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Alcohol prevention strategies: Prevention efforts should be different for men and women

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Over the past few weeks in class, we’ve had conversations about alcohol use and risks associated with it. The NIAAA described the health risks associated with excessive drinkings such as heart disease, cancer, problems of the liver, pancreas and others such as sexually transmitted infections, violence, suicide. Most researchers believe that risks associated with alcohol drinking outweigh any potential health benefits from moderate drinking. As an example, Professor Walter Willett of epidemiology and nutrition at Harvard T.H. Chan School of Public Health thinks that heavy drinking is harmful.

What’s moderate drinking?

 

  The CDC  and NIAA defines the term “moderate drinking” as  

       1. Beer 12 ounces (5% alcohol content).

       2. For malt liquor 8 ounces  (7% alcohol content).

       3. For wine 5 ounces  (12% alcohol content).

       4. 1.5 ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whisk

 

A new study on  Alcohol: Balancing Risks and Benefits concluded that there’s no amount of alcohol consumption that’s safe for overall health — a finding that’s likely to surprise moderate drinkers, and that has left some experts unconvinced.

The federal, state and local authorities in the US work together to minimize health risks associated with alcohol drinking.  

In this blog, I’m sharing some of the alcohol prevention strategies I’ve learned for the past few weeks while taking a class in Special topics in Epidemiology on alcohol and women.

  • Prohibitions of alcohol sponsorship of public events – Alcohol sponsorship by alcohol companies has been a  debated issue in recent months. According to a Sponsorship Today report, more than $1 billion was spent on sports sponsorships by beer companies alone in 2012. prohibition by integrating sports sponsorship with responsible consumption messages. 
  • Increases in price through excise taxes –Increase taxes have consistently been found to reduce alcohol consumption and problems, especially among youth. Alcohol excise taxes affect the price of alcohol and are intended to reduce alcohol-related harms, raise revenue, or both. Alcohol taxes are implemented at the state and federal level, and are beverage-specific (i.e., they differ for beer, wine, and spirits). In the US, Alabama and Washington’s state have some of the highest taxes on alcohol
  • Controls on alcohol advertising (especially on billboards, sides of buses, and in other public areas)-The alcohol industry are among the leading advertisers on billboards. Billboards advertising beer and hard liquor are readily visible to children. These advertisements expose and encourage excessive drinking among youth. Laws of Billboard advertisement in Georgia prohibits advertising alcoholic drinks and tobacco products at children, educational and medical institutions, culture and sports organizations within 100 meters radius of them is prohibited.

  • Limiting hours of sale:    –Another strategy to prevent excessive alcohol consumption and related harms is to limit access by limiting the hours during which alcohol can legally be sold.  In the US they differ from one state to another. In Atlanta, Georgia, packaged liquor may be sold between 12:30 p.m. and 11:30 p.m. on Sunday, and between 8:00 a.m. and 11:45 p.m., Monday through Saturday. Packaged beer and wine may be sold at any time except between midnight Saturday night and 12:30 p.m. Sunday afternoon, or between 11:30 p.m. Sunday night and 12:01 a.m. on Monday.  Alcoholic beverages may be served in bars and restaurants between 12:30 p.m. and midnight on Sunday, and between 9:00 a.m. and 2:30 a.m., Monday through Saturday.

 

Should we make these strategies different for women and men?

The answer to this question is YES. Alcohol offers each group a different spectrum of risks. It is necessary for everyone, especially policymakers to understand that alcohol affects women’s bodies differently. Unlike males, women are more likely to suffer the health and social effects of alcohol consumption. Also, women are vulnerable to the secondhand effects or alcohol harms of excessive alcohol consumption among others.

With a recent report on an increase in the number of women who drink, there should be an awareness of these health risks and make informed decisions about alcohol use. As such, it should be given special attention.

We also need to be aware that women are the target for more recent alcohol ads and campaigns. Advertisers market liquor as “diet” or “natural” in an effort to appeal to health-conscious women. 

The Consequence of Turning a Blind Eye 

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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.  

