Alcoholism

Alcoholism

Aging Is the Chaser

It's been a hard day. You clear off your desk, grab your keys and head for the car. You're going to meet a few friends, forget all about corporate life and, best of all, have a few beers.

Does that make you an alcoholic?

It might. If you look forward to even a single drink as something that you need--to reduce stress, to relax with friends, to achieve orgasm, to cope--chances are good that you're on the way to problem drinking, says Sheila B. Blume, M.D., clinical professor of psychiatry at the State University of New York at Stony Brook and medical director of alcoholism, chemical dependency and compulsive gambling programs at South Oaks Hospital in Amityville, New York.

"Normal drinkers never need a drink," says Dr. Blume. That's because the need to drink, the need to make sure booze is plentiful wherever you go and to want a drink when there's no alcohol around are the classic signs of a problem drinker.

Women: Targeted for Destruction?

For too many American women, alcoholism is more than a favorite theme on talk shows and the daytime soaps. It knocks 15 years off a woman's life span and is the third leading cause of death among women between the ages of 35 and 55.

Alcoholism is involved in one-third of suicides, one-fourth of accidental deaths and one-half of traffic deaths. It also contributes to thousands of birth defects and divorces. And it is something that most women are likely to wrestle with alone.

"Our society is a little more tolerant of alcoholism in men than in women," says Judith Gore Gearhart, M.D., associate professor of family medicine at the University of Mississippi Medical Center in Jackson. "Women are more likely to drink alone and to hide it." Their problem is less likely to be recognized by a physician, and it's more likely to reach advanced stages before it's discovered.

"Unfortunately, many women are single parents, and the only people who can observe their drinking are too young to understand or intervene," says Dr. Blume.

Nonetheless, it's estimated that more than three million women--about half as many as men--suffer from alcoholism.

The beverage industry has targeted women as a growth market, explains Dr. Blume. "Women as a whole drink only about half as much as men. So if the industry can get women to drink like men, there will be a huge increase in sales."

That's one of the reasons problem drinking is increasing among young women, reports the National Institute on Alcohol Abuse and Alcoholism in Rockville, Maryland. Among women 18 through 29, the number of problem drinkers is beginning to equal the number among men, the institute has found.

The Ravages of Drink

Researchers are concerned about the increasing use of alcohol because of the way it affects a woman's health. Women react far more intensely to alcohol than do men. Within moments of drinking exactly the same amount of booze, women will have higher blood alcohol levels than men, and the toxic effects of alcohol will more quickly attack sensitive organs like the liver and brain.

Chronic drinking is known to cause early menopause and may also shrink the ovaries and reduce their production of hormones, interfere with orgasm by depressing the central nervous system, contribute to osteoporosis and breast cancer, and cause infertility, miscarriage, stillbirth, premature birth and birth defects.

What's more, "women tend to become more chemically dependent more easily than men--even when they drink the same amount," says Dr. Gearhart.

Why? "The explanation for that is not entirely clear," she says. But scientists suspect that it's caused by the differing amounts of water and fat in the body. Since women have a higher percentage of body fat and a smaller percentage of water compared with men, says Dr. Gearhart, alcohol is not as diluted with water before it's passed to sensitive organs.

A Woman's Risk Factors

Although men start to drink in their late teens and early twenties, studies indicate that women generally start in their late twenties, thirties and forties.

What sets them off? A ten-year study of women and alcohol at the University of North Dakota at Grand Forks indicates that a low sex drive, the inability to achieve orgasm, a heavy-drinking spouse or significant other, premarital cohabitation, infertility, depression, childhood sexual abuse and unemployment are all risk factors for problem drinking.

Women between the ages of 21 and 34 may develop drinking problems that ebb and flow in response to the shifts in friends, lovers, jobs and roles, says Sharon C. Wilsnack, Ph.D., professor of neuroscience at the University of North Dakota School of Medicine, who conducted the study.

But one-third of these women manage to get themselves on the straight and narrow in a relatively short time. "Leaving the collegiate student scene--where there's a lot of episodic, binge-type drinking--and moving into employment, marital or child-rearing roles causes most women to drastically curtail their drinking," explains Dr. Wilsnack.

