Women And Alcohol Use Disorder

The Impact Of Alcoholism On Women

Addiction impacts everyone, with more women today experiencing the dangers of alcohol use disorder (AUD) than ever before.

The 2023 National Survey on Drug Use and Health (NSDUH) found 27.8 million women participated in binge drinking the month before the survey. Binge drinking is the consumption of a large amount of alcohol in a short period. For those assigned female at birth, binge drinking is consuming four or more drinks in less than 2 hours. Binge drinking is a steadily increasing problem for women.

Of the 16.4 million adults reporting heavy alcohol use in the past month, 6.6 million were women. As one of the leading causes of preventable deaths in the United States, excessive alcohol consumption was a factor in 59,000 recent female deaths.

Do Women Face Higher Risks?

Alcohol consumption impacts women more than men. In general, women are more prone to alcoholism based on their body composition. Because they tend to weigh less and alcohol remains in body water, an average woman can consume the same amount of alcohol as a man, but the results will differ. They may experience adverse effects, like blackouts, and develop AUDs more quickly than their counterparts.

Women are more likely to experience health risks tied to alcohol use sooner than men, like cancers, organ damage or failure, and irreversible physical conditions that may or may not be life-threatening.

Many women with AUD may also have mental health disorders, as co-occurring disorders are more prevalent among women than men. Mental illness refers to various disorders, including:

• Anxiety
• Depression
• Bipolar disorder
• Eating disorders
• Obsessive-compulsive disorder
• Post-traumatic stress disorder
• Suicidal ideation

The NSDUH found that 4.6 million women have co-occurring substance use disorders and mental illness.

What Demographics Are More At Risk?

Studies have found that certain demographics can reveal a heightened prevalence of AUD among women.

Ethnicity

NSDUH results show American Indian/Alaskan Native women have the highest rates of alcohol dependence, followed by people of multiple races, including Whites, Native Hawaiian/Pacific Islanders, African Americans, Hispanics, and Asians.

Education Level

Educational differences among women include those with some college experience having the highest rate of alcohol dependence, followed by college graduates, those with high school diplomas, and then those without a high school diploma. However, when comparing the educational status of those who drank in the previous year, those with less than a high school education were the second highest group, following those with a college degree.

Sexual Orientation

The survey revealed significant differences among people with varying sexual identities. For example, bisexual individuals nearly doubled the number of lesbians and tripled the number of heterosexuals with alcohol dependence. The same is true for those reporting they drank in the past year.

Additional demographics include the following:

• Socially disadvantaged women are more likely to develop alcohol-related issues.
• Sexual minority stressors increase the likelihood of alcohol misuse.
• Poverty affects alcohol misuse among Black women more than White or Latina women.

What Are The Health Risks For Women With Alcohol Use Disorder?

Compared to men, women are more at risk for developing health concerns sooner, with some consequences of excessive alcohol consumption only occurring in women. Alcohol misuse can cause physical and mental illness or worsen already present conditions. Some of the most prevalent health risks include the following:

Pregnancy Risks

Unfortunately, health risks arise for unborn children when a woman consumes alcohol during pregnancy. NSDU results show that 8.4% of pregnant women admit to consuming alcohol in the month before the survey, and 4.8% report binge drinking. Consequently, between 1% and 5% of first graders have symptoms of fetal alcohol syndrome.

Liver Damage

Alcohol hepatitis and cirrhosis of the liver are two conditions women develop sooner and more often than men. Alcohol hepatitis refers to swelling and inflammation of the liver, which eventually can lead to scarring of the liver, or cirrhosis, which can lead to death.

Breast Cancer

Breast cancer develops in the cells of breast tissues, sometimes forming a noticeable lump, but not always. While it can occur in men, it is more common in women. Having just one alcoholic drink a day increases the risk by 5 to 9 times of developing breast cancer in a woman. Increasing the number of drinks per day also increases the risks.

