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5 Reasons Alcohol Problems Are Especially Bad For Women

Research reveals factors that could make alcohol problems extra for women.

In my book, I use examples drawn from actual clients I’ve worked with. One of the clients whose story I tell, Terry (not her real name), is a wife and mother who struggles with an unhappy marriage for over a decade as her drinking escalates. Another is a successful female coach and author. Only one case I discuss involves a man.

That’s uncommon.

Alcohol addiction tends to be most commonly associated with men, which comes as no surprise given that alcoholism is more than twice as common among men than women. What many people don’t realize is that heavy long-term drinking (or even short-term drinking) is particularly detrimental to women’s health compared to men.

In previous articles, I have explored just how many myths surround alcohol use disorders and the challenges faced by people with an alcohol use disorder.

Though men are statistically about twice as likely to be diagnosed with an alcohol use disorder than women, drinking is becoming more socially acceptable for women, a pattern that brings with it some unfortunate consequences. While women may try keeping up with their male colleagues at happy hour, they are actually damaging their health at a faster rate than their male counterparts. Research tells us that women are more vulnerable to the effects of alcohol and at greater risk of developing serious psychological and physical health problems related to drinking than men with similar drinking patterns.

In my own practice, I have seen how women can go “under the radar” with their drinking problems because “alcoholism” is rarely associated with women. My former client Paula (not her real name) was a highly functioning executive who came to see me to reduce her drinking as it was having an impact on her relationship with her husband. She’d progressed from college party-goer to a working mother with nightly blackouts and embarrassing dinner parties that ended in her passing out. But she was also performing at an incredibly high-level in an incredibly competitive industry. Her colleagues were all shocked when she told them she was seeking help for her drinking.

Alcohol struggles among women are a real problem and many women don't seek treatment because of the shame and stigma surrounding “alcoholism.”

Why do women develop alcohol problems?

There are a number of reasons why women find themselves struggling with their drinking. To fully understand the contributing factors, we need to explore all relevant aspects, which I refer to as the four ‘camps' of addiction: psychology, biology, spirituality, and environment. We'll look at some of these "camps" in the context of women and drinking.


One of the primary reasons why women begin to use drugs and alcohol is to cope with trauma and mask mental health problems such as depression and anxiety. Unfortunately, childhood trauma is a strong risk factor for later substance addictions, and the majority of women have undergone some traumatic events in their early life. Current statistics indicate that approximately 1/5 women have been raped, but when the consideration of other trauma is included—assault, sexual harassment, bullying, etc.—the rates increase to more than ½ of women, with some surveys indicating the number is around 80 percent!

The frequency of psychiatric conditions like depression, bipolar disorder, anorexia, and bulimia—all of which are associated with an increased risk of substance abuse—among women may be partly responsible for their vulnerability to chemical dependence and addiction. The incidence of mood disorders, anxiety disorders, and eating disorders is higher in women than in men, which may predispose females to become addicted to certain substances. Depression is reported twice as often in women as in men. Alcohol and prescription drugs are commonly “abused” drugs among women who suffer from anxiety and depression. While women may find themselves more open to talking about their emotional functioning than men, which may explain some of these differences in diagnosis rates, there is still a likelihood that these struggles could lead to “coping through chemicals.”


Women also tend to progress more quickly from ‘normal’ drinking behavior to dependence. This is a phenomenon known as telescoping and is likely due to the biological differences in women compared to men.

Women tend to be biologically more vulnerable to alcohol and substance cravings than men. And at least part of the reason for this is hormones. Estrogen has been found to affect alcohol cravings, potentially impacting the effects of alcohol overall (making them stronger). This can sometimes mean that a man who has been a heavy drinker for 30 years could have moderate physical problems associated with his alcohol use, whereas a woman who has only been a heavy drinker for five years could show moderate to severe problems. Obviously, there are other biological and environmental influences as well…


While it has been more acceptable for men to mask their emotional struggles with alcohol and substances, it’s possible that more women now turn to alcohol (and other drugs) to cope with mental health struggles because of changes in social relationships. In the past five years, social interactions and social media use has impacted on social connectedness and may have left women less able to depend on their social networks for support. Additionally, the increased involvement of women in dual roles (work and family) could increase stress even further and in the process drive a greater reliance on substance use for help. I personally applaud all women who manage these dual roles as it is an incredible feat (I see my amazing wife Sophie doing it daily and it’s the most stressful thing I’ve ever seen).

5 Reasons Why Alcohol Problems Are Especially Detrimental For Women

We’ve touched on some of the reasons why women could be facing a growing risk of developing an alcohol use disorder, but WHY is this problem so detrimental to women in particular?

  1. Women tend to progress more quickly from using an addictive substance to dependence. The window for prevention or addressing the problem earlier is smaller compared with.
  2. Long-term alcohol abuse or binge-drinking takes a greater toll on women’s health compared with men. That’s because women absorb alcohol into the bloodstream more quickly, and since their bodies contain less water and more fatty tissue than men, there is greater exposure for harm to a woman's body.
  3. That means brain atrophy and liver damage occur more quickly in women than in men. Women with chronic alcohol addiction can develop anemia, hypertension and other physical health problems much quicker than men with alcohol use.
  4. Women with an alcohol use disorder are more likely to die from alcohol-related death than men with such a disorder.
  5. Women who are dependent on alcohol are more at risk for developing cancer than men, in particular, digestive-tract cancers and breast cancer.

What help is available for alcoholism in women?

According to the National Institute on Alcohol Abuse and Alcoholism, women are less likely to receive adequate treatment for substance abuse than men. When they do get help, women are less likely than men to receive care at a specialized drug treatment facility. Instead, they are often treated by their local doctors or through mental health programs. Additionally, women face more barriers to treatment such as lower incomes, pregnancies, child protection concerns and access to childcare.

Nationwide studies confirm that even though problems may develop more quickly and are more detrimental for women, more men enter rehab at specialized treatment facilities. Approximately 33 percent of admissions to rehab facilities in 2011 were women, while nearly 67 percent were male. Why? Because of stigma and differential expectations and responsibilities. Women may be more prone to hiding their substance abuse out of fear of social stigma, loss of child custody, or repercussions from a partner or spouse. Traditional addiction treatment programs were developed primarily based on research in men (since the earliest models for current treatment were actually developed in prisoner populations).

Both women and men respond well to specialized behavioral therapies that target alcohol use disorders. Women can benefit from mixed-gender programs for alcohol addiction (unless they have a history of severe trauma and or sexual violence).

How can we support women’s recovery from alcohol addiction?

A better appreciation of gender and sex differences should help women avoid the pitfalls of substance use and help clinicians help women with addiction achieve sobriety. Ultimately, we need to look at all four "camps" of addiction when women seek treatment and as clinicians, we need to be aware of the particular challenges faced by women who have an alcohol use disorder.

Paula, the former client I mentioned earlier, wanted to get to the underlying issues of her alcohol addiction. It was shame that prevented her from getting help earlier. Once we began working together, she not only reduced her alcohol consumption but quit altogether. She no longer ‘needed' alcohol, and because she did address the other issues in her life she saw great improvements in all aspects of her life, including her relationships, her work productivity, and her physical health.

The IGNTD Recovery course was created to offer men and women an individualized approach to addiction recovery and offers an alternative to traditional rehab programs. It's barrier-free, shame-free and judgment-free. Even better than that, you can seek help for your addiction from the comfort of your own home.

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