Alcohol Harm in Women

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The harm alcohol can cause women has been proven, but it is still widely unknown amongst people, hence, the growing amount of women who are consuming alcohol. Because women’s bodies absorb more alcohol than men, it takes a longer time for the body to metabolize and rid the body of it, so there is a greater risk for long-term health problems.

The CDC reports that 46% of adult women reported drinking in the last 30 days, and 12% of women reported binge drinking 3 times per month–averaging 5 drinks per binge. Women may have adverse health outcomes from these behaviors related to reproduction and fertility, liver disease, brain function, heart function, an increased risk of cancer, and an increased risk of sexual assault. 

The relationship between alcohol consumption and breast cancer has also been heavily researched. The Susan G. Koman website reports that from an analysis of 53 studies, it was found that for each alcoholic beverage consumed each day, the relative risk of breast cancer increased 7%. Some may argue that there has been proven benefits for the heart with drinking alcohol, but as this article states–is this a fair trade when the risk of breast cancer is also increased? With such overwhelming evidence that there is a relationship between alcohol consumption and breast cancer (and other diseases), how can we make sure women are receiving the message that alcohol is harmful to our health? 

Doctors should get involved, and ask screening questions about alcohol use. Doctors should be able to educate women on the adverse health outcomes of alcohol consumption.

Brief interventions have been proven to reduce drinking alcohol among women. These interventions were performed in clinical settings and healthcare services, and the study showed that there was an decrease in both the number of days alcohol was consumed and the amount. The effectiveness of these brief interventions was noted to be related to the impact on reproductive health and the lower social acceptance of female consumption.  However, young people are less interested in having babies now more than ever. We also know it is becoming increasingly acceptable for women to consume alcohol.

This article discusses the cultural shift and how pop culture seems to “celebrate women who drink rather than warn against it.” This makes it difficult to identify what kind of interventions would be successful. 

There have been public campaigns against harmful substances such as tobacco and e-cigs, as well as campaigns against drunk driving and texting while driving.  Perhaps a campaign about the gender-specific effects of alcohol on women would be helpful. I, for one, have these campaigns in the back of my mind when I see people smoking cigarettes or texting while they are driving. It is a tricky issue because some may see this kind of campaign as an attack on women. Most importantly, I believe conversations like those tweeting #GSUwhyshedrinks must continue, as awareness is key for solving this growing issue. 

Do we need to consider gender differences when developing prevention strategies for excessive alcohol consumption?

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The negative consequences of alcohol consumption are harmful to both men and women. This could not be overstated, as there are numerous studies in the literature documenting the risks associated with alcohol consumption.   Excessive alcohol consumption leads to alcohol dependence and abuse, but overtime it can lead to the development of chronic diseases. 

Given the high costs of excessive alcohol consumption and the concern of alcohol abuse and dependence to both people and society, evidence-based approaches for preventing harmful alcohol use are key. Are these prevention strategies different for men and women? What do you all think?

Some strategies could be targeted towards both sexes however, definitely without a doubt there needs to be strategies focused only for women. Why is this so?

Most importantly, women are more vulnerable to negative effects of alcohol than men. As noted in the literature alcohol is metabolized differently in women than men and women continue to be at a higher risk for serious health consequences when compared to men. There is evidence from studies that for equivalent doses of alcohol, women are more vulnerable than men to tissue damage and the onset of certain diseases such as cirrhosis of the liver and physical alcohol dependence (1). In addition, it is found from studies that women often start drinking at an older age, yet the progression from first drink to alcohol dependency progresses much more quickly in women than in men (2). This phenomenon is known as telescoping (3).Further, we all know that excessive alcohol consumption by pregnant women is a risk behavior for Fetal Alcohol Spectrum Disorders and other adverse pregnancy and birth outcomes, including miscarriage and stillbirth.

What are some of these prevention strategies targeted for women?

Well, before we think about these, we should first try to determine the reasons why women drink in the first place? According to studies reviewed in the literature, the experience of a negative effect such as anxiety, depression and violence against women serves as cue for alcohol consumption in women. Prevention strategies must focus on targeting the underlying risk factors related to excessive alcohol use such as mental health component of anxiety and depression and offer support to women who are victims of violence. This may in-turn cause the reduction of alcohol use among women.

