Crossing the Line: Women and Alcoholism
Women's Greater Risk
But even though drinking has become an equal-opportunity pursuit, it is not an equal-opportunity problem. Women are at significantly greater risk than men for developing serious problems with alcohol and sustaining physical damage from it. Bluntly put, women get drunk and addicted faster and with much less alcohol than men do.
Why the disparity? Pound for pound, women have less water in their bodies than men do, so the alcohol traveling through their bloodstream is less diluted. Women also have lower levels of a stomach enzyme that helps break down alcohol; indeed, for reasons that scientists do not fully understand, female alcoholics often lack this enzyme altogether. "Even if you correct for weight, if you give a man and a woman the same amount of alcohol, the woman will have a higher blood-alcohol level," says Sheila Blume, MD, a former medical director of addiction services at South Oaks Hospital, in Amityville, New York. Because of differences in metabolism, alcohol also lingers longer in a woman's body than in a man's, and a woman will develop liver disease years earlier than a man will, even if she consumes only a fraction of what he ingests.
Metabolic differences may also explain why women who drink heavily tend to become addicted to alcohol more quickly than men do. Estrogen may be implicated, too, says Carrie Randall, PhD, director of the Charleston Alcohol Research Center at the Medical University of South Carolina and author of a study that showed women to be on a faster track to addiction.
Although male alcohol abusers in the United States still vastly outnumber women abusers -- 10 percent of all males (or roughly 12 million men and boys), compared with about 5 percent of all females (6 million women and girls), according to the 2003 National Survey on Drug Use and Health -- that's probably because more men drink. Some experts, in fact, believe the number of women alcoholics may be as high as 7.5 million. And that number is on the rise, reports the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
Yet many women who do not qualify as abusers imbibe more than what is good for them. According to the NIAAA, one in 10 adult women who drink consume more than the recommended one drink per day maximum (defined by the U.S. Department of Health and Human Services as one 5-ounce glass of wine, one 12-ounce bottle of beer or wine cooler, or 1.5 ounces of 80-proof distilled spirits). Moreover, new research suggests that women who drink are increasingly doing so to the point of drunkenness. "There's been a sizable increase in all age groups reporting intoxication," says Sharon Wilsnack, PhD, a clinical psychologist at the University of North Dakota School of Medicine and Health Sciences who has been tracking women's drinking habits for more than two decades.
And drinking begins at ever-younger ages: One 2004 national study found that 23 percent of girls have had their first drink before turning 13. "The gender gap is closing for all ages," says Susan Foster, director of policy research at CASA. "And among eighth- and ninth-graders, there is no difference at all between boys' and girls' drinking behavior."
One fact is crystal clear. Alcohol abuse can place women at serious risk for physical and mental health problems. According to Residence XII, an alcohol-treatment center for women in Kirkland, Washington, women who become addicted to alcohol die 15 years sooner than their counterparts in the general population and have death rates twice as high as male alcoholics. Every year an estimated 21,000 American women die of illnesses and injuries brought on by drinking.
How should you weigh all these grim risks against the growing evidence that moderate drinking (that is, not in excess of the recommended one-drink-a-day maximum) can enhance your health? One study estimates that if all current consumers of alcohol abstained, there would be an additional 80,000 or so deaths each year from coronary heart disease. Moderate drinking may also provide some protection against stroke, adult-onset diabetes, and Alzheimer's disease.
Another study suggests that drinking may even improve cognitive functioning in women in their 70s. Research also shows that women who drink moderately have lower mortality rates than those who do not drink at all.
Does that mean teetotalers should start drinking simply for the health benefits? Not at all, says Denise Russo, PhD, program director at the NIAAA. "Why would someone want to start down that road?" she asks.
Besides, even moderate drinking is not without hazards: There is a curious link between drinking and breast cancer, according to Eric Rimm, ScD, associate professor of epidemiology and nutrition at the Harvard School of Public Health, in Cambridge, Massachusetts. A single drink a day can elevate breast-cancer risk for the average woman with no family history of the disease by as much as 15 percent -- but only in women who don't have enough folate in their diets. Dr. Rimm speculates that alcohol may cause a folate deficiency that is the real source of the breast-cancer link. His Rx: Eat well and take a daily multivitamin.