Over on Facebook, the group Moms Who Need Wine has more than 660,000 likes. While most of the posts there seem pretty darn cheerful, they point to a darker reality. Alcohol abuse in women is on the rise. And a specific problem for them is binge drinking, as the Centers for Disease Control reported earlier this year.
In the report, the CDC found that 1 in 8 women over age 18 — that’s 14 million women — binge drink about three times a month. Binge drinking is defined as four or more alcoholic beverages in a two to three hour period. One in 5 high school girls binge drink.
Dr. Bob Brewer who leads the Alcohol Program at the CDC’s National Center for Chronic Disease Prevention framed the public health costs of alcohol consumption for a KQED Forum audience recently. It’s the third leading cause of preventable death in the U.S., with an estimated 80,000 deaths and 2.3 million years of life lost every year linked to excess drinking, he said.
But within that excess drinking, it’s the binge drinking that is really taking a toll. “We know that binge drinking is by far the most common pattern of excessive drinking in the United States,” he said, responsible for half of those 80,000 deaths.
Biologically, women are more susceptible to alcohol, explained Gabrielle Glaser who wrote Her Best-Kept Secret: Why Women Drink and How They Can Regain Control. “Women have more fat in their bodies than do men and less water.” Fat absorbs alcohol; water dilutes it.
In addition, Glaser says, women make less of an enzyme called alcohol dehydrogenase which helps process alcohol. “So women are more susceptible and more vulnerable to the toxic effects of alcohol.”
Estrogen also seems to have some effect on how alcohol is processed.
Alcoholics Anonymous: Worthwhile program or ineffective?
Then, in the midst of this discussion of the dangers of alcohol, came a lively debate about the merits of AA — Alcoholics Anonymous, the 12-step program founded in 1935. Glaser asserted that it doesn’t work for the vast majority of people who try it, and says it’s particularly bad for women, since it was developed “by men, for men.”
There are other, better options, she argues. “What I’m trying to do is advocate for women is that there are many, many avenues that do work that have been scientifically shown in evidence-based practice to be more effective than 12-step treatment.”
In particular, she pointed to naltrexone, an FDA-approved drug that can essentially blocks the pleasant effects of alcohol, making the consumption of alcohol a less pleasant experience.
Keith Humphries, a professor of psychiatry at Stanford, agreed that naltrexone is effective, but said he wouldn’t be “uncritical” of it. He defended AA. He estimated there were “hundreds of thousands of women” who would say they “owe their life” to AA. And in the Bay Area, he said, studies of samples of problem drinkers found that women were a little more likely than men drinkers to go to AA, and “if they go, they are likely to benefit.”
College-educated women at greater risk
The CDC report found that white and hispanic women 18-34, as well as high school girls, and women with family incomes about $75,000 a year were most likely to binge drink. And long-term effects can set in more quickly in women than in men. Humphries referred to a “telescoped” course. “In other words,” he told Forum’s audience, “they won’t have been having a problem for very long, may be just five years, but they already have as much wreckage in their lives as a man might accrue over 10 or 15 years.”
Once women enter treatment, Humphries encouraged people to search
for the best approach that works for them. “It’s like shopping,” he said. “It’s a lot about relationship.” Choice is a good thing, he said. There are choices in medications and counseling styles. Forum host Michael Krasny pointed out there’s no silver bullet. Humphries concurred. “The pathway out of this that works is the one that works for you. If what you’re doing is making you healthier, happier, more responsible in life, then just keep doing it.”
Near the end of the hour, Sarah Mart with industry watchdog Alcohol Justice may have pointed to why there’s an increase of alcohol use in women. She argued that the industry is working to “transition women from non-alcohol to alcohol products.”
“They’re sweet, they’re bubbly,” she said in reference to alcoholic beverages targeted to women. “They’re brightly colored, both the product themselves, the liquid as well as all of the packaging.”
Listen to the program: