By John Dyben
Gail wanted three things. She wanted to be healthy enough to play tennis again, to be whole enough to feel at peace and to be sober enough to be allowed to drive her grandchildren to the mall for ice cream.
Born in 1953, Gail had been a responsible person all of her life. She was an obedient daughter, a straight-A student, a hard-working professional and a faithful wife, mother and grandmother. Gail’s parents were part of the Greatest Generation and taught her to live morally and with restraint.
In Gail’s family, it was not uncommon for her father or uncles to drink to intoxication. Even when male cousins snuck a bottle of whiskey out behind the house and became violently ill, after doling out a sound talking to, the adults would say, “Boys … they will be boys, won’t they?”
In stark contrast, Gail recalled an episode when her mother’s younger sister drank too much one Thanksgiving, becoming loud and boisterous. The incident was rehashed in hushed tones for years, always with a palpable sense of disgrace.
Women’s Alcohol Consumption Catching Up to Men’s
There is a lack of research to inform us whether these different standards between genders caused women to actually drink less or simply to report drinking less. What we do know is that studies have historically and consistently indicated that men are far more likely than women to drink, to drink to excess, to binge drink and to develop problems with alcohol.
In recent years, this trend is changing both nationally and internationally. Women are catching up with men in their alcohol consumption and problematic alcohol use. In Gail’s generation, according to a 2017 study by Breslow et al., and published in Alcoholism, from 1997 to 2014 the percentage of men who binge drink (drinking five or more drinks at a sitting) has remained fairly steady, while the number of women who binge drink has been increasing by about 4 percent per year.
The study authors, speculating about this trend, identified the following commonly associated reasons: loneliness following the death of spouses; anxiety over finances; stress related to caregiving; and “empty-nest” syndrome. These are valid concerns and professionals working with this population should explore all of these areas with their patients. Professionals also posit that the baby boomers’ impact on American culture effected permanent change in gender expectations relative to alcohol use.
Growing up, Gail learned from her family that women should never drink to intoxication. Only men did that. Then, as a teenager, she began to experience a new dialogue. At 15, ads on television, magazines and billboards told her women had “… come a long way, baby!” One of the most important cultural revolutions came about through this generation’s idea that equal treatment, expectations and opportunities should be available to all, regardless of gender, race or sexuality. Perhaps this thinking also influenced accelerated drinking patterns in baby boomer women.
Happier Now in Later Life
This was the case for Gail. She felt liberated when she went to college and could drink openly with others and “could cut loose just like the boys.” Over the next few decades, Gail developed a pattern of drinking that included one or two glasses of wine most days and two or three episodes of drinking four to six drinks with friends per month.
She maintained this throughout her mid 50s until about age 58, when she began to realize that drinking as she had been for years was having a greater effect on her. Her doctor suggested that she cut down. Much to her surprise, she found that she could not. She would develop tremors and strong cravings, feeling that she “needed” a drink. Gail had developed alcoholism, a neurobiological condition, and she could not stop drinking on her own.
What she didn’t know was that because women have less total body water than men, and total body water is critical in processing alcohol, alcohol affects women more than it does men. And, as people age, their total body water decreases over time, making older women the most susceptible to the effects of alcohol. Additionally, women tend to have higher concentrations of body fat, which intensifies blood alcohol concentration, as alcohol is not drawn into body fat as well as it is into lean muscle mass.
A female, age 64, who weighs 130 lbs. and drinks two glasses of wine in two hours will have a blood alcohol concentration (BAC) around .05, whereas a male of the same age, who weighs 168 lbs. and drinks two glasses of wine in two hours will have a BAC around .02.
Today, Gail’s life is a happy one. She sought help and found recovery and freedom from alcoholism. Her path to healing included residential treatment followed by active engagement in a 12-step recovery process. Additionally, Gail experienced a renewed sense of purpose and meaning in her life—but her story is a cautionary tale.
If people choose to drink alcohol, consumption should be limited to levels that follow guidelines set forth by the Centers for Disease Control and Prevention. This means one drink per day for women and two for men. As people age, consumption should be limited to one drink daily for both men and women. Consistently drinking at higher levels, especially binge-drinking, increases everyone’s risk for developing problems. If care professionals seek help for a client, patient or loved one (or even themselves), the National Council on Alcoholism and Drug Dependence has an informative website with links to connect people with the help they need.
John Dyben, DH.Sc, M.C.A.P., C.M.H.P., is the chief clinical officer for Origins Behavioral Healthcare in South Padre Island, Texas.