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Women who drink face special risks but also have advantages over men

Dr. Carlos Santana

Dr. Carlos Santana

If you want to get women to your next gathering, there may be nothing that will draw a crowd quite like the promise of wine or fruity cocktails served in frosty stemmed glasses. From grocery stores and salons to trendy boutiques, chic fundraisers, even Botox parties, alcohol lures the "girls' night out'' crowd. • For women who know when to say when, social sipping is fine, but drinking among women, measured in government surveys, DUI statistics and hospital admissions, is on the rise. Fifteen percent of women who imbibe are binge drinkers — meaning they consume four or more alcoholic drinks within two hours, at least once a week. While a quarter of binge-drinking women are of college age, 10 percent of women between 45 and 64 admit that they binge, a recent CDC survey shows. • Thanks to biology, women get intoxicated sooner and on less alcohol than men — meaning more health risks, drink for drink. But women also have some advantages that can protect them from addiction. • We spoke with Dr. Carlos Santana, an associate professor of psychiatry at the USF Health Morsani College of Medicine who specializes in addiction treatment and research, about these differences.

Why are women drinking more?

Let's face it, alcohol is cheap, it's legal and it's fun. It helps you unwind, and women are stressed from juggling jobs, kids, aging parents, divorce and other life crises and responsibilities. There's no question that it helps you feel relaxed. It used to be taboo for women to drink in public and especially to drink excessively. Now it's not only acceptable, it's encouraged. Advertisers target women — they know what women like from market research, looking at credit card sales and such. And women are good at rallying support for a cause, bringing others with them — their friends, husbands, other couples — so it makes sense to try to appeal to women.

Why can men tolerate more alcohol than women?

Men have more of a stomach and liver enzyme known as ADH that helps break down alcohol. Men metabolize alcohol more quickly than women. That means men end up having less alcohol in their bloodstream when they drink compared to women. Men also have more water in their bodies and more lean muscle mass, so alcohol is more diluted in men than in women.

What about drinking among younger women, such as college students?

Younger women tend to drink faster, sometimes because they are trying to beat or keep up with men, sometimes because (they're under age) and they are trying not to get caught so they down the drink quickly. With less ADH in their stomach and liver, they get intoxicated more quickly and just have more alcohol in their bloodstream longer.

Why are fewer women than men addicted to alcohol?

Women just seem to have more common sense and tend to drink more responsibly in general, which ends up being a protective behavior. Ten percent of men are alcoholic. Three to 3.5 percent of women are. Women have more of a sense of responsibility. Maybe they have to pick up the kids or get home to make dinner.

Whatever it is, they tend to decrease alcohol drinking before men, especially if they are married, have children and are older, meaning women in their 40s and older. The research tells us that single women are more at risk for alcoholism than married women; younger women are more at risk for alcohol abuse than older women.

Then why are more women than men in treatment?

Women get help sooner than men. Men are in denial, late to accept that they have a drinking problem, and they try to conceal it and delay accepting that it's a problem. Women are more willing to accept that there's a problem and fix it. Women seem to reach a point, maybe it's because they are a certain age where they develop other health problems like high blood pressure or diabetes, and realize their vulnerability and mortality and they just say, "This has to stop. I need to get it together."

How can women drink safely?

First, women should avoid all alcohol during pregnancy or if they are thinking of getting pregnant.

Otherwise, drink slowly. Drink with food in your stomach. Don't have several mixed drinks, especially the ones made with multiple kinds of alcohol and juices. It's easy to drink several of those cocktails and not realize how much they have affected you.

Contact Irene Maher at imaher@tampabay.com.

Do you need help?

According to the National Institutes of Health, a "yes" to any of these questions is worth investigating further:

• 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?

Your family doctor, and free self-help groups such as Alcoholics Anonymous, can help you find the services you need. The federal government has a national treatment services locator and links to resources at findtreatment.samhsa.gov.

Women who drink face special risks but also have advantages over men 07/24/14 [Last modified: Thursday, July 24, 2014 7:03pm]

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