These past three months has been the most trying times for all us. We have lost jobs, loved ones, and even our own sanity. The shelter-in place orders have been extremely boring and overwhelming. If you told me last year that we would be stuck in our houses for months at a time with no income, barely any water, and no toilet paper or paper towels, I would have  definitely laughed and not even respond to such blasphemy! But yet here we are basking in our homes, fighting for necessities in the store and barely able to see our loved ones and meet new people. You can agree that this situation has been extremely stressful. This new found stressed have forced many people most importantly women into drinking more heavily. Women drink because they want a sense of relaxation, looseness, and freedom. And I’m not just talking about a wine glass or two, we are referring to multiple bottles of wine a day or even hard core liquor. 

“Alcoholic beverage sales rose by 55% in late March, when many states and public health officials urged residents to stay at home, compared to sales in 2019.” This increase in alcohol says was promoted by the stay at home order as well as governers allowing businesses to sell To-Go alcoholic beverages. This has never before been seen unless you’re in New Orleans walking on Bourbon Street. 

https://news.usc.edu/168549/covid-19-alcohol-sales-abuse-stress-relapse-usc-experts/

Alcohol usage can be quite damaging to the body and eventually become addictive habit in your life. Health professionals have states that drinking alcohol can weaken your immune system, which can result to you putting yourself at risk  to catching Covid-19. “Alcohol, like other substances, can affect the general health of the body, leading to potential outcomes like sleeping less, and a weakened immune system. Individuals should be instituting behaviors that will fortify their health and help keep them protected from the virus”. This article also suggest that the self medicating that people are doing at home with alcohol and drugs can ruin their health. 

https://www.healthline.com/health-news/resisting-using-pot-alcohol-to-ease-stress-during-the-covid-19-outbreak#Alcohol-use-can-lead-to-additional-health-risks,-too

We should be more responsible with ourselves and help the people around us who truly struggling during this time. There are plenty of prevention strategies when stress or waves of depression hit you and you’re itching for a drink. “A change of scenery can also be great for mood. If you’re facing a self-quarantine or lockdown, you can still break out of that isolation and go for a walk or hike, as long as you’re mindful of all recommendations about social distancing Trusted Source and prevention of the coronavirus”.  My suggestion is find constructive things to do around the household, things that you have put off to do when you did’t have time. You can even take on a new project with interior and exterior building or remodeling in your home. There are a few universities that are offering few online classes in many subject that you can take and get accreditation for. There are more positive and healthier things to do to cope with your stress so next you’re at the grocery store, make sure to pick up a new cookbook or even a flower to plant before you decide to choose the wine.

References: 

https://www.healthline.com/health-news/resisting-using-pot-alcohol-to-ease-stress-during-the-covid-19-outbreak#Positive-coping-practices-can-have-healthier-long-term-outcomes

Here, I speculate on visions for the future of alcohol – what it will mean, how people may drink differently in the future, and also how alcohol abuse may manifest itself differently in the future. In deciding where to start talking about the future of alcohol, alcohol use and abuse, I thought “why not just search on Google?” The first two “hits” from my search amaze me in ways that I never expected!  First is a glossy “white paper” (which is a misleading phrase that referring to an “industry report”) from a marketing consulting firm named FutureBrand (www.futurebrand.com/the-future-of-alcohol).  I enjoyed skimming this report, and it definitely wasn’t “white.” It is a slick, colorful brochure with terrific photos, art, and buzzwords. What amazed me was how little of the brochure actually mentions alcohol. In fact, I kept asking myself as I scanned through the glossy photos: “is this report really about alcohol, because it keeps veering off to completely-different topics having nothing to do with alcohol?”  The report kept using buzzwords like “the wellness era,” “conscious consumption,” “the democratization of smartphones,” and “a revolutionary at-home clothing care system.”  Are you confused yet? That’s even before they mention the new brand where each bottle you purchase allegedly) leads to social change.  The brand name is UneSpirit (where une is the French article word for “an” or “one”).  What is remarkable about this forecast is that the word alcohol (or beer/wine/cocktail) only appear seven times in the 46-page report, an average of once every 7 pages. In contrast, the words “health,” “healthy” or “wellness” appears ten times! My take-away is that this management consultant, FutureBrand, is preaching to their clients (alcohol producers) that alcohol is not something that people drink.  No, just like people’s smartphone, alcohol is who they are and how they live their lives. This connection is reinforced by frequent references to millennials, to this generation’s preference for spending money on experiences rather than on goods, and on the ultimate value of sharing one’s behavior on social media.

While this is my interpretation and take-away from this report, the fact that alcohol is actually one of the least frequently-used words in it, contrast to other terms like experience (12 times), it suggests that the future of alcohol is all about showing others who you are! A companion article I read about the future of alcohol seemed, at first, to support this notion that consumers can choose their own personalized drink to fit their image: blogger, Olga Kovaleva, writes “brands will facilitate consumers’ quest for being the most optimised versions of themselves.” Yet, in the rest of that sentence and the next, she identifies a positive twist – the optimization of one’s self through beverages can include non-alcoholic version of one’s favorite drinks.” Moreover, “Brands … [will]  offer wider ranges of non-alcoholic options tapping into this healthy hedonism trend.. In several London based restaurants and bars, bartenders collaborate with scientists to find a way to remove the alcohol from popular drinks (e.g. Campari, Aperol, and gin) while retaining the flavour. This approached proved to be especially popular with drivers and pregnant women.” (www.scenariomagazine.com/the-future-of-alcohol-gradual-disappearance-or-new-role/).

The second “hit” I found was even more startling than the above – a prediction from scientist David Nutt of Imperial College, London, that in 30 years, people will no longer drink alcohol, but instead, they will imbibe “alcosynth” – a synthetic version of alcohol with (supposedly) all the “gain” but none of the “pain” (no hangovers, no liver disease) (www.thrillist.com/news/future-of-alcohol-according-to-scientist; see also www.theguardian.com/science/2019/mar/26/an-innocent-drink-could-alcosynth-provide-all-the-joy-of-booze-without-the-dangers ). Did I mention that Dr. Nutt (his real name) not only predicts that alcosynth will replace alcohol, but also he is the scientist who invented it?  As outlandish at it sounds, there are many online articles about this futuristic ingredient, including its alleged health benefits. 

