Do I Drink Too Much? The Ugly Truth About Women and Alcoholism

Cocktails with the girls. Wine with dinner. A nightcap before bed. Are you drinking too much? To mark Alcohol Awareness Month, here's what addiction experts say about women and heavy drinking. It’s a lovely evening. You’re relaxed and having a good time with friends, so you signal the waiter for a second cocktail. That extra glass or two won't hurt, right? Wrong, say medical and addiction experts. Actually, it's a fine line between moderate and excessive drinking and it's easier to slip than you think. Nationally, more women are being arrested for driving under the influence of alcohol and drugs, up 28.8% in 2007 from 1998. About 5.3 million women in the U.S. threaten their health and safety with drinking, says Roy David Eskapa, Ph.D., author of The Cure for Alcoholism (BenBella Books). How Drinking Hurts Women According to U.S. Dietary Guidelines, women should have no more than one alcoholic drink a day – the equivalent of 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof distilled spirits. So while you and your boyfriend can both have a martini, the drink will take a greater toll on your body than his. Men are 2-3 more likely to abuse alcohol than women are, says David Sack, M.D., CEO of Promises Treatment Centers in the Los Angeles area. “But women alcoholics are significantly more likely to have medical complications and develop them earlier in their addictions.” If a woman drinks the same amount as a man, she's more likely to develop liver-related disease, says Sharon C. Wilsnack, Ph.D., a clinical psychologist specializing in substance abuse at the University of North Dakota School of Medicine and Health Sciences in Grand Forks. Although the lower water content of women’s bodies may be to blame, experts also have two other theories: They break down acetaldehyde – a toxic byproduct of alcohol – more slowly, which means it sticks around longer and damages the liver. Women's higher levels of estrogen make some liver cells more sensitive to alcohol's toxic effect. Women drinkers are also more likely to get stomach ulcers, which can lead to infection, bleeding or even rupture. 2. Cancer The ongoing British Million Woman Study found that as little as one alcoholic drink a day may increase their risk for cancers of the liver, rectum, mouth, throat and esophagus. That study and others have found a link between alcohol consumption and breast cancer too. The more you drink, the higher your risk, Wilsnack says. “The unanswered question is what level of consumption is really a significant risk?” she says. So should light and moderate drinkers give up their evening glass of Cabernet Sauvignon, especially when red wine may have some benefits? It depends on the woman. “What are the possible benefits?” Wilsnack asks. “Do those offset the risks for breast cancer?” 3. Heart Disease Resveratrol, a compound in the skin of red grapes and plentiful in red wine, is associated with a reduced risk of heart disease. But drink more than the recommended one glass per day and you reverse the heart-healthy benefit. “Chronic heavy drinking is a leading cause of cardiovascular disease,” Eskapa says. Excessive drinkers also face: A higher risk of damaging heart muscle – and that occurs earlier in drinking women than in men Higher triglyceride (fat) levels in the blood High blood pressure Heart failure Diabetes Stroke Cardiac arrhythmia (irregular heartbeats) Death from heart attacks Anemia (a shortage of red blood cells, which carry oxygen to the body) 4. Brain Damage Women drinkers are more vulnerable to brain damage, Eskapa says. Long-term alcohol abuse destroys the cerebellum, the brain region responsible for sensory perception, coordination and motor control, according to the Women’s Heart Foundation. They may face irreversible damage resulting in slowed thinking, an unsteady walk and slurred speech. “Most alcoholics have some loss of mental function, reduced brain size and changes in the function of the brain cells,” Eskapa says. 5. Violence Alcohol doesn’t cause violence, but it can make a drunk woman more vulnerable to physical abuse because she can miss danger signs. “Victimization is really a huge issue for drinking women,” Wilsnack says. “Sexual assault is also a risk.” And the danger doesn't disappear when they’re drinking behind closed doors. In research spanning 10 countries, Wilsnack found a consistent link between alcohol and aggression between spouses and partners. “Any alcohol use increased the risk of a violent incident,” she says. And the consequences tend to be greater and more life threatening than those of more sober arguments. Recognizing Alcohol Abuse Many women look forward to the nightly glass of wine and occasionally tie one on with girlfriends. So do they - or you - have a drinking problem? “Alcohol abuse is a pattern of drinking that's harmful to the drinker or others,” Eskapa says. You may be abusing alcohol if you repeatedly: Miss work or skip child-care responsibilities because of drinking Drink in dangerous situations, such as before or while driving Are arrested for driving under the influence Hurt someone while drunk Continue to drink even with ongoing alcohol-related tensions with friends and family Other characteristics of alcoholism include: Cravings for alcohol The inability to stop drinking once you have begun Physical dependence and withdrawal symptoms – nausea, sweating, shakiness and anxiety – when you stop drinking after a binge. Still not sure if you have a problem? If you answer “yes” to any of these four questions from the National Institute of Alcohol Abuse and Alcoholism (NIAAA), it may be time to get help: Have you ever felt you should cut down on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt bad or guilty about your drinking? Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover? Getting Help The good news? You have many ways to conquer alcohol dependency, including 12-step programs, addiction counseling, psychotherapy and medications. The Food and Drug Administration (FDA) has approved four medications for treatment of alcoholism: Naltrexone (ReVia) helps curb cravings. It's available in both oral and injectable forms. Acamprosate (Campral) reduces anxiety and insomnia. Disulfiram (Antabuse) discourages drinking by making you feel sick when you drink alcohol. Still, no magic bullet exists for alcoholism, says the NIAAA. And medications don’t address associated psychological problems. Medication will take care of the physiological symptoms, “but it doesn’t do anything for the underlying problem," says Mitchell E. Wallick, executive director of C.A.R.E. Addiction Recovery in North Palm Beach, Fla If you're ready to help yourself or someone else with an alcohol problem, talk to your doctor about treatment options and check out these resources: Women for Sobriety, www.womenforsobriety.org, (215) 536-8026 Alcoholics Anonymous (AA) World Services, www.aa.org, (212) 870-3400 Al-Anon Group Headquarters, www.al-anon.alateen.org, (888) 4AL-ANON (425-2666) National Association for Children of Alcoholics, www.nacoa.net, (888) 4COAS (554-2627) Substance Abuse Treatment Facility Locator, www.findtreatment.samhsa.gov, (800) 662-HELP (4357).