More Americans — especially American women — are drinking heavily and engaging in episodes of binge-drinking, according to a large new study conducted by the Institute for Health Metrics and Evaluation at the University of Washington.
The findings, published Thursday in the American Journal of Public Health, show that heavy drinking among Americans rose 17.2 percent and binge drinking increased by 8.9 percent between 2005 and 2012, largely due to rising rates among women. By contrast, the percentage of people who drink any alcohol has remained relatively unchanged over time, the study found.
In 2012, 8 percent of Americans were considered heavy drinkers and 18 percent were binge drinkers, according to the study. The Centers for Disease Control and Prevention defines heavy drinking as exceeding an average of one drink per day during the past month for women and two drinks per day for men. Binge drinking is defined as four or more drinks for women and five or more drinks for men on a single occasion at least once during the past month.
Strikingly, in the decade between 2002 and 2012, the rate of binge drinking among women increased more than seven times the rate among men. “We are seeing some very alarming trends in alcohol over-consumption, especially among women,” said Ali Mokdad, a lead author of the study.
Why women are drinking more
Experts say a number of cultural and economic factors likely have a role in the increase in excessive drinking, particularly among women.
As a result of changed social norms, it’s now more acceptable for women to drink alcohol in a way that has traditionally been associated with men, said Dr. George Koob, director of the National Institute on Alcohol Abuse and Alcoholism. “Women are drinking more like men, to put it bluntly,” he said. Women in college, for example, may try to keep up with their male counterparts, while female professionals often face unique pressures to drink at social events or while traveling for work, especially if they are employed in male-dominated fields.
Alcohol has also become more accessible in recent years. Taxes on alcohol have not risen along with the Consumer Price Index, so wine, beer and liquor have gotten cheaper over time in real dollars, while alcohol control policies — such as limits on when and where alcohol can be sold and how long bars can stay open — have weakened in past decades. Looser regulations may partly explain rising consumption nationwide, particularly in those states where “blue laws” once prohibited alcohol sales on Sundays or in supermarkets.
Meanwhile, alcohol advertising — particularly for hard liquor — has sharply increased in recent years. According to a study by the Federal Trade Commission, U.S. companies spent about $3.45 billion to advertise alcoholic beverages in 2011. Experts also point to the emergence of female-friendly alcohol-marketing strategies about a decade ago — including flavored vodkas, alcopops, Smirnoff Ice, Barcardi Silver and Mike’s Hard Lemonade — as a contributor to rising consumption among women.
Health risks of heavy drinking among women
The uptick in drinking among women is of particular concern, as women are at greater risk than men for developing alcohol-related problems.
Alcohol passes through the digestive tract and is dispersed in the water in the body. The more water available, the more diluted the alcohol. As a rule, men weigh more than women, and, pound for pound, women have less water in their bodies than men. Therefore, a woman’s brain and other organs are exposed to more alcohol and to more of the toxic byproducts that result when the body breaks down and eliminates alcohol. This is why alcohol guidelines call for lower levels of consumption among females than males.
Excessive alcohol consumption comes with serious short- and long-term health consequences for women. In the short-term, heavy drinking increases the risk of car crashes, domestic violence, and risky sexual behavior, such as not using birth control or condoms; as a result, women who drink heavily are more likely to contract sexually transmitted infections and experience unintended pregnancies.
In the long-term, heavy drinking can disrupt women’s menstrual cycles and increase the risk of infertility, miscarriage, stillbirth, sudden infant death syndrome, and premature delivery, as well as fetal alcohol syndrome . Many studies have also established a link between moderate to heavy levels of drinking and a heightened risk of breast cancer. Furthermore, research also indicates that women are more likely than men to develop and die from alcohol-related conditions including alcoholic liver disease, alcohol-induced brain damage, and alcohol-related heart disease.
Need for gender-specific treatment
Overall, fewer than 10 percent of the estimated 20 million Americans with harmful drinking habits ever receive specialized treatment, and the figures are even worse for women. Compared to men, women face more barriers to treatment and tend to wait longer to seek help for alcohol problems — and when they do seek help, women tend to go to primary health care physicians rather than to specialty substance abuse programs, which is associated with poorer outcomes.
Furthermore, because traditional treatment approaches such as Alcoholics Anonymous were designed by men for men, they typically fail to address the issues underlying alcohol abuse in women — which may include depression, stress, sexual abuse, partner violence, or a combination of those factors. Even worse, Alcoholics Anonymous can put vulnerable women in the path of predatory men who use the program to identify new victims.
That’s why leading health authorities are calling for greater attention to gender differences in the treatment of alcohol-use disorders. Even the Obama Administration has joined in, recognizing that “there is a growing need for more gender-specific substance use treatment services for women.” With heavy drinking on the rise among American women, that need has never been greater.