If I have learned anything from this course, it’s that the problems resulting from alcohol consumption and the glorification of drinking in our culture cause many forms of harm that are diverse and pervasive. Perhaps alcohol has different outcomes for different people (men, women, rich, poor, young, old, etc.); however, even for those who are not psychologically dependent on alcohol, there are many forms of harm nevertheless. In addition to obvious medical problems such as liver disease, certain cancers, drunk driving and other accidents, there is also financial harm. One cultural anecdote that I like (which I learned from my husband who lived two years in Japan) is that, in Japan, the women/wives control the family budget and they dole out a small allowance to their husband.  While this is surprising in a nation where women lack equality with men in other areas, the reason they are permitted control of the family purse strings is that the men might drink away their salary in late nights of after-work drinking (which is part of being a good “salaryman.”). Women must take control of the finances, leaving the husband with okozukai – which translates to “pocket money” (www.japan-talk.com/jt/new/okozukai and www.bbc.com/news/business-19674306).  This indicates financial harm that can befall families, in addition to other health, safety, and accident problems.

The range of harms from alcohol are diverse and widespread. I anticipate that they will continue to be so – but perhaps not in ways that we can imagine today.  Just as a decade ago, nobody would have known about “drunk texting,” so will the future behaviors related to heavy drinking and alcohol dependency be different from today.  One area for possible hope is replacement of alcohol by marijuana.  In Olga Kovaleva’s blog, she considers different possible alternatives of marijuana serving as a replacement for alcohol, based on the declining alcohol sales in some states, and yet mentions the opposite possibility of these two substances serving as economic “complements” – meaning they go together, with more of one enhancing the benefit of the other. Further searches I performed to determine if traffic deaths have decreased in states that legal marijuana (which would be likely if alcohol and marijuana were substitutes, and if marijuana had no impairment on driving) found more studies that show no increase in traffic deaths from legal marijuana (which is a good thing), but also no evidence of decreased traffic fatalities. The link included here is to the simplest summary of the research; however, academic articles that I located and skimmed also reported the same results: no increase, but also no decline in such deaths (newfrontierdata.com/cannabis-insights/data-shows-fatal-traffic-accidents-do-not-increase-after-cannabis-legalisation/).

One other aspect of the future to consider is the following: even if the drinking habits of people do not change substantially in the future, we already know the long-term health consequences for those who drink heavily today. the NIAAA’s data inform us that many will have increased risks of cancers – breast cancer (as we read elsewhere, including in Drink), but also head/neck, throat, liver and colo-rectal cancers (www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet). Moreover, as we have explored in this course, women in developed countries drink much more heavily now, due to effective marketing specifically to them, combined with the belief that drinking makes women emancipated. This falsehood reminds me of Amy Schumer comedy routines – a comic who I mostly like and laugh along with – but she certainly over-does the role of the party girl turns into a sloppy drunk and makes bad choices about who she goes home from the bar or party with.

We know that heavy drinking among men and women today leads to a much increased probability of various cancers (listed above), as well as hypertension and diabetes. These are not signs of emancipation for women! Just as we have learned, based on the backlash to the tobacco industry that there is nothing macho about heavy smokers having a stoma in their neck to breathe through, there is nothing sexy or emancipated about women (or men) developing any of the cancers or other diseases discussed above.

Stigmas incorporate negative views towards an individual or a group of people. The stigmatizing attitudes towards individuals with substance abuse, which is strongly associated with other mental illnesses, can affect individuals to feel isolated, rejected, and experience levels of discrimination.

Society has a negative stigma about individuals who are battling and struggling with alcohol abuse. There are strong opinions of what is deemed socially acceptable among men and women when it comes to alcohol. Historically, alcohol use has been more evident among men; however, alcohol consumption levels are similar between men and women over the past decade. Women are consuming higher levels of alcohol than ever, which reflects the shift in the gender roles of women in our society.

In the past, women took on traditional gender roles of taking care of their house, family, and children.  Women of today are becoming go-getters, having economic independence, mothers, wives, and are taking up spaces in dominating male career fields. Women who take on some of these roles may engage in excessive or binge drinking, traditionally was viewed as “masculine” activities. Regardless of the shift of gender roles, drinking excessive amounts of alcohol has adverse health effects, which is now affecting many women today.

circa 1960: An American housewife demonstrates the cleaning power of ‘Vel’ detergent for a T.V. advert. (Photo by Hulton Archive/Getty Images)

In 2018, the National Survey on Drug Use and Health estimated 5.3 million adult women from the ages of 18 and older had an Alcohol Use Disorder (AUD) [4]. Many women are managing their lives and not fully acknowledging the fact they may have a drinking problem. Many of these women want to reject the narrative of being labeled as an alcoholic. Women who are labeled as alcoholics are viewed as sloppy, “loose”, having slurring of speech, difficulties holding down a job, consistently hungover, and their personal relationships are dysfunctional.

According to the American Psychiatric Association, individuals who do not fall into this mold of the “typical alcoholic” are known as high-functioning alcoholics. The high functioning alcoholic may appear to be a successful woman who can juggle her work and family life with ease. This woman is displaying an image of perfectionism and does not show she is physically or emotionally dependent on alcohol, but still, she may have difficulty resisting alcohol [1,3]. The successful woman or “Miss Has it All Together” comes in many different forms. She may not fit the generic alcoholic stereotype, yet this does not remove the fact she may be suffering from alcohol addiction[1,3]. Women will live in denial until their health starts to decline, facing issues at work, broken relationships, being emotionally drained, or other life events that will allow them to realize the extent of their drinking problem.  

Like many women who are denial of their drinking problem, I wanted to share a story of a woman named Jean, who appears to be the “successful woman” but is a recovering alcoholic [5].  

“I am one of the fortunate alcoholics who has lived to tell my story. But for the grace of God and the program of A.A., I would have died.