For those who do go on to develop a chronic drinking problem, the underlying cause of their drinking is often sexual dysfunction or being unmarried or jobless, the study says.

Preventing Problem Drinking

No woman is destined to be an alcoholic. Studies show that even those who are raised in homes with alcoholic parents are not doomed to become alcoholics themselves.

How can problem drinking be prevented? Here are some suggestions.

Don't turn to alcohol. If you find yourself in an unusually stressful situation--such as going through a divorce, being laid off or having a baby--find ways other than drinking to calm your fears and relieve your tension. Start exercising, talk to friends or, if necessary, get professional counseling, says Dr. Blume.

Learn the risks. Take a class, talk to your doctor or educate yourself about the genetics of alcoholism. Learning about alcoholism will help you make the right decisions about drinking, based on your family history, according to Dr. Blume.

Look at yourself honestly. Take a personal inventory of your drinking at least once every year, says Dr. Blume. Ask yourself, "How would I feel if my daughter were drinking the way I do?"

Turn back at the first sign. "Alcoholism moves faster in women than in men," says Dr. Blume. And once a woman actually becomes an alcoholic, the disease is very difficult to halt.

That's why you need to understand its natural progression. Know the signs that indicate you're headed for trouble, then stop your drinking.

"The first sign is that a woman starts to drink to make herself feel better, to make herself feel more confident, to make herself feel like she fits in or to counteract anxiety, depression or stress," says Dr. Blume.

"The second sign is that she begins to make sure there's alcohol around. If she's going somewhere, she wants to make sure she can have a drink if she needs it. A later sign is tolerance, which means that for what one drink used to do, it now takes two. For what two drinks used to do, it now takes three."And a fourth sign is saying things or acting in ways while drinking that are not like you at all.

"Any woman who's trying to evaluate herself should ask people frankly if she says or does uncharacteristic things while drinking," says Dr. Blume. She shouldn't trust her own memory, because the alcohol can cause blackouts, which means memory lapses while drinking, not passing out.

"Unfortunately, some women who have alcohol problems are given Xanax or Valium to control stress," says Dr. Blume. Doctors think they're suffering from anxiety when what they're really suffering from is problem drinking.

If you can, discuss your drinking patterns with your doctor. She may be able to recommend treatment programs to suit your needs.

Have a drink a day--or less. Women should limit their drinking to one drink a day, according to the U.S. Department of Agriculture dietary guidelines.

"I would say that women who come from alcoholic families shouldn't drink at all," says Dr. Blume. "Any woman who is the daughter of an alcoholic parent or who comes from a family with alcoholism should accept that if she drinks the way nature moves her, she is at high risk for trouble."

Stay away from heavy drinkers. "One of the strongest predictors of women's drinking is the drinking behavior of husbands or partners," says Dr. Wilsnack.

How does she define heavy? "Two or more drinks a day. To a lot of people that doesn't sound very heavy. But only about 5 percent of women drink that much--and 'problem' drinkers generally drink quite a bit more."

See a therapist. Of several hundred possible predictors in a large study, the single strongest predictor of chronic problem drinking was sexual problems, such as having little interest in sex, experiencing pain during intercourse or having an inability to reach orgasm, says Dr. Wilsnack.

The problem gets started because most women believe that alcohol can make sex more pleasurable, eliminate sexual inhibitions and make them feel closer to their partners.

But it doesn't work. Alcohol actually reduces your physical sex drive and makes it less likely that you'll reach orgasm, says Dr. Wilsnack.

Any woman who deliberately uses alcohol to solve sexual problems should see a therapist pronto, says Dr. Wilsnack. Doctors can provide a referral to a specialist in the community.

Make a commitment. Back in the 1970s, researchers thought women drank as a response to the stress of trying to be "superwoman"--the perfect wife, the perfect mother, the perfect career woman, says Dr. Wilsnack. Now they say that some women drink when they have too few roles. Some women simply don't have enough opportunities to fulfill themselves and build their self-esteem.

That's why studies show that women who are unmarried or without a full-time career are at greatest risk of developing a chronic drinking problem, says Dr. Wilsnack.

It's not that women need a man or a job, she adds. It's that they need a central focus toward which they can direct their lives.