In the spring of 2008, I was moving my three daughters from my beloved home state of Oregon back to the East Coast. My husband had a great new job in New York City and was commuting between there and Portland. Before me were the tasks of selling our house, finding one in New Jersey, getting the girls into new schools, and saying goodbye to my parents. I spent my time cleaning for prospective buyers, jettisoning old clothes, and feeling really, really anxious.
At night, I found myself drinking a third glass of wine to cope with the lump of sadness that seemed to have lodged itself permanently in my throat.
Within a few weeks, I began to see that this more-than-usual drinking wasn’t helping, and I scaled back. But I also realized that if a healthy eater and disciplined exerciser like me could start to be careless with my drinking, it could happen to anyone.
Soon, I began noticing women’s drinking as a cultural trope. In my new suburb, I saw women secretly dumping their empty wine bottles at the recycling depot instead of leaving them in their curbside bins. I met moms who joked about bringing flasks to school-board meetings.
Wine-loving women also showed up in popular culture: books, movies, and certainly on TV. On The Good Wife, The Real Housewives, and Scandal, big goblets of wine seemed like characters themselves. On Facebook, I found groups like “OMG I So Need a Glass of Wine or I’m Gonna Sell My Kids” and “Moms Who Need Wine.”
The trend became so striking to me that I spent three years researching and writing about it in my recent book, Her Best-Kept Secret: Why Women Drink — And How They Can Regain Control.
Here’s what I learned from federally funded studies, talks with clinicians and researchers, and plenty of marketing surveys, as well as what I discovered about promising new strategies that seem to work best for women who want to cut back or quit drinking altogether.
Why We Drink
A wide range of data confirms that women are drinking more now than at any time in recent history. They drink the majority of the 800 million-plus gallons of wine consumed in the United States each year.
Over the past few decades, Gallup pollsters have found that the better off and educated a woman is, the more likely she is to drink. White women are more likely to imbibe than women of other racial backgrounds, but national studies conducted in the last 30 years have found that the number of women who say they’re regular drinkers has risen across the board.
In a sense, the rising drinking rate among women could be seen as a sign of parity with men. But while women tell their daughters they can do everything boys can, drinking is one example where that’s a bad idea.
Biologically, women are more vulnerable to alcohol’s toxic effects. Female bodies have more fat (which retains alcohol) and less water (which dilutes it) than male bodies. Women drinking the same amount as men their size and weight become intoxicated more quickly.
Men also produce more of the enzyme alcohol dehydrogenase, which breaks down alcohol before it enters the bloodstream. This may be one reason why alcohol-related liver and brain damage appear more quickly in heavy-drinking women than men.
Women have additional risk factors for drinking to excess. They are twice as likely as men to suffer from depression and anxiety disorders, and often medicate their negative feelings with alcohol. And those who had eating disorders or were sexually abused are also more prone to turn to alcohol, researchers say.
According to Richard Grucza, PhD, an epidemiologist at Washington University in St. Louis, heavy drinking begins in college for many women. Even though women outnumber men on college campuses today, activities are still dominated by male culture, and that involves a lot of drinking — in dive bars, at tailgate parties, at fraternity houses on weekend nights.
Many women continue this excessive drinking when they join the work force, particularly if they’re in male-heavy fields like banking and tech.
And so it goes as the stress of life mounts — when work deadlines loom, when teenagers get sassy, when partnerships falter, when aging parents have health problems.
It’s clear that women aren’t just drinking more than ever before. They are also worrying more about their drinking. Sharon Wilsnack, PhD, a neuroscientist at the University of North Dakota, pioneered the study of women’s drinking habits in the 1970s. In the early ’80s, she found that one in 10 women answered yes to the question “Are you concerned about your drinking?” By 2002, that number jumped to one in five.
That rise is reflected in the number of women who’ve sought help: Between 1992 and 2007, the number of middle-aged women entering rehab nearly tripled.
Mary Ellen Barnes, PhD, an addiction specialist who treats women with alcohol problems at her outpatient clinic in Rolling Hills Estates, Calif., links many women’s increased drinking to milestones in their lives: divorce, death of a parent, or leaving a career to stay at home with kids.
When life changes disrupt structure, women can find themselves adrift, bored, anxious, and lonely as they try to power through.
“Alcohol is a well-known and time-tested way to medicate all of these conditions,” Barnes says.
The mixed feelings a woman might have staying home with kids, the anxiety she might feel about an empty nest, or the pain she might experience losing a loved one. Drinking can seem like an easy fix for all of these challenges — at first.
So what does it mean, exactly, to have a drinking problem? According to American health officials, anything more than a drink a day is risky for women. (Notably, authorities in France, Italy, and Spain, where life expectancy is longer, set the safe threshold at double that — and sometimes higher.)
Many of the women I interviewed said that the limited recommendations in the United States was one factor in driving their drinking underground. A few glasses slide into a whole bottle, which becomes an embarrassing habit they feel they need to hide. And at that point, many perceive that their options for help are limited to the abstinence-based model of Alcoholics Anonymous (AA), which can pose specific challenges for women.
AA was developed in 1935, when knowledge of brain chemistry was in its infancy; the group’s primary reference text has remained virtually unchanged since its initial publication in 1939. Its general recommendation is that members declare they are powerless over alcohol and accept that they have a chronic, progressive disease whose only cure is abstinence.
While this may be a reasonable solution for some severely alcohol-dependent people, that’s only about 10 percent of excessive drinkers, according to the Centers for Disease Control and Prevention (CDC).
The remaining 90 percent are left with the choice between drinking too much and declaring their powerlessness — a declaration that may well produce the same stress for women that triggered their excessive drinking in the first place.
More-nuanced perspectives on alcohol use might prove more helpful to women who want to drink less or quit altogether. To classify problem drinking, the Diagnostic and Statistical Manual of Mental Disorders (known as DSM-5), used by mental-health professionals, now uses the term “alcohol use disorder” (AUD), which denotes a spectrum. This replaces the older terms “alcohol abuse” and the much-older “alcoholism.”
And here’s the good news: The vast majority of women with AUD fall within the mild to moderate range.
What’s more, there are new evidence-based ways to change and moderate your drinking habits. And research shows moderation is a realistic goal for most: A recent CDC study of more than 138,000 adults found that those 90 percent of excessive drinkers who are not dependent on alcohol could successfully moderate their drinking with the help of evidence-based strategies and clinical preventive services.
Many new peer-led support groups for changing alcohol use deploy tools that have been proven to help people learn new behaviors (see next page for examples). They stress personal responsibility; the ability to shift one’s thoughts, feelings, and beliefs; and the individual’s own capacity for change.
Those messages are especially important for women, Barnes says: “Women need to feel powerful, not like victims of something beyond their control. It gives women power to feel they themselves can change.”
For many of those women who have crossed the sipping point, these options are welcome news.