Women are more at Risk for Health Consequences of Drinking

Spotlight: John Kelly, PhD, Massachusetts General Hospital, Director - Recovery Research Institute, Associate Director - Center for Addiction Medicine & Program Director - Addiction Recovery Management Service

John Kelly shares his expertise on women and alcohol

How does stigma come into play with women who drink?

John explains that women have been targeted with alcohol industry advertising for the last 30 years. There has been an attempt to glamorize drinking wine, without being honest about some of the health risks. While women have achieved more equality and empowerment regarding their independence and lifestyle choices, they are stigmatized more than men when it comes to alcohol- they don’t necessarily get the same treatment or benefit of the doubt when they are intoxicated. Men seem to get a more favorable, less stigmatized view regarding intoxication and alcohol problems, but are perceived as more unpredictable and dangerous. On the other hand, women are stigmatized for having a problem. The result is that many women hide the fact that they are struggling with an alcohol disorder, and are reluctant to ask for help. This is despite the fact that they are suffering as much, or more, and are likely to suffer a telescoped acceleration of health consequences.

What advice do you have for women who want to cut back on or stop drinking?

John recommends the following:

1. Educate yourself – recognize that alcohol is the most commonly used drug in the U.S. and accounts for 75% of all substance use disorder cases each year
2. Recognize that alcohol can cause harms-through toxicity effects, increasing breast cancer risk, for example – and hazards, including accidents due to intoxication, independent of accident risk
3. Get a baseline on your situation
   – Are you feeling guilt, regret or remorse in relation to your alcohol use?
   – Is alcohol beginning to cost you more than just money?
   – Is alcohol starting to impact your life (relationships, job, legal situation)?
   – Use an online tool, such as the Audit, accessible through MGB EAP screenings to get a sense of the level of your problem
4. Decide if you can cut back drinking on your own or if you need professional help. John explains that about 50% of people can do this on their own. Some factors include the following:
   – Severity of the problem
   – Internal resources to support change
   – External support systems through spouses, friends, role models
   – Success or failure of attempts to stop or successfully reduce drinking previously – 2 or more failed attempts trigger a recommendation for outside help
5. Reach out for help from:
   – A friend or family member
   – Someone who has experienced recovery from an alcohol problem
   – A trusted healthcare provider
   – Alcoholics Anonymous
   – Women for Sobriety
   – Smart Recovery 
6. Tools for making changes in your drinking:
   – MGH Recovery Research Institute – Guide to Drinking Levels
   – NIAAA – Rethinking Drinking – Supports for Drinking Changes

How to help if you are concerned about alcohol use in a family member or friend

It can be awkward to discuss these issues with a friend or family member, but the important thing is to let this person know that you care and want to help as needed. John recommends starting with the following:

1. Provide non-judgmental feedback about your concerns, with concrete examples of observations about how big of a priority alcohol has become in that person’s life or how alcohol has impacted their functioning or relationships
   – Sometimes this may help the person to move beyond their own minimization or denial surrounding their alcohol use, especially if communicated at time when the person is likely to hear your concerns (e.g. while feeling remorse after a bad night)
2. If there is co-occurring depression or anxiety, start with that
   – Some may be more open to discussing depression or anxiety, which is less stigmatized in society than “alcohol problems”
   – This may provide an opening for making the connection between alcohol and depression and anxiety
3. Discuss health effects (breast cancer risk or weight gain) of increased alcohol use of which they may be unaware.
   – Mention that they can access confidential information and Audit, accessible through MGB EAP screenings or  NIAAA – Rethinking Drinking – Assess and Change Risky Drinking Habits