Women and Drinking

How to know if your go-to stress reliever is a problem – and how to make a change if so

by Amanda MacMillan

Journalist Gabrielle Glaser wrote the 2013 best seller Her Best Kept Secret after observing a profound shift in the way women were drinking. For the last 10 years or so, she'd been interviewing moms who regularly finished off bottles of wine during playdates, after a long day at the office, or while being stuck at home with the kids. The notion that women – especially those with children – drank regularly was no longer taboo or surprising. It had become a social norm.

"It became this acceptable release valve for mothers," she says. "It became an understanding: Our kids drive us crazy, so we drink." Glaser researched the phenomenon extensively, writing about the unique circumstances and challenges women face when it comes to drinking. "I think as women and mothers we need to understand our relationship with this substance, and take it out into the light," she says.

Thanks in part to Glaser's book, the topic of women and alcohol has been in the news and on our minds more in the last few years than ever before. But the issue is far from resolved as research shows that women continue to drink more – both in higher quantities and with greater frequency. And although alcohol can certainly be part of a healthy lifestyle, it can also have negative effects on a woman's health, happiness, and family life.

One new understanding based on the latest research is that having an unhealthy relationship with alcohol does not have to mean being alcohol dependent. According to the Centers for Disease Control and Prevention, 90 percent of people who drink excessively are not alcohol dependent. For women, binge drinking (four or more drinks on one occasion) or heavy drinking (8 or more drinks per week) is considered excessive. In the past year, only about 2.5 percent of women met the diagnostic criteria for alcohol dependence, but 12 percent report binge drinking three times a month.

Of course, not everyone who drinks needs to make a change, but it can be helpful to take a closer look at your relationship with alcohol if you drink regularly. Here's some information to help you determine whether your relationship to alcohol is healthy and what to do if you decide that it isn't.

Women are drinking more
According to a 2015 study from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), men still outdrink women in the United States, but the gap is closing: In the 10-year period from 2002 to 2012, the percentage of women who reported drinking alcohol during the previous month increased from 44.9 percent to 48.3 percent. For men, that number decreased from 57.4 percent to 56.1 percent.

Women have also become more frequent alcohol users, increasing the number of days they drink each month from 6.8 to 7.3. (For men, that number declined from 9.9 to 9.5.) Other research has shown that that among women who drink, 13 percent have more than seven drinks per week – the upper limit of what's recommended by the U.S. government for women's long-term health.

It's especially worrisome that women are drinking more because they process alcohol differently than men, says NIAAA director George F. Koob, PhD. Not only do women tend to weigh less than men, but their bodies also contain more fat and less water.

"Alcohol likes to thin out in water, so the same [amount] is going to be more diluted in a man's body – and cause a lower blood alcohol content – than in a woman's," he says. "That's an important thing to keep in mind in social situations and one reason you shouldn't try to keep up with what other people are drinking."

Drinking also affects a woman's risks of certain long-term diseases. Having one alcoholic beverage a day may have some health benefits, but even this moderate amount has been linked to a slightly increased risk of breast cancer. Women may also be more vulnerable to consequences of heavy drinking, including heart disease, liver inflammation and cirrhosis, brain damage, and other types of cancer.

Moms and alcohol
Few studies on alcohol have parsed out the differences between women who do and don't have children. But anecdotally, it seems that many women continue drinking – or even start drinking more – when they have kids. Wine is cited as a mom's beverage of choice so often that an entire "Facebook wine mom" culture has sprung up on social media, with groups like Moms Who Drink and Swear (more than 1 million "likes") and Moms Who Need Wine (more than 700,000).

On the parenting blog Scary Mommy, contributor Kristen Schrotberger explains why so many moms "need" wine so much. "We may be so worried about something, whether it be our children, cabin fever (for the stay-at-home moms), careers (for the working moms), bills, the dog, the cat, the husband … Our minds need a break," she writes. Another perk: "We feel glamorous drinking out of a wine glass, even if we are in sweatpants with no makeup and our hair is a mess."

But the biggest reason, she argues, is simple. Moms share everything with their kids: Their wombs, their beds, the television, even the bathroom. "But here's the awesome thing about wine …" she writes. "We don't have to share it because the kids can't have it!"

Moms of all ages, education levels, and socioeconomic backgrounds can experience these emotions, says Mary Ellen Barnes, PhD, president and cofounder of Your Empowering Solutions, a research-based alcoholism treatment program in Southern California. In her practice, she regularly sees women in their 40s who spent years working their way up the corporate ladder before leaving their job to start a family.

"They had these big, stimulating, fast-paced careers, and now – even though they love their children – they feel guilty because they're bored and lonely at home with them all day," Barnes says. "And they cope by saying, 'I'm going to start drinking at noon.'"

There's nothing inherently wrong with having a glass of wine with lunch, says Barnes. But sometimes that one glass turns into two, then three, then an entire bottle. And depending on the circumstances, a mom who is drinking could be putting herself or her kids at risk.

"It gets worrisome when I hear about a pool party where all the moms are sitting around drinking chardonnay and margaritas while the children play in the pool," says Barnes. "That's concerning to me because if a kid gets into trouble, is an adult sober enough to jump in or drive to the hospital?"