Another prevention strategy is to make women aware of risks of alcohol use. However, education and awareness strategies on Alcohol and its related risks use must be given at a time for women in their adolescence period as this can contribute to behavior change thereby enabling opportunities to encourage delaying the use of alcohol. This prevents excessive alcohol consumption among women which can also delay all potential risks associated for young women when using alcohol.

An American College of Obstetricians and Gynecologists Committee Opinion recommends alcohol use screening for all women seeking obstetric-gynecologic care, including counseling patients that there is no known safe level of alcohol use during pregnancy, and recommends that women who are pregnant or who might be pregnant be advised to avoid alcohol use.

REFERENCES
1. Kalant H. Absorption, diffusion, distribution and elimination of ethanol: effects on biological membranes. In: Kissin B, Begleiter H, eds. The biology of Alcohol ism, vol 1. Biochemistry. New York: Plenum Press, 1971.
2. Cyr MG, McGarry KA. Alcohol use disorders in women. Screening methods and approaches to treatment. Postgrad Med.2002; 112:31-32,39-40,43-47.
3. Greenfield SF, Manwani SG, Nargiso JE. Epidemiology of substance use disorders in women. Obstet Gynecol Clin North Am.2003; 30:413-446.

Ending Excessive Alcohol Use – Do Some Methods Work Better for Women?

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Alcohol is the third leading cause of preventable death in America – right behind tobacco and poor diet and physical inactivity. The Center for Disease Control and Prevention (CDC) released data that reveals the grim truth about alcohol abuse in the United States. This dangerous activity is responsible for 88,000 deaths and almost $250 billion in economic burden every year! Of those deaths, it is estimated that 26,000 are women. Excessive alcohol use has two forms – binge drinking and heavy drinking. Binge drinking is defined as consuming 4 or more drinks in a 2-hour period for women and 5 or more drinks in the same time frame for men. Heavy drinking is drinking 15 or more drinks per week for men or 8 or more drinks per week for women. In 2015, nearly 30% of the adult population reported that they’d engaged in binge drinking in the prior 30 days. Seven percent reported heavy drinking. As we can see – excessive alcohol use is a real issue in the U.S. What is even more alarming is the fast rate at which women are engaging in risky drinking behaviors.

Prevention is necessary for combating the rising rates of alcohol abuse in general. There have been many prevention strategies proposed. There are several questions that remain, however. Should prevention methods differ between men and women? If so, which methods are best for women? To answer these questions it is necessary to know why women drink. The answer, though likely multifaceted and complicated, will guide public health professionals the most appropriate prevention techniques. 

Regulating Alcohol Outlet Density

The Community Preventative Services Task Force (CPSTF) recommends regulating – through licensing and zoning – the density and number of alcohol outlets as a method to reduce alcohol overconsumption. Places that have employed this method have fewer alcohol sales – which one could only assume means less usage. Several studies have found an association between alcohol outlet density and alcohol-related harm. Where the density was high, the level of consumption was high and more harm occurred. Whether or not this method would be effective in women has not yet been determined. We may see that the effect on lower alcohol outlet density may have equal effects among men and women because women drivers outnumber male drivers so getting to an alcohol outlet that is further away would still be possible for women. 

Increasing Alcohol Taxes

Another method of prevention recommended by the CPSTF is to increase the price per unit of alcohol by raising the alcohol tax. A similar method was adopted for tobacco sales which resulted in a dramatic reduction in sales.  A similar rationale applies to alcohol – if you make it more expensive, fewer people will buy it and fewer people will drink it. Several studies have shown that this is an effective method. The downfall here is that this method will do nothing to reduce alcohol consumption in wealthy populations which we know are responsible for the consumption of most alcohol. Whether or not it will work to reduce consumption in women would depend on the socioeconomic status (SES) of the women. Employing this method will almost certainly result in a reduction of use in women with a low to middle SES but probably won’t have much of an effect on those women who have a higher SES. 

Image result for alcohol use in women

Maintaining Limits on Hours of Sale

This method for alcohol consumption control may limit the times of day that alcohol can be sold or served. Recently, Fulton County, Georgia proposed and passed a bill that would allow drinks to be purchased in a restaurant earlier in the day on Sundays. This bill was commonly referred to as the “Brunch Bill” because it mostly affected brunch alcohol sales. This bill mostly increases alcohol consumption in women. If the permitted hours of alcohol sales were limited, we may see a reduction in how much women are consuming. 

