Closing the Gap: Gender Disparities in Alcohol Use Disorder and Suicide Rates 

While alcohol use disorders and suicide are topics often avoided due to their sensitivity and difficulty to encapsulate in words, they are everpresent in the lives of millions of Americans. Suicide alone accounted for over 47,000 deaths in 2017 alone, and is ranked overall as the 10th leading cause of death among Americans. But, adding context to this issue brings it more clearly into focus; suicide is the second leading cause of death among those aged 10-34. Some of the youngest of us are at the highest risk for ending their own lives. And, looking at those suffering from alcohol use disorders, the population of victims soars. The NIAAA estimates that 16 million americans have AUD. With such numbers being direct victims, it’s inarguable that we can ignore these challenges. 

While anyone from any background, gender, ethnicity, or culture can suffer from either or both suicidal tendencies and alcohol use disorder, we know that a higher rate of men suffer than women. In 2017 alone, men were 3.54 times – not percent, but multiplied – more likely to die by suicide than women. Men are also almost 2 times more likely to have AUD. Because of this reality, many treatment methods have been created by and, perhaps subconsciously, for men. Until recently, we have operated under the assumption that alcohol use, long term, impacts all genders in the same way. But now we know that we were wrong. By being less efficient at metabolizing alcohol, women suffer the negative consequences of alcohol abuse more quickly and with a lower volume of alcohol than men. When we take AUD into account in terms of death by suicide, then, what does the gender gap look like? In line with the new research showing that women are physiologically more susceptible to the effects of AUD, we may hypothesize that the same would occur psychologically. But, the question remains. By how much?   

Without taking into account the impact of AUD, men are 293.75% more likely to die by suicide. When we look at alcohol-attributable suicides, however, we see that enormous gap shrink to only 55.24%. This suggests that while the rate amongst men still remains higher, excessive alcohol use creates a greater impact on death via suicide amongst women. 

Our current culture is one that is both acknowledging women drinking – and drinking more- while simultaneously encouraging the behavior. While the awareness might create an openness for women to discuss AUD and recognize harmful patterns in their own drinking, the encouragement to drink more dwarfs this silver lining. 

The necessary response, I believe, is clear; gender and culture-sensitive AUD treatment methods and programs must be developed and made available to all those suffering. It would be an irresponsible and cruel act to divert all of our energy and resources to studying and treating AUD in women, leaving men behind. The next steps should be ones of equity as we continue to uncover the many variables that can affect one’s risk of suicide. 


The Consequence of Turning a Blind Eye 


While there are some general, yet quantifiable, differences between males and females in terms of biology and physiology, there are seemingly endless dichotomies between these two genders in terms of social norms and expected behaviors. From preferences to habits, from tendencies to relationship expectations – we’ve created cultural binaries and placed men and women on opposing sides. This results in measurable differences that have real impacts on physical, mental, and emotional health. 

We know about how alcohol has varying physiological afflictions on these two sexes, but we haven’t yet adequately considered the different approaches required to address how men and women must approach recovery. Because women are “less likely to seek treatment” for an alcohol use disorder and instead “tend to seek care in mental health or primary care settings,” women are immediately at a disadvantage when it comes to addressing dependence and addiction (Gender and Use of Substance Treatment Services). Part of this is due to a heavier stigma placed upon women when it comes to substance abuse – leading women to not only avoid such a diagnosis but also be less able to recognize one – and it seriously damages a woman’s ability and likelihood to recover. 

In order to address this disparity, we must recognize the ramifications not only presented by physiological divergence, but also those created by an arbitrary, two-sided culture. By seeking equality, we fail to achieve equity. Our response must be to acknowledge these distinctions while they continue in light of gender-specific norms. We must accept the unique needs of different cohorts – be they by gender identity, ethnicity, or the unpredictable nature of individuality. 

As it relates to women in need of treatment for alcohol use disorders, a crucial next step in improving care and outcomes would be to collaborate with mental and primary healthcare providers. If women are failing to see the addiction within their anxiety or depressive symptoms, they must be defined. Mental and primary healthcare providers should receive additional training on recognizing alcohol use disorder in women of all ages, and they should have appropriate and specialized referrals they can make. In this way, we address one of the first and most crucial obstacles – helping people to recognize that they have an unhealthy and toxic relationship with alcohol.  

Under the Guise of Self-Care: Alcohol Use & Women

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We’ve hit a revolutionary point in human medicine – we nearly completely acknowledge the existence, pain, and cost of poor mental health. We’ve addressed this medically through prescription drugs and therapy. We’ve even taken a stand culturally and recognize the importance of taking mental health days as you would sick days, and participating in self-care habits that go beyond our physiology and sooth our minds as well. 

This evolution has been overwhelmingly beneficial as individuals from all walks of life feel more able to discuss their mental wellbeing and recognize its importance. Addressing chronic stress and loneliness has undoubtedly extended and saved lives. We’ve moved even further as we not only see the value, but actively encourage acts of self-care that address our physiological and phycological needs. It’s in our TV shows, memes, HR policies, self-help books – we know self-care is important. 

But… Do we know how to give self-care? Do we understand its complexities? Can we differentiate between adaptive and maladaptive behaviors or coping mechanisms? With troubling messages through our cultural media and a growing alcohol use disorder rate amongst women, I believe the answer is “no.” 

Much of the communication directed towards women explains the “steps” she can take to relax and focus on herself. And there’s nothing inherently wrong with these behaviors.  

Having a glass of wine. 

Spending the night in. 

Purchasing gifts for oneself. 

Donning loungewear. 

Declining social invitations. 

Indulging in comfort food.

In moderation, all of these things are okay. In excess, however, or combined, they become problematic. 

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Drinking alone, isolating oneself, bingeing on food or alcohol, making excessive purchases, and not leaving the house are not healthy ways to manage stress or practice self care. They may act as temporary “bandaids” that distract from the challenges around us, but the challenges are never addressed.

It is through reaching out to loved ones, staying active, and eating well that we can begin to overcome our mental and emotional struggles. It’s through seeking professional help and recognizing if or when medication would be a meaningful addition. It’s by addressing the problem, not veiling it, that we practice true self care.