ‘crisis’ levels.”

National Institute on Alcohol Abuse and Alcoholism: “Liver Cirrhosis Mortality in the United States: National, State, and Regional Trends, 2000-2013.”

 

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