Determining which methods will work best for women will require more research and surveillance to figure out what factors that influence drinking and abstinence are unique to women. This information can then be used to develop best practices that will ultimately lead to a reduction in excessive alcohol use in women. 

 

College Drinking Culture: Men and Women Differ

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“Drink! Drink! Drink! Drink!”, a familiar chant during a typical Friday night on campus. Students are hanging upside down chugging down a keg, coolers filled with jungle juice and alcohol games in every room you turn in. Has college drinking gone too far? Is it time we change the culture? Depending on whom you talk to this topic  can become reasonably controversial.

Young adults between the ages of 18–25 report high rates of alcohol consumption, including heavy episodic (binge) drinking, defined as consuming five or more drinks at a time (Kate, 2007). Compared to their peers not attending college, college students consume larger quantities of alcohol on drinking occasions (Kate, 2007), and as many as 43% of undergraduates report heavy episodic drinking at least once in the last two weeks (Kate., 2007). 90% of college schools provided counseling and treatment services for students, and nearly as many provided prevention services (e.g., alcohol education) for freshmen or other at-risk groups.

Three major findings emerged from a A meta-analytic review for Individual-level interventions to reduce college student drinking:

(a) individual-level alcohol interventions for college drinkers reduce alcohol use

(b) these interventions also reduce alcohol-related problems, and reductions in problems vary by sample and intervention characteristics

(c) the contrast between students who receive interventions and those in control conditions diminishes over time. 

Collegedrinkingprevention.gov provides comprehensive research-based information on issues related to alcohol abuse and binge drinking among college students. An alcohol prevention strategy they propose involves parents and it is called, “Fall Semester—A Time for Parents to Discuss the Risks of College Drinking”. As college students arrive on campus in the fall, it’s a time of new experiences, new friendships, and making memories that will shape their future; for many students, it is also a time of underage drinking.

Outlined is the prevention strategies parents are urged to help reduce unhealthy alcohol use by:

  • Talking with students about the dangers of harmful and underage college drinking—such as the penalties for underage drinking, and how alcohol use can lead to sexual and other violence, as well as academic failure and other adverse consequences.
  • Reaching out periodically and keeping the lines of communication open, while staying alert for possible alcohol-related problems.
  • Reminding students to feel free to reach out to them to share information about their daily activities, and to ask for help if needed.
  • Learning about the school’s alcohol prevention and emergency intervention efforts.
  • Making sure students know the signs of alcohol overdose or an alcohol-related problem, and how to help.

Now with all this said, would you think there needs to be different prevention strategies for women and men?

The short answer is yes. Gender differences in alcohol use and associated problems have been the focus of research and news stories to develop prevention strategies. Below are a few links of alcohol gender based differences: 

Why alcohol affects women more than men

Think Before you drink: Alcohol Affects Men and Women & Differently

Women appear to be more vulnerable than men to many adverse consequences of alcohol use. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) documents that women achieve higher concentrations of alcohol in the blood and become more impaired than men after drinking equivalent amounts of alcohol. Research from the NIAAA also suggests that women are more susceptible than men to alcohol-related organ damage and to trauma resulting from traffic crashes and interpersonal violence. 

In order to be an effective alcohol prevention strategy there must be a focus on the problems affecting that subgroup of the population, being men and women in this case. The World Health Organization (WHO) developed a framework called the strategic communications framework. The purpose of this Framework is to describe a strategic approach for effectively communicating information, advice and guidance across a broad range of health issues. In order to communicate effectively across the audiences (men/women), the prevention strategy has to be tailored to them. Everyone knows that men and women think different, act different and are different, after all men are from Mars and women are from Venus. 