At that time, my drinking was fairly well under control; I was young, I had the stamina to get drunk every night and work every day, and the vicious cycle went on and on. I was married several times, held very prestigious jobs, i.e., working in various law firms, for a state Senator and a Probate Judge and the Lt. Governor’s office. I had a beautiful home and a husband who I thought I loved at the time; and most of all, my beautiful children.

Well, this husband didn’t love me as much as I thought; he did the right thing; he took my children, he booted me out of my beautiful home, and he divorced me because of my drinking problem.

I tried to blame everyone and everything I knew for my drinking, the death of my child, the ex-husbands, etc. Everyone was responsible for my drinking except me. The blackouts were, in a way, a blessing. I don’t want to remember some of those times…..None of my family would allow me in their homes; this was bottom out time. I looked in the yellow pages of the phone book and found the number for A.A.”

You can read more of her story through this link.

https://www.verywellmind.com/jeans-alcoholics-anonymous-story-63503

Women who are functional alcoholics like Jean are in denial and attempt to hide their drinking problem from others. It is essential just like Jean’s family to be aware if you have a loved one, family member, or friend who may have a drinking problem. That person may need an intervention to fully understand that they are putting themselves at risk health-wise and how it is affecting other areas of their personal lives. Women who struggle with alcohol abuse, hesitate to seek help because they do not want the label of an alcoholic and fear judgment from family and friends.   

 We need to change the narrative and stigma of alcoholism, for many women are suffering in silence. Women are drinking excessively because of many reasons, but alcoholic beverages are easily accessible, which is a problem. The government needs to create policies relating to pricing and taxes of alcohol, retail access, and reducing exposure to alcohol advertisements. These steps are necessary to minimize alcohol consumption and alcohol-related harm among women[2]. 

Also, early intervention is critical to reassure that long term effects of alcohol do not take full effect. Women who may not know where to get help can first seek advice from family, friends, and even your local doctor’s office. Doctors can perform different tests to see if you are showing any signs of chronic diseases or conditions caused by excessive drinking. Doctors can also speak with you on how to quit drinking or lessen the problem. Women who are experiencing alcohol abuse need a support system such as family, friends, school counseling, therapy, or outpatient treatment plans, which will aid in their recovery and healing. There are available resources and call a national helpline from the Substance Abuse and Mental Health Service Administration. The SAMHSA can help provide and locate services for individuals who are facing alcohol use disorders [6].

The high functioning alcoholic may appear to have it all together, but drinking excessive alcohol over time can have adverse effects if not appropriately addressed. Making changes in government policies and seeking help through intervention programs or support from loved ones can promote positive health outcomes of women who are struggling with alcohol abuse.

References

1. “What Is a Functional Alcoholic?” Dual Diagnosis, dualdiagnosis.org/alcohol-addiction/functional-alcoholic/.
2. “Addressing Alcohol-Related Harms: A Population-Level Response.” AMERICAN PUBLIC HEALTH ASSOCIATION, apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2020/01/14/addressing-alcohol-related-harms-a-population-level-response.
3. “Intervention Strategies for a High-Functioning Alcoholic.” org, www.alcohol.org/intervention/best-methods/.
4. “Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 18 Feb. 2020, niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics.
5. “Jean’s Alcoholic Story: I Tried to Blame Everyone and Everything.” Verywell Mind, Verywell Mind, 8 Apr. 2019, www.verywellmind.com/jeans-alcoholics-anonymous-story-63503.
6. “National Helpline: SAMHSA – Substance Abuse and Mental Health Services Administration.” gov, www.samhsa.gov/find-help/national-helpline.

ADVERTISEMENT

As we know, alcohol is everywhere. We don’t know if it’s possible to go an entire day without seeing an advertisement for alcohol. Whether it’s a prominent ad with a massive billboard of a beautiful lady sipping a frothy new flavor beer, or something as subtle as a close up of wine, our favorite movie star is drinking, alcohol has infiltrated our home life, work-life, and for many, our school life. As we’ve been talking about the increase in women drinking in the U.S and all around the world, it’s important to recognize new platforms alcohol companies are using to promote, such as social media. Although they are specific guidelines alcohol companies must adhere to, those regulations seem very vague, for such an important issue. The self-regulated guidelines for advertising alcohol on social media are mainly focused on not promoting to those under the legal drinking age [3]. In 2014, 67% of Americans aged 12 and older said they use social media [1]. For alcohol companies for marketing on social media, 71.6% of their audience must be over the age of 21 [1].  Please take a look below at some of the common social media platforms about how they protect against advertisements being shown to those under the legal drinking age.

We couldn’t find any regulations about how often you could see alcohol advertisements on social or the time of day these ads are prohibited. This is problematic as we discuss the normalization of heavy drinking. Not only are ads practically unregulated, but they are targeting specific groups. Are clever ads and new group-specific products driving the number of women who are engaged in drinking up? Look at this ad that came across my Instagram story as I was casually strolling.

Are you worried about the calories you consume while drinking? No worries, there are now many products targeting women, promoting few calories, and a refreshing fruity taste. How problematic is this? We need more policies to regulate how often, when, and where products can be promoted. Many of us have been warned that having too much screen time is for us. Now, it’s for new reasons.

You can find more information about the prohibited practices for alcohol advertisement here [2].

ACCESS

               As discussed in our previous blog post, stress drinking of alcohol is on the rise during the COVID-19 pandemic, especially for women. Access to alcohol plays an important role in this. Twenty-four-hour liquor stores and wine box subscriptions have kept the alcohol flowing for women stuck inside their homes. Many restaurants are currently offering “cocktails-to-go” and bottles of wine for sale with curbside pick-up orders. Lawmakers are even supporting this movement with temporary legislature, allowing the sell of to-go alcohol [5].

However, many organizations are calling for restrictions on access to alcohol during this pandemic. For instance, the World Health Organization European Region is arguing for restrictions to be “upheld and even reinforced” during the pandemic, in order to reduce alcohol harm [6]. WHO is fighting rumors circulating about alcohol protecting against the coronavirus. Setting the record straight, the agency has reported that alcohol compromises the immune system and can make one more susceptible to the virus.

