Women and Drinking

By Tracy Morris

Talking about drinking can be a touchy topic. So many Americans have been impacted by alcohol in negative ways, whether directly or indirectly, that just bringing it up in certain crowds can be as risky as venturing away from the weather toward politics and religion.

We live in a conflicted society when it comes to this – the most popular legalized non-prescription feel-good substance in the country. We talk a lot about the dangers of kids’ drinking, about drinking and driving, about unfortunate leaders who find their drinking problems exposed to the harsh light of public knowledge. But when the conversation comes down to a personal level, many of us can squirm with defensive discomfort.

With the premise that open discussion is healthier than stigma-inducing silence, I spoke to a woman whose career focus is the impact of alcohol on not only individuals, but the bigger picture as well. Susan E. Foster is the Vice President and Director of Policy Research and Analysis at the National Center on Addiction and Substance Abuse (CASA) at Columbia University. CASA is a non-profit organization of professionals from myriad fields – substance abuse and addiction, communications, criminology, education, epidemiology, government, law, journalism, psychology, public administration, health and policy, social work, sociology and statistics – with the goal of understanding and informing Americans about the costs of substance abuse. In the end, CASA’s mission seeks to remove stigma and replace shame and despair with hope.

Foster offers these intriguing facts and opinions which women who drink, regardless of whether it’s a problem or not, should know:

  • Problems with alcohol frequently co-occur with inappropriate use of controlled prescription, use of illicit drugs, and with smoking.
  • Vulnerabilities to alcohol (and other drugs) increase as women age.
  • Women should be aware that the alcohol industry preys on them from a young age for purposes of industry profits. Their ads glamorize use, make it appear sexy and without consequence, and they openly admit targeting women. Up to half of consumer expenditures for alcohol come from underage and adult abusive or dependent drinking.
  • Doctors are not well trained to screen for alcohol and other substance use problems, recognize it, or know what to do if they do spot it. Neither do they recognize gender differences when it comes to these substances.
  • 92 percent of women who need treatment for substance use disorders do not receive it; of treatment facilities, only 38 percent report having any programs designed for women.

TM: Are there any “good reasons” to drink alcohol?

Susan Foster: Most adult women who drink do not drink excessively; that is, they enjoy a drink or two in combination with a meal or other social event. Women (and men) who consume alcohol in this way report pleasurable, mild mood altering effects linked to relaxation and socializing without increasing their risks of health or social consequences. It is important to note, though, that combining drinking of as little as one drink with driving increases the risk of harm, as does drinking by minors, pregnant women or others with specific health problems.

There has been some research that suggests that consumption of small amounts of alcohol may have some health benefits for some people; however, even in the credible studies these effects are small and can be realized in other, safer ways such as diet, exercise, etc. Even low levels of alcohol use can, for example, increase the risk of breast cancer. Because the potentially negative effects of alcohol consumption are so significant, there is no “good medical reason” for alcohol consumption.

TM: What is “responsible drinking”?

Susan Foster: According to the U.S. Department of Agriculture and National Institute on Alcohol Abuse and Alcoholism, Dietary Guidelines for Americans, drinking in moderation is defined as having no more than one drink per day for women and no more than two drinks per day for men. This definition is referring to the amount consumed on any single day and is not intended as an average over several days. Drinking more than these amounts and any drinking by minors, pregnant women and others with specific health problems increases the risk of harm.

To my knowledge, the term ‘responsible drinking’ is used primarily by the alcohol industy to suggest that a person can drink as much as she/he wants as long as that person finds a designated driver. In this case, ‘responsible’ means ‘don’t drive drunk,’ not ‘don’t drink excessively.’

TM: What is “problem drinking,” and would you say that there is a difference between that and “alcoholism”?

Susan Foster: Think of drinking as a continuum from no use, to some use, to problem-risky-excessive use, to substance use disorders. The term ‘problem drinking’ can range from someone who is drinking more than the federally recommended levels of safe drinking described above to someone who meets medical criteria for alcohol abuse.

Generally, the concept of ‘problem drinking’ includes people who are encountering problems in their lives as a result of their drinking, such as not fulfilling responsibilities at home or work or at school, drinking in situations that are physically dangerous, ending up in dangerous circumstances as a result of drinking, experiencing problems with the law, or continuing to drink in spite of adverse events.

The term ‘alcoholism’ is usually used to refer to dependence on alcohol. Alcohol dependence is a disease characterized by a strong need or urge to drink, not being able to stop drinking once a person starts, withdrawal symptoms after stopping, and the need to drink increasing amounts to achieve the same effect.

It is important for women to understand that they get drunk and addicted faster than men, with the same or less quantity of alcohol, and the health consequences are more severe and come on faster than they do for men. Also, the time between the first drink and eventually becoming dependent is shorter for women than it is for men. This is in part a function of metabolic differences where one drink for a woman is equivalent to approximately two drinks for a man.

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