Source:

Fact Sheet For New College Students And Parents. (n.d.). Retrieved from https://www.collegedrinkingprevention.gov/NIAAACollegeMaterials/FactSheets/colle

H. Wechsler, M. Seibring, I.C. Liu, M.Ahl Colleges respond to student binge drinking: Reducing student demand or limiting access
Journal of American College Health, 52 (2004), pp. 159-168

Kate B. Carey, Lori A.J. Scott-Sheldon, Michael P. Carey, Kelly S. DeMartini, Individual-level interventions to reduce college student drinking: A meta-analytic review, Addictive Behaviors,
https://doi.org/10.1016/j.addbeh.2007.05.004.

National Institute on Alcohol Abuse and Alcoholism,  No. 46. Are Women More Vulnerable to Alcohol’s Effects? https://pubs.niaaa.nih.gov/publications/aa46.htm

World Health Organization. WHO strategic communications framework. https://www.who.int/mediacentre/communication-framework.pdf

 

 

The Culture of Abstaining From Alcohol

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“Abstinence [from alcohol] was found to be associated with a staggering 45 per cent higher risk of dementia compared to those who consumed between one and 14 unites of alcohol a week.”

 -Sean Morrison, Evening Standard

I know what you’re thinking, who did this science experiment? Well, the French National Institute of Health and Medical Research in Paris along with scientists from the University College London. They followed 9000 men and women with ages ranging between 45-55 over 23 years and found that 45% of those who did not drink developed dementia. Now, the downfalls of this is that their health history was not really controlled for, it is just that they abstained from drinking during the 23 period time period.

But, for the average Joe to google abstaining from alcohol, and retrieve these articles can be detrimental to the culture of abstaining from alcohol. By the way, this is the first image that comes up when you google “abstaining from alcohol.”

So why exactly is there so much pressure in some societies to consume alcohol? Is it really NEEDED to be social? Are we not FUN enough without it? Are you too RELIGIOUS and need to loosen up a little? I have heard it all. No, I am not too religious but my religion has forced me to do my own research. Why is alcohol so specifically forbidden in the Quran? Reading and learning and realizing that I really do not need it to have fun and I have more effective coping mechanisms, I decided abstaining from alcohol was the right choice for me.

So how do we get others to not only abstain from consuming alcohol but also make that idea culturally accepted? Well here are two ways to start:

  1. No Beer, No Botox, No Problem

Seems simple, educate the masses on what alcohol does to you. But the twist is, get them with what they care about most in today’s society: vanity. Vogue recently published an article on how giving up alcohol can transform your skin. “I always joke with my patients, ‘If you want to get older, go ahead and drink!’” says nutritionist Jairo Rodriquez, who gave the Vogue advice on how no drinking means looking more radiant and youthful. More women are also diving into the “sober curious” waters for vanity reasons and blogger Kate of The Sober School writes that the fewer calories, less bloating, beauty rest, and motivation to gym are all reasons why no drinking is really the right choice. Which leads us to tip number 2 for creating a more culturally accepting environment for abstainers.

 

  1. Success Stories Create Success Stories

Kate, a previous heavy drinker, started her blog page, “The Sober School” as a way to motivate herself to continue on that path as well as build a community for like women to join in and feel welcomed, whether you are new to the abstinence life or been sober all your life. Kate writes “I show them [women] how to have fun, relax and be confident without a glass of wine in their hand… and I can help you too” and suggests that there is no need to label yourself as being in recovery. She offers a 6 week course to women in need of help. This welcoming environment creates a culture of acceptance and hopefully a domino effect too. She has a page dedicated to “graduates” of her program and their testimonies, with women both young and old. And Kate’s page isn’t the only blog page out there. Hip Sobriety, UnPickled, Drunky Drunk Girl, and Sober Senorita are just a few of the FEMALE led blog pages. Some are about the process of sobriety and some about the success of sobriety, but all creating awareness in a positive, more inviting way.  

 

“Mommy Juice”: The Kool-Aid in The Cult of Perfection

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The NIAAA describes the differences in impact faced by men and women who drink alcohol. While mostly biological, the NIAAA mentions in passing that women “are more vulnerable than men to alcohol-related… interpersonal difficulties.”

“Interpersonal difficulties? I thought my friends and I gathering around with our “mommy juice” in our very own “sippy cups” was considered a social victory! I get to unwind with my friends after an insane day of parenting small children and/or working and speak to someone who understands English at a level that exceeds that of a toddler. What could be so bad about that interpersonal climate?”