REFERENCES

1. https://sproutsocial.com/insights/social-media-alcohol-marketing/
2. https://www.law.cornell.edu/cfr/text/27/5.65
3. https://www.alcohol.org/laws/marketing-to-the-public/
4. https://www.ttb.gov/advertising/alcohol-beverage-advertising
5. https://www.bizjournals.com/philadelphia/news/2020/05/21/pennsylvania-to-go-cocktails.html
6. http://www.euro.who.int/en/health-topics/disease-prevention/alcohol-use/news/news/2020/04/alcohol-does-not-protect-against-covid-19-access-should-be-restricted-during-lockdown

As we have all seen in recent months and years, social media influencers, Instagram influencers, to be more specific, have taken it upon themselves to promote alcoholic products to other women. They do this through partnerships with alcohol companies, wineries, and breweries across the globe. But maybe instead of influencers marketing for alcohol companies and receiving payment, they should do the same thing for the promotion of alcohol awareness and education among women. I mean we are living in an age where women are constantly saying ‘let’s build each other up,’ so what better way than to spread education on the use of alcohol for women by women?

Take a look at the list below for 3 ways female influencers can use their platform for marketed alcohol awareness education rather than product marketing for big alcohol!

Partnerships with public health-oriented organizations

About 84% of Instagram influencers are women who have built a strong follower-base through their online content. Companies like, Truly Hard Cider and RumHaven, have partnered with ladies of the Bachelor/Bachelorette franchise to promote their products. These promotions are usually completed through #ads or #sponsored to increase awareness among people like us of their products and latest site promotions.

Sources: @ashely_iaconetti and @hannahg11

But maybe instead of ad promotions for alcoholic products, influencers could partner with organizations like UN Women or CDC Foundation. Both publicly funded organizations that share public health-related content on their Instagram’s and work each day with government, private, and public partners to create and protect policies for the health, safety, and security around the world. If influencers like Hannah G. or Ashley I. [pictured above] could partner with these not-for-profit organizations to share alcohol awareness education rather than marketing for big alcohol, as a society, we could get ahead of the women and alcohol epidemic and promote healthier lifestyles, much like what some influencers already do with small fitness companies.

#ALCOHOLAWARENESS campaigns

In 2016, a woman named Louise Delage became a viral Instagram sensation, where she posted a photo each day featuring herself and an alcoholic beverage. Delage’s account quickly reached more than 10,000 followers and received about 50,000 likes on each post almost overnight. But to everyone’s surprise, this account was all fiction, created by a French addiction support organization called Addict Aide, to bring awareness to the subject of women and alcohol in France. Alcohol and women is not a topic of discussion in France culture, according to Julien Leveque, French strategic advertiser. He also mentioned that French women are too often targets for alcohol marketing and as a result have begun drinking too much, a universal theme seen among alcohol and women.

Source: @shalomelambert

While this may be an unorthodox way to bring awareness to alcoholism among women, it was very effective. The creation of this account shows all of us how alcoholism does not discriminate and how social media allows some of us to hide our addictions in plain sight. With more than 10,000 followers, all of them were surprised to learn that Delage was addicted to alcohol, since posting photos and videos of yourself and friends drinking alcohol has become a cultural norm.

In addition to promoting alcohol awareness education in partnership with not-for-profit organizations, influencers could participate in the #ALCOHOLAWARENESS campaign to share their own struggles and further the education of alcohol among women in order to help others like Louise who may be struggling with alcoholism in plain sight.

So, what is next for alcohol and female influencers?

Challenge yourself and your followers

• Challenge yourself and your followers to talk about how alcohol affects your physical and emotional health.
• Challenge yourself and your followers to experience life events without using alcohol as a social clutch.
• Challenge yourself and your followers to share education on the negative effect’s alcohol causes, like depression, negative affect, cognitive fuzziness, or nausea.
• Challenge yourself and your followers to get personal about how alcohol has affected your life and your loved ones.
• Challenge yourself and your followers to participate in a ‘dry month’ where no alcohol is involved in your day-to-day and share your experiences on your Insta-stories or feed.

Since social media will never go away in our current culture, it is important that we continue to support and uplift each other as women. Female influencers who use their social media platforms in order to educate about alcohol rather than market for big alcohol companies will provide us with longer and more productive lives filled with the things we love the most.

Source: @drinkershelp

Women who do excessive drinking are at greater risk. CDC suggests excessive alcohol use among women is risks to women’s health. According to the Behavioral Risk Factor Surveillance system data, it is reported that at least 40 % of adult women in the last 30 days were involved in drinking alcohol and at least 12 % of them were involved in binge drinking. [1] U.S dietary guidelines suggest that only one drink of alcohol per day must be consumed by women. Alcohol misuse by women can increase the chance of facing higher risks. [2] One of the reasons stated by National Institute of Alcohol Abuse and Alcoholism is that if a woman who weighs the same as man drink the same amount of alcohol, woman’s blood alcohol concentration will be higher because women bodies consists have less water compared to men which put women at greater risk. [5] So, what happens next? How does excessive drinking affect women’s health?

Some of the long-term health risks for women who drink excessive alcohol are as follows: Alcohol use disorder, liver damage, heart disease, brain damage, breast cancer, and fetal alcohol syndrome. [5] Alcohol use disorder (AUD) is the brain disorder it is caused due to the inability to stop drinking alcohol because of emotional and physical dependence on alcohol. Alcohol use disorder ranges from mild to severe. [5] Treatment for AUD includes behavioral therapies and counseling such as cognitive-behavioral therapy, motivational enhancement therapy, martial and family counseling, and brief interventions. Therapies and counseling can help change the behaviors of people who drink excessive alcohol. [3] Liver damage occurs to women as a consequence of drinking excessive alcohol. Treatments for liver damage include alcoholic rehabilitation program, multivitamins such as B-complex vitamins, liver transplant if it is affected by cirrhosis and vitamin A supplements. [8]

Source 1 : https://www.ailbsindia.com/alcoholic-liver-disease-symptoms-treatment/

