Women are more at Risk for Health Consequences of Drinking
Stacey J. Drubner, JD, LICSW, MPH
EAP Ask the Expert: John Kelly, PhD, Massachusetts General Hospital
Alcohol is entrenched in our world as a means of social connection and “unwinding”. The article below discusses the importance of understanding health-related facts about alcohol, so you are in the best position to make decisions about your drinking habits.
Historical societal perceptions were that men drink more and have greater issues with alcohol than do women. Unfortunately, women are achieving “equity” in matching men in this area. Many are not aware that even moderate alcohol use may have more significant health impacts on women due to biological factors.
Before COVID, statistics showed the problem drinking gap closing, and the most concerning patterns occurring in young adults. There are a variety of factors which contribute to this change. Harvard Health referred to cultural shifts, in which “changing social norms around female alcohol consumption and the alcohol industry’s targeted marketing to women” have shifted historical trends. In addition to increased “social” alcohol use, women may be more likely to use alcohol to deal with stress.
COVID-19 Impacts on Drinking in Women
The Pandemic revealed an increase in already troubling trends. JAMA Open Network reported that Americans of any gender between the ages of 30-80 indicated a 14% increase in drinking frequency during the Pandemic but:
- Women showed a 17% increase in drinking from the same time period the previous year
- Instances of heavy drinking by women increased by 41%
One explanation for this increase might be the rise in stress and mental health impacts experienced by women during the Pandemic. Many had greater responsibility at home and women are well represented in the essential worker and healthcare workforce. An April 2021 CVS Health Survey indicated that:
- The COVID-19 Pandemic has universally amplified levels of stress and anxiety among women, with moms and caregivers most deeply affected
- Six out of ten women indicated that the Pandemic has had a negative impact on their level of stress
- 46% reported they are experiencing significantly more or somewhat more stress compared to pre-Pandemic levels
Women are More at-risk for Negative Health Outcomes related to Alcohol
According to the National Institute on Alcohol Abuse & and Alcoholism and the CDC, women are at greater risk for health impacts from drinking, even if they consume less than their male counterparts. This is due to biological differences and the fact that women tend to weigh less. Essentially women have proportionately less “body water” to dilute alcohol, resulting in higher blood alcohol concentration levels and slower metabolism of alcohol. In the short-term, women may be more easily and quickly impaired. In the long run, they are more susceptible to:
- Liver disease
- Heart disease
– Long-term alcohol misuse is a leading cause of heart disease
– A glass of red wine may not be as protective as once believed
- Brain impacts
– According to the American Cancer Society, alcohol use is one of the most preventable risk factors
– Breast cancer risk in women who consume alcohol is higher, even for light drinkers
– Risk increases with higher consumption
- Mental health
– Alcohol is a depressant
– Use of alcohol can increase depressive and anxiety symptoms, and impact the effectiveness of
– Alcohol is a sedative that can induce sleep, but ultimately interrupts sleep, decreasing sleep duration and quality
- Weight gain
– This can lead to many health issues
– Use this alcohol calorie-counter from NIAAA to get a sense of how alcohol impacts your calorie intake
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:
- 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
- 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
- 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
- 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
- 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
- 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:
- 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)
- 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
- 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
About the MGH Recovery Research Institute
The Recovery Research Institute is a leading nonprofit research institute of Massachusetts General Hospital, an affiliate of Harvard Medical School, dedicated to the advancement of addiction treatment and recovery.
Help from the EAP
The Mass General Brigham EAP is available to help with alcohol use concerns about yourself or someone you care about. The Program offers free and confidential services for employees and immediate household members. EAP records are separate from medical and HR records. Contact the EAP at 866-724-4327, or request an appointment via our online form for confidential assistance.