 

I can almost hear the bank vault filling up in the fancy headquarters of the Mommy Juice brand(s). As a woman, I do understand the expectation to join what my favorite author, podcaster and television writer, Karen Kilgariff, describes as “The Cult of Perfection.” I can sympathize with the stress that mothers must be enduring. The cult has strict rules and is quick to ostracize, and, in true cult fashion, demands that women prioritize following the rules over acknowledging the possible detriment to their own children.

According to Dr. Koob, NIAAA Director, women are motivated to drink alcohol by negative reinforcement (removing something negative to strengthen a behavior, such as the stress of being a perfect mother), while men are motivated by positive reinforcement (adding something positive to strengthen a behavior- read “sporting event”).

Prioritizing this stress relief means that, whether or not they know it, women may be friendly with justifying their drinking despite its impact on their children. There is always the possibility that they will become an alcohol-dependent mother, a serious consequence for their child. Children of alcoholic mothers face a barrage of emotional trauma, can feel isolated, and, as Ann Dowsett Johnston describes in her book “Drink,” can feel unprepared for life without the support of a non-alcoholic mother. These children may even turn to alcohol to calm these traumas later in life, possibly repeating their mothers’ patterns.

In the case that the mother does not become dependent on alcohol as a result of too-regular Mommy Juice break, there are other consequences for children of mothers who drink. DrinkAware of the UK published an article about the effects on children when parents drink. “DrinkAware’s new research suggests a strong link between the frequency of young people’s underage drinking and their exposure to drinking at home.” Sue Atkins, parenting expert, writer, speaker, broadcaster, coach and author, suggests that “parents should hide their own alcohol consumption from their kids,” and try to set a good example of moderate drinking behavior for their children.

While Atkins’s advice is sound, perceptions of “moderate” drinking have been altered by commercial and lifestyle advertising from what I like to call “Big Alcohol”, an industry that capitalizes on women as nothing more than an untapped market. Memes, influencers, and bottle packaging are the insidious advertisements that encroach on mothers’ senses of “moderate” drinking, glamorizing a standing playdate with Mommy Juice. Moms on social media end up doing some of the industry’s best advertising at little to no cost.

As a world full of social media content develops before us, I wonder how future children will feel about the “vintage” 2010s memes about Mommy Juice.

Guilty that they were so difficult to parent that their mothers spent years in rehab? Comfortable with the idea that drinking is for parents, perpetuating the cycle of parental alcohol use disorders? Confused about why the 2010s was a decade full of mothers turning to alcohol in a comfortably sassy advertising climate? This future holds a whole new host of adolescent trauma.

At face value, the memes we see daily about drinking the Mommy Juice, the Kool-Aid for moms trying to keep up with the Cult of Perfection, are simply funny. However, housed forever on the Internet will be a Mommy Juice museum for future generations to examine their role as mommy’s reason to turn to irregular drinking.

I Promise Not to Drunk Dial You; Alcohol You Later.

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Memes have become synonymous with modern pop culture. Accounts dedicated just to posting memes exist on every social media platform and according to many, often outnumber posts by friends and family members in feeds. It is easy to understand how they became so popular; they are funny, and often speak a relatable truth. In a society where it is increasingly less cool to talk about your feelings, it is less pressure to double tap a meme and keep scrolling, instead of type out a whole post and wait nervously to see what social feedback will be like. While this can make you feel like you are not alone in your opinions or quirks, it can also make bad behavior seem relatable or encouraging.

One example of this is alcohol related behavior and consumption. Dr. George Koob of the National Institute on Alcohol Abuse and Alcoholism discusses in his presentation that a fundamental difference between male and female alcohol consumption is the reason behind drinking. Dr. Koob asserts that men drink for positive reinforcement – because they enjoy the experience and sensation that comes with being drunk, while women drink for negative reinforcement – to lessen anxiety or to combat a tough day or uncomfortable experience. Meme culture has really grasped onto this concept and flourished into something that perhaps it shouldn’t have. This is evident by many memes that hint at, or outright state, alcohol should be consumed as a fix for anxiety or stress.