Heart disease is caused by long-term, excessive and heavy drinking. Women are more likely to experience alcohol-related heart problems than men. Intake of excessive alcohol increases blood pressure which one of the risk factors for getting a stroke or heart attack. Excessive drinking can also make heart muscle weak which can cause heart failure and die. [6] Alcohol also affects the brain; it can also cause brain damage. Based on research alcohol misuse causes more brain damage to women than men because of their body size. Excessive consumption of alcohol directly affects the brain’s neurons and alcohol can damage or kill neurons. There is no treatment for alcohol-related brain damage. [4] Studies show that consuming alcohol can also lead to breast cancer. According to the National Institute of Alcohol Abuse and Alcoholism, women who take one drink a day have a 5-9 % higher chance of developing a risk of breast cancer than the women who don’t consume alcohol. [5]

Fetal alcohol syndrome (FAS) is caused by heavy drinking during pregnancy. Drinking during pregnancy can be harmful, it can interrupt the normal development of the brain and the face. It can also cause cognitive, behavioral, and physical problems in children. Interventions for FASD include school-based interventions, this can help children learn easily. Family support classes and groups help parents on taking care of child with FASD. Behavioral interventions for FASD children include training in problem-solving, personal safety, and personal safety. [7]

Source 2: https://eu.clipdealer.com/vector/media/A:97523658

References

1) Fact Sheets – Excessive Alcohol Use and Risks to Women’s Health. Centers for Disease Control and Prevention. March 7, 2016. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/alcohol.htm

2) U.S. Department of Health and Human Services and U.S. Department of Agriculture. Appendix 9: Alcohol. 2015–2020 Dietary Guidelines for Americans. Eighth Edition. December 2015. Available at https://health.gov/dietaryguidelines/2015/guidelines.

3) “Alcohol Use Disorder (AUD) Treatment.” MedlinePlus, U.S. National Library of Medicine, 17 Apr. 2020, medlineplus.gov/alcoholusedisorderaudtreatment.html.

4) “Alcohol-Related Brain Damage.” Alcohol Rehab Guide, 8 Oct. 2019, www.alcoholrehabguide.org/resources/medical-conditions/alcohol-related-brain-damage/.

5) Women and Alcohol. (2020, February 24). Retrieved from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/women-and-alcohol

6) Alcohol and heart disease. (n.d.). Retrieved from https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/diseases/alcohol-and-heart-disease

7) Fetal Alcohol Exposure. (2019, December 24). Retrieved from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/fetal-alcohol-exposure

8) Alcohol-Related Liver Disease. (2017, April 18). Retrieved from

https://www.healthline.com/health/alcoholism/liver-disease

9) Source: 1 https://www.ailbsindia.com/alcoholic-liver-disease-symptoms-treatment/

10) Source: 2 https://eu.clipdealer.com/vector/media/A:97523658

COVID-19 has brought many new changes in women’s lives. Due to the pandemic, many have lost their jobs and there was economic downturn. Research suggest that COVID-19 has negatively impacted women’s mental health such as increased depression, distress, low self-esteem, and anxiety. Additionally, it also led to excessive consumption of alcohol and drugs. (8)

According to a report there was a 50 % increase in alcohol sales and home delivery of alcohol also drastically increased about 300 % in March compared to January 2020. (3) People were stocking beforehand for social distancing. Some of the reason’s women are using alcohol during the pandemic is to treat their stress, worries, fears, anxiety, and depression. (1) Stress and anxiety are usually caused when they are locked in the house due to self-isolation, helping kids to finish up their school assignments, stress of loneliness, stress about job layoffs, stress with their newborn child, or fear of sleepless nights.

Source: https://sites.gsu.edu/whyshedrinks/2019/06/21/i-promise-not-to-drunk-dial-you-alcohol-you-later/

Especially, with the ongoing threat of coronavirus, women feel worried, anxious, and stressed for themselves or their loved ones. It is human nature that we all worry that something may happen to us. And when faced with unknown situations and circumstances we go through fear and doubts which may lead to self-medication. And some women choose alcohol as self-medication to calm their anxieties. (4)

Due to social distancing, it has become highly impossible for people to meet at the bars to socialize and drink. Another means of socializing these days is through social network sites. People are using social network as a way of expressing and communicating with each other.

https://www.facebook.com/TheWhiskyBarrelPub/photos/pb.1810695922333536.-2207520000../2817115131691605/?type=3&theater

https://www.pinterest.com/pin/416301559281337304/

Memes like these are widely spreading over the internet to encourage people in consumption of alcohol. There is a high possibility that memes are convincing women to consume alcohol during the COVID-19.

So, what are some ways to cope with stress during COVID-19?

CDC listed several ways to cope with stress during COVID-19. Firstly, they suggest that one must avoid alcohol and drugs. They also suggest taking breaks from listening to news stories, reading, or watching information about pandemic can help reduce stress because hearing stuff about COVID-19 repeatedly can affect a person’s mental health. Making connections with others such as talking with people who you trust will reduce one’s stress. Trying to do other activities that you enjoy can also calm a person’s anxiety. Additionally, they suggest it is important to take care of one’s body, such as mediation, taking deep breaths, stretch, eat healthy, well-balanced meals, exercise regularly, get sufficient sleep at nights.(5)

Meditation can improve woman’s mind and reduce stress.(6) According to National Center for Complementary and Integrative Health, many studies suggest that meditation can be helpful in number of conditions which includes, pain, psychological disorder, and high blood pressure. In general, mediation is a practice of mind and body. It increases calmness and relaxation to state of mind and body. (7) Mediation can be a powerful tool in treating women with anger, anxiety, depression, and stress. (6) Mediation practice during COVID-19 can be helpful in fighting stress. Based on the results 2014 study, mediation helped improve anxiety and depression of 3,515 participants. (7)

References:

(1) Abbey, A., Smith, M. J., & Scott, R. O. (1993). The relationship between reasons for drinking alcohol and alcohol consumption: An interactional approach. Addictive behaviors, 18(6), 659. https://pubmed.ncbi.nlm.nih.gov/8178704/

(2) “Pin by T. Dubs on Memes – Alcohol: Alcoholic Drinks, Neon Signs.” Pinterest, www.pinterest.com/pin/416301559281337304/.