Read about how to evaluate your drinking and whether you should consider making a change.

Options for making a change
Women who do decide they'd like to change their relationship with drinking have several options: They can enlist the help of family and friends. They can talk to their physician or a therapist or counselor. They can attend support groups. Or they can join a structured program or enter a treatment facility.

If you don't think you are dependent on alcohol but you simply want to drink less, setting goals for yourself and sticking to them may be all you need to feel better, says Barnes. "The vast majority of people just decide on their own that they're drinking a little too much – kind of like you'd decide to diet if you want to lose 10 pounds," she says. "For many people, that works fine."

If you're drinking to relieve stress, Glaser recommends finding a way to take something off your plate. That may mean leaning on your spouse for extra support or encouraging school-age kids to take more responsibility around the house. Then, she says, find a healthier way to blow off steam.

"Come home, connect with your kid, pour yourself a big glass of seltzer, and take a walk around the block," she says. "These are some strategies moms can do that I think will take the place of that glass or two of wine."

If you want more help or a structured plan, the nationwide group Moderation Management provides online and in-person support to people who want to drink less. This includes guidelines for how much you drink and how often you can indulge, plus strategies to keep track of your drinks and avoid overdoing it. 

Moderation can work for most people, agrees Koob of the NIAAA. But for those who meet the diagnostic criteria for problematic drinking, cutting back to a healthy level can be easier said than done. Heavy alcohol use can damage brain function, he says, making it more difficult for someone to control their drinking once they start.

"If someone really has a problem, we [believe] that abstinence should be the goal," says Koob. "If you are successful in cutting back and aren't completely abstinent, so much the better. But because we can't predict who will be able to maintain a healthy level of drinking and who is going to relapse into heavy drinking, quitting completely is really the best option."

That's one reason why the country's best-known treatment program Alcoholics Anonymous (AA) requires participants to give up alcohol completely. AA is free, has chapters nationwide, and is endorsed by many former drinkers.

Diane,* a mother of three, began attending AA after she decided that drinking at least one glass of wine every night (and often more) was too much. She'd tried to stop dozens of times on her own but always made excuses for going back to her daily habit. Still, she didn't feel like an alcoholic and considered AA a last resort. "I sort of expected to see a lot of people much worse off than me."

She was pleasantly surprised by what she encountered. "The women's meetings had tons of moms and people who you would never suspect had a drinking problem," she says. "They were so happy to help me and include me and wanted me to be a part of [their group]. I got [their] phone numbers, and they asked for mine. And when the urge to drink hit me in the late afternoons, I would call somebody or they would call me, and it saved my life."

AA worked for Diane: She's been sober for seven years and still attends meetings, both to keep herself accountable and to pay forward the help to newer members. That's not the case for everyone, however. Some people are turned off by the organization's religious underpinnings or 12-step approach. And because AA doesn't keep records of its participants, statistics about its success or failure rates are limited.

Glaser notes that in her research she found that the organization, founded by men in the 1930s, doesn't have as wide an appeal for women. For example, members are urged to surrender their egos to a higher power – a concept that she says often doesn't resonate with frazzled, stressed-out moms who may already feel powerless in other areas of their lives.

For women who are not interested in AA, there are other programs that take science-based approaches to treatment with the goal of abstinence. Nationwide options include Rational Recovery, the Secular Organization for Sobriety (SOS), SMART Recovery, and Women for Sobriety. Medical treatment facilities, either inpatient or outpatient, can also provide professional help, including medications or behavioral treatments that can make it easier to quit drinking. 

Even if you don't want to give up alcohol forever, you might consider quitting for 30 days – a strategy recommended by Moderation Management. "It's a good way to reevaluate when you've been drinking and why you've been drinking, and to really know that you don't have a problem giving it up," says Sheila Vakharia, Ph.D., MSW, assistant professor of social work at Long Island University-Brooklyn. "Once you've done that, you'll know you have your drinking under control – and you may not even want to drink as much when it's over."

For anyone who's conflicted or concerned about their alcohol use, Vakharia also recommends the book How to Change Your Drinking by substance abuse counselor Kenneth Anderson. The book follows Anderson's method of harm reduction, abstinence, and moderation support (HAMS). The HAMS method aims to help people improve their relationship with alcohol in any way that will work for them, whether that means quitting, cutting back, or drinking in a way that's safer to themselves and those around them.

No matter what strategy you use to address a potential drinking problem, it's important to act sooner rather than later. "Some programs promote the idea that you have to hit rock bottom before you can pick yourself up and seek treatment, but that's a really horrible idea," says Barnes.

"You should not end up with a DUI and child endangerment charges or your husband wanting to divorce just so that you're ready for help," she adds. "If you start thinking that maybe you have a problem, talk to somebody and do something about it early."

*Not her real name.

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Amanda MacMillan

Amanda MacMillan

Amanda MacMillan is a freelance health and science writer who lives in Brooklyn with her husband and bulldog. Her work has been published on CNN.com and in Health, Shape, Prevention, Runner's World, and O, the Oprah magazine.

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