Take for example this meme: “It’s not alcoholism, it’s a stress intervention”. This suggests when dealing with high or continued stress, alcohol consumption is a perfectly legitimate way to handle it. Generally, interventions are considered good or necessary, as a way of remediating a poor habit or behavior. Sending the message that alcohol should be the appropriate response to a high stress environment is dangerous, especially since it reinforces the negative reinforcement mindset women already have. Will Ferrell is featured in this meme and as a renowned comedian and celebrity his likeness attracts attention. While of course he did not endorse this meme, his image will increase its popularity and viral nature. This brings us to another danger of memes. They were first popularized by taking still images with interesting facial reactions and adding a funny descriptive caption. This eliminates any sourcing, citing, or required condoning from subjects of these images. There are now ‘meme generators’ where you can insert any photo and add a captain, or have one created for you. With zero regulation, and zero current copyright precedence, memes can be created to push any idea, behavior, or concept with minimal backlash. This in turn only encourages the churning out of ‘funny’ memes.

Women are particularly targeted by these memes as now companies marketing graphic tees and sassy mugs are using meme accounts to draw you in to their site. Mouthymerch on Instagram is a prime example. “This vodka tastes like I’ll be texting you later.” and “I cant wait to get home and pour myself some dinner….maybe even 2 dinners”. The first expresses how the narrator clearly knows ahead of time that her alcohol consumption will lead to behavior she wouldn’t normally engage in. Based on cultural stereotypes we can infer that the ‘you’ she’ll be texting later is not someone she should be sober texting, but she will after she’s imbibed = bad decision. The second example refers to how after a tough day the narrator cant wait to get home and relax, and that means a liquid (inferred, alcoholic) dinner. Furthermore, a second ‘dinner’ starts to get into the fuzzy discussion of alcohol limits and proper quantity consumption. This insinuates the tougher the day, the more dinners you can have. The message here: the harder you work, the more you should be rewarded, with alcohol.

Similarly, another meme featuring celebrity Aubrey Plaza chugging from a wine bottle says “Just when I think I cant take it anymore… But then I remembered that alcohol existed.” Grammar aside, this makes reference to at best a tough day and at worst depression and other mental health concerns like suicide. Plaza is a comedic actor known for taking roles with dramatic substance and alcohol consumption central to the characters personality. While this image was sliced from a show that would have had context around this scene, this meme does not. There are many versions of this same message featuring different celebrity women or popular TV shows so as to capture the relatability among all women despite their particularly TV preferences.

Peer pressure is another form of negative reinforcement that encourages women to drink more. This meme “I saw a husband cheering on his wife to chug her margarita at dinner….that’s the type of relationship I want.” Is scary for many reasons. When there is a mismatch of genders present when alcohol is consumed it often is more dangerous for the women than the men. While this meme clearly describes a married couple, domestic violence and sober consent are still issues at play. If you removed the ‘husband’ and ‘wife’ from this scenario it sounds like a predatory man trying to get a women drunk for potentially nefarious reasons…and the onlooker being envious of this situation. While this is likely not the case here, the meme still normalizes chugging of hard liquor and makes it sound like an ideal significant other is one who encourages you to do so.

Recently, posts by twitter users have been screenshot and turned into memes. “One time when I was drunk a guy asked me if I’d go on a date with him and I said ‘ok! But when I’m sober I’m not going to want to anymore’ and I think about that a lot.” This one delves deeper into the potentially dangerous situations women can end up in when making inebriated decisions. Dangerous or not, they are often decisions women just don’t want to be in. This author at least is self reflecting and acknowledging the difference between her sober and drunk decision making, but this example is unique in that her reflection came while drunk – not the next day when hungover wondering why the night before turned out as it did.

Anxiety is a serious health condition that 23.4%  of women have been diagnosed with. As such a pervasive issue, it has become subject of many memes. Many are relatable, some are nonsensical, but most make reference to alcohol in one way or another. This further strengthens the relationship between women and alcohol, and negative reinforcement that often causes women of all walks of life to imbibe.

