Alcohol Consumption Among Women Is on the Rise

The guest author of this post is Elora Basu, a fourth-year medical student at Weill Cornell Medicine.

Alcohol consumption among women has dramatically increased in the past decade. Historically, men have had heavier drinking patterns and therefore more medical consequences of unhealthy alcohol use compared to women. However, this gender gap is decreasing due to changes in socio-cultural environments that impact drinking patterns and normalize female drinking. Though these societal changes are mostly positive, such as higher numbers of women in the workforce, women have been disproportionately impacted by increased alcohol use.

For instance, young women are actually driving the rise in the number of deaths from alcohol-related liver disease, according to experts. The biggest increase in deaths from alcohol-related liver disease was among women age 25-34. Additionally, women die of liver disease on average about 2-3 years earlier than men, based on a 2020 study. The lifetime prevalence of drinking and alcohol dependence is thus increasing at a faster rate for women than men.

The frequency of alcohol use among women has also been impacted by the COVID-19 pandemic. Women reported greater rates of pandemic-related changes in sleep, mood, habits, and stress compared to men. A survey from the RAND Corporation noted that psychological distress from the pandemic directly relates to alcohol use; heavy drinking days have increased by over 41% for women since pre-pandemic.

Researchers suggest that women experience a phenomenon known as telescoping, meaning that there is a quicker timeline from the initiation of substance use to dependence on that substance. Women may have an accelerated path to medical and psychosocial problems, even though they might have consumed less alcohol overall and for a shorter period of time compared to men.

Consequences of women's unhealthy alcohol use

The consequences of unhealthy alcohol use can be devastating. In 2016, 3 million deaths or 5.3% of all global deaths were attributed to alcohol. Excessive alcohol use can cause a myriad of health issues; over 48% of all deaths from liver cirrhosis are linked to alcohol-related liver disease. Other medical consequences of heavy alcohol use include heart disease, stroke, and certain cancers. Psychiatric consequences of unhealthy alcohol use are also pervasive, including depression, anxiety, accelerated memory problems, and risk of dementia.

In fact, women with unhealthy alcohol use have higher rates of psychiatric illness, notably mood and anxiety disorders, compared to men. Often psychiatric disorders precede alcohol use, suggesting that alcohol may be serving as a form of “treatment” or self-medication for people with anxiety or depression. A Danish study showed that any type of psychiatric illness, including mood and personality disorders, was more likely to be present in women averaging greater than three drinks per day compared to non-drinkers. Women in substance abuse treatment also have higher rates of lifetime physical, emotional, and/or sexual abuse and trauma compared to men. Co-occurring alcohol use disorder and psychiatric illness may impede treatment for both conditions.

Strategies to reduce unhealthy alcohol use in women

How can we thus change the course of unhealthy alcohol use in women to prevent medical and psychiatric consequences? The efforts can start off with public health interventions about the effects of heavy alcohol use and what the “right” amount of alcohol consumption is for men versus women. These interventions should start early, as individuals often start drinking heavily during their college years. Primary care providers should also ask standardized screening questions related to alcohol use. Finally, we should specifically focus on reducing barriers to treatment for women, such as child-care provision and treatment for co-existing psychiatric illness.