Alcoholism is a growing public health concern among women. Physical, psychological, and social effects of alcohol differ among women and men and present challenges when considering diagnosis, treatment, and prevention². According to the CDC, gender differences such as body structure and brain chemistry can cause women to absorb more alcohol and take longer to remove, or metabolize, from their system. If women and men were to drink the same amount of alcohol, women would be more impacted and as a result would have detrimental effects from the alcohol quicker than men. Women who misuse alcohol are more likely to experience psycho-sexual dysfunction, anxiety, shame, low self-esteem, and bulimia than women who do not misuse alcohol¹. The negative emotion of shame and guilt is experienced more by women than men and can affect treatment¹. In 2013, 40% of White women, over 10% of Hispanic women, and less than 10% of African American women were found to binge drink, which for women is considered as 4 or more drinks in a 2 hour time-period.

What are the risks…

Misuse of alcohol includes a number of serious risks, including:

• Breast cancer
• Unintentional injuries (car crashes, falls, burns)
• Alcohol use disorders
• Chronic diseases
• Violence
• Sexually transmitted diseases
• Fetal alcohol spectrum disorders (FASD)
• Adverse pregnancy outcomes
• Liver disease

What are the treatment options…

As new generations experience acclimation to social, economic, and cultural characteristics, the gender gap in drinking behaviors has become less significant². This can be due to several factors including a decline in impact on known psycho-socio-cultural factors and the consequences of alcohol-related disorders. It’s important to note that these factors have an influence on alcohol use and can be used to determine effective treatments.

Other treatments include motivational enhancement, cognitive behavioral therapy, brief therapy, and Alcoholics Anonymous (AA) and can be women-only based. Studies have shown that women prefer treatment geared towards their specific needs in relation to low self-esteem, poor self-image, self-harm, and depression, instead of an overall therapy¹. Drinking behaviors related to cultural perceptions, social drinking patterns, and private rituals are considered when treating alcohol misuse⁴. Even among a pandemic, there are programs that have switched to online group sessions to help those in need through professionally led discussions, support groups, and video counselling.

What can be done to reduce this global concern…

What options are there for reducing harmful alcohol consumption? The World Health Organization (WHO) recommends three “best buys” which consists of enforcing bans on alcohol advertisement, restricting alcohol access, and increasing alcohol taxes. These strategies have the greatest potential for improving public health, along with formulating and implementing policies that reduce alcohol consumption.

With the global pandemic, we have seen an increased number of alcohol advertises on social media, TV ads, and the internet. They have different catch phrases but are all coaxing the audience to buy their product. Some businesses even advertise the fact that they deliver pre-made to-go alcoholic drinks. Earlier this month, almost three-quarters of alcohol ads (71%) referenced the COVID-19 pandemic, while two-thirds (66%) had a coupon/offer button that linked directly to the businesses online store.

Enforcing alcohol policies and reducing exposure to alcohol marketing can decrease alcohol consumption, not just in the United States but globally. Some countries have a reduced or weak alcohol regulatory system which provides opportunity for corporations and alcoholic industries to market their product³. Other high-income countries use creative techniques to target women drinkers using fruity or fun beverages, or “healthier” beverages for the health-conscious drinkers³.

Overall, the three recommendations by the WHO should have the most promising lead for enhancing the regulation of excessive alcohol consumption. Leaders, countries, and organizations should band together to implement alcoholic policies and improve the public health infrastructure. Unfortunately, with a global pandemic, it will be harder to enforce the recommendations.

References:

[2] Angove, R., Fothergill, A. 2003. Women and alcohol: misrepresented and misunderstood. Journal of Psychiatric and Mental Health Nursing. 10, 213-219.

[1] Erol, A., Karpyak, V.M. 2015. Sex and gender-related differences in alcohol use and its consequences: Contemporary knowledge and future research considerations. Drug and Alcohol Dependence. 156, 1-13.