 

Women Drinking: A Lifestyle on the Rise

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Bubbly, fruity drinks are amongst most women’s favorite type of alcoholic beverages. Often associated with women are pink, girly drinks, a booming market where the alcohol industry is spending billions of dollars developing and marketing drinks geared towards women. According to the National Institute of Alcohol Abuse and Alcoholism (NIAAA), Women’s drinking patterns are significantly different from men’s – especially when it comes to how much and how often they drink. It is has concluded that women’s bodies react differently to alcohol than men’s bodies due to metabolism and other bodily mechanisms. That means women face more particular health risks from alcohol compared to their male counterparts.

Drinking Levels among Women
According to the Center for Disease Control (CDC), the following statistics have supported a peak interest in research related to the rise of excessive alcohol use and risks to women’s health:
• Approximately 46% of adult women report drinking alcohol in the last 30 days.
• Approximately 12% of adult women report binge drinking three times a month, averaging five drinks per binge
• Most (90%) people who binge drink are not alcoholics or alcohol dependent
• About 2.5% of women and 4.5% of men met the diagnostic criteria for alcohol dependence in the past year

*Statistics obtained from the CDC fact sheet on excessive use and risk to women’s health* 

So Why Do Women Face Higher Risks?
Research has shown that women start to have alcohol-related problems sooner and at lower alcohol volumes than men and for several reasons (NIAA,2017). Women tend to have less water in their bodies than men, meaning that after a woman and a man of the same weight drink the same amount of alcohol, the woman’s blood alcohol concentration (BAC) will tend to be higher, putting her at greater risk for harm (CDC, 2016). Amongst these reasons and others, women have become more susceptible than men to alcohol-related organ damage and trauma resulting from traffic crashes and personal violence (CDC,2016).

Health effects
Liver damage
Women who regularly misuse alcohol are more likely to develop alcoholic hepatitis, and liver scarring and shrinkage called cirrhosis (NIAA 2017). Loft et all, released a study that has been cited by many health organizations on the Increased susceptibility to liver disease in relation to alcohol consumption in women. They concluded that results support the concept that women may develop similarly, and sometimes even more severe, liver disease after use of less alcohol than men, the apparent difference in susceptibility to alcohol may be partly explained by differences in the volume of distribution ( Loft S, Olesen KL, Dossing M, 1987).

Heart Disease
Studies have shown that women who drink excessively are at increased risk for damage to the heart than men even for women drinking at lower levels (CDC, 2016). Cardiomyopathy and myopathy are as common in female alcoholics as in male alcoholics; these findings indicate that women are more sensitive than men to the toxic effects of alcohol on striated muscle (Urbano-Marquez A, Estruch R, Fernandez-Sola J, Nicola JM, Pare JC, Rubin E, 1995).

Brain Damage
NIAAA documents that research suggests that alcohol misuse produces brain damage more quickly in women than in men. Girls who drink in their adolescent years may be more vulnerable to brain damage than teen boys who drink, and women have become more susceptible than men to alcohol-related blackouts; periods of memory loss of events during intoxication without loss of consciousness (NIAA, 2017).

There are many other health conditions affected by excessive alcohol use that affect women. For more information, the CDC has produced a Fact sheet listing more statistics associated with women and excessive alcohol use listed here (https://www.cdc.gov/alcohol/fact-sheets/womens-health.htm).

You should always drink responsibly, which means abiding by the NIAAA guidelines for moderate drinking, never getting behind the wheel while intoxicated and avoiding all forms of alcohol while pregnant.

Sources:
CDC. March 7, 2016. Fact Sheets – Excessive Alcohol Use and Risks to Women’s Health. Content source: Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/fact-sheets/womens-health.htm
Loft S, Olesen KL, Dossing M. Increased susceptibility to liver disease in relation to alcohol consumption in women. Scand J Gastroenterol. 1987;22(10):1251–6.
NIAA, National Institute on Alcohol Abuse and Alcoholism. June 2017. Women and Alcohol, Understanding the impact of alcohol on human health and well-being. National Institute of Health. https://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/women
Urbano-Marquez A, Estruch R, Fernandez-Sola J, Nicola JM, Pare JC, Rubin E. The greater risk of alcoholic cardiomyopathy and myopathy in women compared with menExternal. JAMA 1995;274(2):149–154.