(3) “Stress Drinking: Alcohol Consumption Increases During COVID-19.” University of Utah Health, https://healthcare.utah.edu/the-scope/shows.php?shows=0_p0xim6x3

(4) “Coronavirus (COVID-19) & Alcoholism.” Alcohol.org, www.alcohol.org/resources/coronavirus-and-alcoholism/.

(5) “Mental Health and Coping During COVID-19.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 Apr. 2020, www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html.

(6) “Meditation Helps The Woman’s Mind: Less Stress, Anxiety, Addiction.” EOC Institute, eocinstitute.org/meditation/meditation-benefits-for-women/.

(7) “Meditation: In Depth.” National Center for Complementary and Integrative Health, U.S. Department of Health and Human Services, www.nccih.nih.gov/health/meditation-in-depth.

(8) Panchal, Nirmita, et al. “The Implications of COVID-19 for Mental Health and Substance Use.” KFF, 21 Apr. 2020, www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/.

With most states legalizing medical cannabis, and others legalizing recreational cannabis use, or decriminalizing cannabis possession, there has been a great deal of interest into how this may affect alcohol use and outcomes. The common debate amongst those for and against the legalization, with regard to alcohol, are the ideas of cannabis as a substitute (those for) or as a complement (those against). Why does it matter? Well, if cannabis and alcohol are substitutes, meaning increases in cannabis use result in decreases in alcohol use, there could be a reduction in alcohol related costs such as healthcare, traffic accidents, dependence, and even deaths [3]. Consuming alcohol can lead to organ failure and other health issues, which can not be said for cannabis. If the two substances are complements, legalization would result in an increase use of both cannabis and alcohol, increasing the costs referenced above significantly. Consuming both simultaneously could lead to even more individual and societal harm than what alcohol causes alone.

Multiple studies have been done trying to understand cannabis legalization’s effects on alcohol in the states which have already legalized it, but it is a hard issue to navigate and truly understand because much of the available research is politically motivated, whether it be influenced by conservative values, liberal values, or the alcohol industries deep pockets; and if I learned one thing from my bio-statistics class, it is that data can be easily manipulated to give the results you want. Also, there has been limited research done on how it could affect women and men differently. The only way we can truly understand the relationship between cannabis and alcohol consumption is if more unbiased research is done, looking at specific indicators and populations.

So, what has the available research shown us so far?

Arguments and evidence for substitution:

Decrease in Alcohol Sales and Consumption:

Our very own Georgia State University professor, Alberto Chong, published a 10-year study that showed alcohol sales dropped 13% in states with medical marijuana laws [2]. While a separate study showed a decrease in the per-capita sales of beer [3]. Alcohol consumption and likelihood of becoming a frequent drinking has also dropped in states with legal medical and/or recreational cannabis, especially amongst high-schoolers and young adults [3]. A reduction in sales and consumption is considered direct evidence of cannabis as a substitute for alcohol.

Decrease in Alcohol Related Harms:

If cannabis use increases and alcohol use decreases, we would expect to see a large reduction in alcohol related harm. There are no fatal effects of overusing cannabis, unlike binge drinking alcohol, which can kill you quickly and unexpectedly. College students are known to partake in binge drinking, with consequences including alcohol poisoning, drunk driving, and assault. One study showed that alcohol binge use dropped 6% in states with legal recreational cannabis, with an even larger drop in students over 21 years old [1].  Multiple studies on medical, recreational, and decriminalization found a reduction in fatal alcohol related traffic accidents, and emergency room visits mentioning alcohol [1,3]. Though there is little evidence on cannabis’ addictiveness, we know alcohol is highly addictive, so increased cannabis use could reduce the lifelong struggle and health and treatment costs of alcoholism.

As a substitute coping mechanism:

Though using any substance to cope is not good for one’s mental health, using cannabis instead of alcohol could be a better alternative because of the above-mentioned harms associated with alcohol. Substitution depends on a similarity between substance effects. “Neuroscience research indicates that marijuana and low-dose alcohol use share neuro-pharmacologic effects of reward and sedation,” giving evidence to similar effects [3].  

College students who tended to use drugs/alcohol to cope showed a substitution effect switching to cannabis, with women less likely to co-use cannabis with alcohol [8]. Dr. Chong and his fellow authors also found evidence of an increase in women using cannabis to self-medicate instead of turning to alcohol [2]. In Washington state legalization of recreational cannabis led to a large decrease in alcohol related harms at home and financial harms for women [7].

Amongst 350 adult customers of medical marijuana dispensaries in Berkeley California, researchers found that 40% of them reported using cannabis as a substitute for alcohol due to its less severe symptoms, better symptom management, and less withdrawal potential [3].

Arguments and evidence for complementary:

Cannabis use and Co-use harms:

Further relaxing controls on cannabis use could lead to more developmental effects on young adults underdeveloped brains, especially since there is a connection between cannabis and increased risk for psychosis [1]. Also, since cannabis is most commonly used through smoke inhalation, there could be significant lung issues from chronic use. Multiple studies against legalization use the “gateway drug argument,” with one study showing cannabis use is associated with later symptoms of alcohol disorders [3]. Women’s progression to cannabis use disorders (CUD) is much faster than males and despite women using cannabis less regularly than men, they have more severe psychiatric, medical, and employment complications. [6] Also adolescent girls are more likely to meet the criteria for cannabis abuse [6].

When alcohol and cannabis are used simultaneously there is more risk and danger than when either is used alone, “for example, those who use marijuana and alcohol together have the highest rates of unsafe driving” [3]. Studies have also shown that THC (tetrahydrocannabinol) levels increase if alcohol is consumed simultaneously resulting in more pleasurable mood effects [3]. This might lead to people combining the substances to reach a better high. If judgment or decision-making is impaired by cannabis, unintended increases in alcohol consumption could result.  

Academic performance:

College students who use cannabis infrequently by itself have lower GPAs, and those who report co-use have an even greater decrease in their GPAs, affecting males more than females [5]. This is mostly likely due to cannabis impairing mental functioning and memory. Students were also less like to graduate on time or even be enrolled their senior year [8]. Those who were less likely to use drugs normally, showed a complementary effect in states with legal recreational cannabis, reporting co-use approximately once a month [8].