[5] Esser, M.B., Jernigan, D.H. 2018. Policy Approaches for Regulating Alcohol Marketing in a Global Context: A Public Health Perspective. Annual Review of Public Health. 39, 385-401.

[3] McCrady, B.S., Epstein, E.E., Cook, S, Jensen, N.K., Ladd, B.O. 2011. What do women want? Alcohol treatment choices, treatment entry and retention. Psychol Addict Behav. 25, 521-529.  

Excessive alcohol consumption, such as binge drinking, is a global health concern among women. According to the CDC, gender differences such as body structure and brain chemistry can cause women to absorb more alcohol and take longer to remove from their system. About 12% of adult women binge drink three times a month, with an average of 5 drinks per binge. The drinking patterns can have adverse effects on the liver, heart, and brain. There are several options in helping reduce the risk of alcohol, one of which is Alcoholics Anonymous (AA).

AA is an international program for recovering alcoholics where they help those in need through support groups, self-help groups, and abstinence models. It is a way to improve on emotional, mental, psychological, and physical stability and well-being. AA groups support those in need through regular group meetings and are crucial in the recovery program. The initiation of physically going to a meeting, sitting in a chair, and listening to others that can relate to you is powerful. For those who have gone through the program and are on their way to a milestone of sobriety, certain factors can have an impact on relapse. It’s difficult enough to acknowledge the fact that someone might need help and support in alcohol consumption reduction, but now let’s add a global pandemic to the mix…

The pandemic has brought on many changes to lives such as unemployment, self-isolation, quarantine, social distancing, and closing of businesses. These factors can greatly increase stress and anxiety in an individual or in a community. Stress induces structural and functional ramifications on the brain producing altered behaviors in individuals’ coping capabilities. A global pandemic just magnifies these stressful conditions. Stress and anxiety have been found to be important triggers for relapse and they promote increased motivation to drink in some individuals. Studies have shown that for women, marriage and martial stress are triggers for relapses in alcohol.

COVID-19 has placed a financial burden on millions of people as they have filed for unemployment. The stress and anxiety from wondering how they will pay bills, when will they get their job back, or even if they will get their job back, can be a trigger to relapsing. Women who are independent and have to support their children might find comfort in their “mommy-juice” like before. According to Dr. Koob, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Director, physical or social distancing can impact treatment services. Social support is an influential and beneficial reinforcer for helping people avoid relapses. Another trigger to alcohol relapse is that drinking has become a societal norm. Social media is teeming with alcohol ads and memes. The pressure from society that you need to drink to relieve stress can trigger alcoholics into relapsing. Even memes on AA programs have become degraded and seen as a joke for after the global pandemic ends. 

But all is not lost… Even in these trying times, there have been some programs that have migrated towards hosting virtual sessions and have overcome the obstacles COVID-19 has presented. The Atlanta AA program, along with other city programs, have converted to a digital platform devoted to people in recovery. As mentioned earlier, women metabolize alcohol differently than men and this can put them at jeopardy if it’s not managed. Many AA communities have special interest women’s meetings where it might be easier to identify as an alcoholic among other women. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has many great resources on alcohol relapse during COVID-19. The resources include professionally led treatment via phone or video, therapy sessions, mutual support groups, podcasts, and apps.

[1] Becker, H.C. 2017. Influence of stress associated with chronic alcohol exposure on drinking. Neuropharmacology. 122, 115-126.

[2] Burtscher, J., Burtscher, M., Millet G.P. 2020. (Indoor) isolation, stress and physical inactivity: vicious circles accelerated by Covid‐19?. doi:10.1111/sms.13706

[3] Ferri, M., Amato, L., Davoli, M. 2006. Alcoholics Anonymous and other 12-step programmes for alcohol dependence. Cochrane Database Syst Rev. (3):CD005032.

[4] Walitzer, K.S., Dearing, R.L. 2006. Gender differences in alcohol and substance use relapse. Clinical Psychology Review. 26, 128-148.