Men Are From Mars, Women Are From Venus, trumpeted a popular book in the 1990s. • Author John Gray focused on how we communicate and how these gender differences can lead to conflict. • Here's another significant way in which the sexes differ: alcohol addiction. • Physical differences mean men and women metabolize drinks differently. And other conditions, notably depression — on its own or related to drinking — add to the gender gap. • "Depression is more frequent in women than in men; addiction is more frequent in men than women, but if women have a problem of addiction or alcoholism, there is more likelihood of having other psychiatric problems like depression. The likelihood they were exposed to trauma is higher," said Ihsan Salloum, professor of psychiatry and behavioral sciences, and chief of the Division of Substance and Alcohol Abuse at the University of Miami Miller School of Medicine.
The numbers
The National Institute for Alcohol and Alcohol Abuse estimates about 5.5 million women drink alcohol at levels that place their health at risk. Double that number for men, said Dr. John Eustace, medical director at the South Miami Hospital Addiction Treatment and Recovery Center.
But drinking among women appears to be on the rise, numerous reports indicate.
In 2012, there were more than 1.7 million substance abuse treatment admissions in the United States, and alcohol was the most common primary problem.
Teens and men were 67 percent of admissions in 2012, down from 70 percent in 2002, suggesting that more women were beginning to seek help. For example, 41 percent of the patients at South Miami Hospital's Addiction Treatment & Recovery Center are women, compared with 10 percent in the 1980s and '90s, Eustace said.
Addiction on the brain
Addiction, for both genders, impacts the brain's medial forebrain bundle, also known as the reward target of the body that gets activated whenever an individual engages in activities perceived as pleasurable, including eating and sex. Physical changes to the brain, brought about by the release of dopamine when pleasure centers are tapped, can render people vulnerable to overuse.
Drugs — and alcohol is a drug — cause the brain to release dopamine in a disproportionate quantity compared to regular pleasurable activity like eating, having sex or exercising. The brain is not built for such overstimulation, and as a result, the pleasure centers of the brain require a larger hit to derive the same sensation, allowing addiction to take root.
Genetics is a risk factor, too, but here gender doesn't matter.
"A female grandparent doesn't mean the girls are more at risk. It's equal between the male and the female," Eustace said.
The ADH advantage
Take two 135-pound individuals, a man and a woman. Give each a glass of alcohol.
"Women physiologically have less of a chemical called alcohol dehydrogenase, the chemical that immediately begins to break alcohol down into a less toxic chemical. So when the woman takes that ounce-and-a-half of ethyl alcohol, it'll be metabolized much slower."
An hour later, if the couple orders another round, the man is essentially starting over. The woman, however, is adding on to the effects of the first drink, Eustace said.
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Explore all your optionsWhat's more, the man likely has more muscle, which also helps speed alcohol metabolism.
"That's the physiological and biological reason; it's not that men are tougher by some macho formula: 'I can hold my booze and you can't.' It isn't that at all.''
Drinking, depression
Another property of alcohol is that it is a central nervous system depressant.
"Part of its pharmacology is to depress nerve conduction," Eustace said.
So for women who drink to feel better, alcohol can have the opposite effect.
"That's part of the seductive nature of the drug," Eustace said.
"When people drink heavily, they get depressed," Salloum said. "Heavy drinkers, 80 percent would tell you they are depressed and 30 percent might have clinical depression when you ask in a more structured way. Clinical depression, independent from alcohol, does improve when you get away from drinking, but the depression still needs to be treated."