So, what does all this mean?

Alcohol and cannabis have both been used since the earliest recorded human history and have been the two most commonly used intoxicants in the United States for decades. The early stigma of cannabis use in the United States is a result of racism and prejudice, propaganda portraying users (minorities) as thieves, rapists, and murders, with no scientific evidence backing these claims up [4]. The increasing amount of evidence on the health benefits of cannabis has begun to break down the negative connotations associated with its use. If the stigmas are broken down even more, that could lead to better unbiased research. Also, with limited evidence for both positive and negative effects of cannabis use for women, future research should focus on better determining the difference between sexes.

With alcohol laws changing at the same time as cannabis laws, it can be hard to show correlations between the two. Whether showing a substitution or complementary effect, most studies made sure to mention that substance use, no matter which substance, most importantly depends on prices, age, availability, convenience, and what motivates one to drink [3,8]. To better understand the public health implications and inform policy decisions, the factors that influence substance use must be identified. And no matter whether they are substitutes or complements, moderation is still critical. Its important to mention that cannabis legalization and use could have no effect on alcohol issues. So, what does all this mean? We’ll have to wait and see.

References:

1. Alley, Z. M., Kerr, D. C., & Bae, H. (2020). Trends in college students’ alcohol, nicotine, prescription opioid and other drug use after recreational marijuana legalization: 2008–2018. Addictive Behaviors, 102, 106212. doi: 10.1016/j.addbeh.2019.106212
2. Baggio, M., Chong, A., & Kwon, S. (2017). Helping Settle the Marijuana and Alcohol Debate: Evidence from Scanner Data. SSRN Electronic Journal. doi: 10.2139/ssrn.3063288
3. Guttmannova, K., Lee, C. M., Kilmer, J. R., Fleming, C. B., Rhew, I. C., Kosterman, R., & Larimer, M. E. (2015). Impacts of Changing Marijuana Policies on Alcohol Use in the United States. Alcoholism: Clinical and Experimental Research, 40(1), 33–46. doi: 10.1111/acer.12942
4. Ivanov, K. (2017, March). High Times: The evolution of the stigma on marijuana and attempts to tear it down. Retrieved from https://www.lakeforest.edu/live/news/8003-high-times-the-evolution-of-the-stigma-on
5. Meda, S. A., Gueorguieva, R. V., Pittman, B., Rosen, R. R., Aslanzadeh, F., Tennen, H., … Pearlson, G. D. (2017). Longitudinal influence of alcohol and marijuana use on academic performance in college students. Plos One, 12(3). doi: 10.1371/journal.pone.0172213
6. Secades-Villa, R., & Fernández-Artamendi, S. (2017). Gender Differences in Cannabis Use Disorders. Handbook of Cannabis and Related Pathologies, 131–137. doi: 10.1016/b978-0-12-800756-3.00015-6
7. Subbaraman, M. S., & Kerr, W. C. (2020). Subgroup trends in alcohol and cannabis co-use and related harms during the rollout of recreational cannabis legalization in Washington state. International Journal of Drug Policy, 75, 102508. doi: 10.1016/j.drugpo.2019.07.003
8. Suerken, C. K., Reboussin, B. A., Egan, K. L., Sutfin, E. L., Wagoner, K. G., Spangler, J., & Wolfson, M. (2016). Marijuana use trajectories and academic outcomes among college students. Drug and Alcohol Dependence, 162, 137–145. doi: 10.1016/j.drugalcdep.2016.02.041
9. Tardosky, E., Tardosky, E., Tardosky, E., Meyer, M., Meyer, M., Meyer, M., … Meyer, M. (2020, January 11). Cannabis vs Alcohol in 2020: Drinking Deaths on the Rise, is Marijuana the Answer? Retrieved from https://www.healthmj.com/cannabis/alcohol-marijuana-use/

One of the biggest things that have I have become aware of since coming to college is the increase in awareness of alcohol abuse within the Hispanic/Latinx community. While looking for research topics for my paper, I noticed an underrepresentation of research in mental disorders and alcohol abuse within the Hispanic population.^[1] Let’s take a closer look at the population in general.

What do the numbers look like?

Let’s begin by comparing women in different ethnic backgrounds in the National Survey on Drug Use and Health in 2018 who’ve had alcohol dependency or abuse in the past year.^[2]

^ANSDUH 2018: Race/Hispanicity 

^BNSDUH 2018: Had alcohol dependence or abuse in the past year 

^C: CI means Confidence Interval 

When looking at just the percentages from the 2018 survey, we see that among the minorities, women who identified as Hispanic had the largest percentage of alcohol dependence or abuse in the past year compared to Non-Hispanic Black women and Non-Hispanic Asian women. There is a high percentage of abuse among Latinas but there isn’t enough research on how to help women with this cultural background.

So, what’s the reason behind this? Let’s start with understanding Hispanic culture and the relationship that they have with mental disorders.

Latin Americans and Barriers to Mental Health

Now in order to understand why further research hasn’t been done, it’s important to learn about the barriers that can stop people from seeking help. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has identified key factors that could prevent Hispanics from seeking help.^[3]

• Cultural barriers, language barriers, and other barriers to communication
• Issues with discrimination and even perceived discrimination
• Fears of being singled out or persecuted
• The level of acculturation achieved by the particular individual
• Barriers to access to medical care
• Cultural views of treatment for addiction
• Family responsibilities that may result in some individuals not seeking treatment
• Stigma or shame associated with being diagnosed with an addiction or alcohol use disorder or being in treatment for one
• Obvious issues with undocumented immigrants, such as the fear of deportation, fears of persecution, lack of resources, etc.

One of the key points that resonates the strongest among Hispanics is the very first bullet point. Current research has shown that immigrants who reject American culture are 10x less likely to report alcohol abuse than immigrants who accept American culture. Those who accept American culture are more suspectable to peer pressure with alcohol abuse and even more likely to develop chronic and recurring problems associated with their addictive behavior. ^[4]

How to Treat Hispanic Women with Alcohol Abuse and Mental Disorders

The first step is to realize the cultural differences in the Hispanic culture will also translate when treating mental health disorders associated with alcohol abuse. According to the Substance Abuse and Mental Health Services Administration, there are guidelines to follow for those coming from Hispanic cultures.^[5] The first step is to be able to find someone who speaks the language. In the United States, language barriers are an issue when trying to help immigrant communities, not just Hispanics.