Heart Disease

Heart disease refers to various heart-related conditions that can be fatal because they prevent the heart from functioning properly. High blood pressure, arrhythmias, stroke, congestive heart failure, and heart attacks are examples of heart diseases that are influenced by alcohol consumption.

Brain Damage

Women who drink excessively or for long periods can experience brain damage sooner than men who drink comparatively. Alcohol alters the structure of the brain and how it functions. It impacts memory, decision-making, motor skills, and more.

Mental Illness

Because alcohol affects the brain, it changes how neurotransmitters communicate. Alcohol is a sedative that suppresses essential neurotransmitters in the brain that signal the release of “feel-good” chemicals. This can lead to higher anxiety, depression, or both. It can also worsen any pre-existing mental health symptoms.

Alcohol Use Disorder

Misusing alcohol can lead to an alcohol addiction in women, which is when you aren’t able to stop drinking alcohol despite a desire and effort to do so. Alcohol becomes a priority, even though it can cause relationship problems, career or academic losses, financial problems, and health problems. This disorder interferes with every aspect of a person’s life.

How Alcohol Affects Women Differently Than Men

Gender makes a difference in how alcohol affects health. Biological processes that must occur when drinking alcohol take longer in people with varying weights, food intake, interacting medications, and other health conditions. Women and men can consume the same amount of alcohol but will experience very different outcomes, like the following:

Gastric Alcohol Dehydrogenase

Gastric alcohol dehydrogenase is an enzyme involved in metabolism. It helps process alcohol in the stomach and is about 50% higher in men’s versus women’s intestinal tracts. This means more alcohol is absorbed into a woman’s small intestine, increasing her blood alcohol concentration.

Fat Vs. Muscle

Blood flows through muscle and fat at different speeds, with muscle having better flow, which allows alcohol to become more diluted. Blood flowing through fat is slower, making alcohol more concentrated in those areas. Men tend to have more muscle than women, and women tend to have more fat than men. Therefore, alcohol remains in a woman’s body longer, increasing the effects of alcohol quicker than it does in their counterparts.

Water Volume

Men have more water and fluids in their bodies (65%) than women (50%). These fluids dilute and push alcohol through the body, so having more fluids means alcohol is processed quicker. In women, alcohol remains in the system longer, increasing its effects.

Hormones

Women’s hormones play a significant role in how alcohol affects them, especially before and during their menstrual cycle. An increase in hormones during this time means some women will experience an increase in alcohol’s effects for more extended periods. Taking contraceptives can have the same effect.

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Treatment Options For Women With An Alcohol Use Disorder

AUDs differ in women, and effective treatment options recognize these differences. The number of women seeking treatment is a small percentage of those needing help; barriers to treatment, like childcare, stigma, and financial issues, are often greater for women. Only 43% of treatment centers report having specialized services for women with an alcohol use disorder. That leaves a lot of room for growth.

Specialized treatment services range from gender-specific groups to programs that allow a mother and her children to stay together. Examples of treatment options that work include:

• Mixed-gender treatment programs with specialized activities and groups specific to women
• Women-only treatment programs with no gender-specific activities or groups
• Women-only treatment programs with gender-specific activities and groups

Women-only treatment programs produce better outcomes, with participants showing higher retention, completion, abstinence, and follow-up care rates. The types of treatment activities showing the most effectiveness include:

• Motivational interviewing (MI)
• Cognitive-behavioral therapy (CBT)
• Female-specific CBT (FS-CBT)
• Dialectical-behavioral therapy (DBT)
• Twelve-step facilitation (TSF)
• Trauma-informed care (TIC)

Treating the whole person is a common goal in treatment plans for women because addressing all their needs simultaneously will enable them to maintain recovery long-term. Utilizing programming focusing on gender-specific needs and issues gives them a higher chance of success.

Taking The Next Step

If you or a woman in your life is struggling with alcohol use disorder and needs treatment, contact a treatment provider today. They can help answer your questions and explore your treatment options.

Once you have narrowed down your options, you can contact your selected facility to see if they offer women-centered programming so you can get the treatment you deserve and start your journey to a healthier, alcohol-free future.