Finding someone who has the same cultural background is a hurdle in getting help and recovering. The lack of representation is something that does stop many from seeking help as most believe that no one will be able to relate to what they have gone through. This includes views on how Hispanics see alcohol consumption, how gender roles affect alcohol consumption, and lastly the stigma toward mental health in general.

A big cultural factor affecting recovery is how family-oriented the Hispanic household is. The biggest thing when someone seeks help for substance use disorder is therapy. Therefore, family therapy is strongly recommended to help Hispanics on the road to recovery. In fact, recent studies have shown that Hispanic families relied more on extended family more than friends.^[6] In a recent study by the American Psychological Association showed that acculturation is needed in order to expand ethnic inclusivity in research and improve practices for minorities dealing with mental health disorders. ^[7]

Now and Beyond

Currently, there are programs being expanded in order to help the Latinx community. For example, the SAMHSA website outlines different programs to help combat the stigma in mental health and substance abuse written in both English & Spanish.^[8] Programs include teaching parents/caregivers’ methods to talk to adolescents about the harm that can come from alcohol abuse. The website also includes clinics and healthcare professional guidelines on how to help those in Hispanic culture with alcohol abuse.

There is still a strong need to expand representation in all fields regarding mental health and alcohol abuse. As the Hispanic population grows in the United States, so will the research and practices will become refined.

References

1. “Alcohol and the Hispanic Community.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 26 June 2019, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-and-hispanic-community.
2. SAMHDA. (20 May, 2020). National Survey on Drug Use and Health, 2018. Retrieved from https://pdas.samhsa.gov/#/survey/NSDUH-2018-DS0001/crosstab/?column=NEWRACE2&control=SEXAGE&filter=NEWRACE2!=6,3,4&results_received=false&row=ABODALC&run_chisq=false&weight=ANALWT_C  

3. “Information on Hispanic Alcoholism & Rehab Rates.” org, 13 Dec. 2019, www.alcohol.org/alcoholism-and-race/hispanic/.
4. Myers, Raquel, et al. “Acculturation and Substance Use: Social Influence as a Mediator among Hispanic Alternative High School Youth.” Journal of Health and Social Behavior, U.S. National Library of Medicine, June 2009, ncbi.nlm.nih.gov/pmc/articles/PMC4181567/.
5. “CSAT.” gov, 14 Apr. 2020, www.samhsa.gov/about-us/who-we-are/offices-centers/csat.
6. Alvarez, Josefina, et al. “Substance Abuse Prevalence and Treatment among Latinos and Latinas.” Journal of Ethnicity in Substance Abuse, U.S. National Library of Medicine, 2007, ncbi.nlm.nih.gov/pmc/articles/PMC3059600/.
7. Berry JW. Conceptual approaches to acculturation. In: Chun KM, Organista PB, Marin G, editors. Acculturation: Advances in theory, measurement, and applied research. Washington, D. C.: American Psychological Association; 2003. pp. 17–38. 
8. Schwartz, S. J., & Zamboanga, B. L. (2008). Testing Berry’s model of acculturation: A confirmatory latent class approach. Cultural Diversity and Ethnic Minority Psychology, 14(4), 275–285. https://doi.org/10.1037/a0012818

goodtherapy.org

It is not a small thing to say that women are integral in today’s workforce. As of 2017, 47% of the U.S. workforce are women, with 10 million businesses also being owned by women. With more families becoming dual-income households (60% as of 2012), 70% of mothers with children under 18 are in the labor force, with over 75% of them employed full-time. Mothers are the primary or sole earners for 40% of households with children under 18 today, compared with just 11% in 1960. If all of these statistics haven’t made it clear yet, women today are under more stress today than they were in previous years. With the increasing burden of workforce stress on the female population, women are still expected to maintain household responsibilities. Married Americans mothers spend almost twice as much time on housework and child-care than do married fathers. With work bringing its slew of issues that cause stress, women are then coming home to more pressure from home life demands, when and how are women dealing with the increasing burden of stress in their lives?

In the past year, women were twice as likely as men to have symptoms of depression. Unipolar depression is

understandingsociety.ac.uk

predicted to be the second leading cause of global disability burden by 2020 and is twice as common in women. Many women deal with the challenges of single parenthood, such as working multiple jobs to make ends meet. Also, women may be caring for their children while also caring for sick or older family members.

Along with depression, some women may become more susceptible to substance use or alcohol dependence, making depression and other disorders harder to treat. Women who drink have a higher risk of some alcohol-related issues compared to men. Studies show that women start to have alcohol-related problems sooner and at a lower drinking level than men. These alcohol-related diseases include liver damage, heart disease, alcohol use disorder (AUD), brain damage, breast cancer, and problematic pregnancies. While the overall prevalence of drinking and binge drinking did not change for men, there was a 10.1% increase in the incidence of drinking and a 23.3% increase in binge drinking among women.

huffingtonpost.com

With these statistics, the future can seem bleak for women; we have made fantastic strides with equality with the scars; it seems to prove it. Future directions in women’s health need to take primary preventive actions to build barriers between women and initial factors that can lead individuals to mental health and substance issues. Primary physicians should be more sensitive to the stresses that their female patients encounter with their lifestyles. Make sure individuals are aware of signs of alcohol misuse, depression, anxiety, and other disorders that can be caused by stress. If employers want their employees to be at their optimal health to avoid additional expenses in healthcare, they should invest in a resident psychologist or counselor. Someone that employees can talk to, to relieve stress and lessen the burden towards diseases. Just like businesses promote healthy eating and physical activity, employers should also put resources towards mental health. The U.S. government can push for policies making paid parental, family, and sick leave mandatory for all workers. Discussing gender roles and expectations in the families can also help to break down the unacknowledged disparity in the workload at home. These collective efforts and more are necessary for protecting not just women but all adults against stress, depression, alcohol-related issues, and more.