Volume 19, Number 3
In the Solution
Chilling Out vs. Chilling Reality: Women and Alcohol
By Carol P. Waldhauser
One late afternoon, a well-dressed, attractive female attorney stopped by my office. It was not long before "Mildred," without warning, leaned across my desk and whispered, "I think my drinking has gone beyond chilling out. I think that I am an alcoholic!"
It seems that Mildred had a habit of relaxing by drinking wine late at night, alone, after a long day of work. "In the beginning, I would pour one glass of wine; then suddenly that one glass of wine turned into a hearty mug of wine; and soon the hearty mug of wine became a bottle of wine, each and every night." Then Mildred asked, "Does my chilling out have a chilling reality?"
Today, many studies have publicized the positive attributes of drinking alcohol in moderation. Conversely, other studies, perhaps less publicized, suggest woman may be taking their relationship with alcohol too lightly. In fact, estimates predict that there soon may be as many female as male alcoholics. Moreover, this data supports a causal relationship between as few as two drinks (or even less) a day and health problems in women. There is direct evidence that women are more vulnerable than men to alcohol-related organ damage, trauma, and legal and interpersonal difficulties.
Ironically, since the 1980s, the number of adult women considered heavy drinkers-which is defined as two or more drinks a day-has declined. However, drinking among certain groups of women has steadily increased. In 1993, the National Household Survey on Drug Abuse found that women who work outside the home are 67 percent more likely to drink heavily than homemakers. A more recent study by the National Center on Addiction and Substance Abuse puts that number even higher, at 89 percent. Of course, more American women are working than ever before. In 1960, less that 20 percent of married women with children under age six worked outside the home; in the year 2000, that figure was approximately 65 percent.
An ongoing study by psychologist Sharon Wilsnack and sociologist Richard Wilsnack at the University of North Dakota School of Medicine and Health Sciences surveys a nationally representative sample of 1,100 U.S. women, 696 of whom have participated since l981. Their data finds that women in male-dominated occupations (measured by the U.S. Census Bureau as more than 50 percent male, including law and engineering) drink more than women in traditionally female professions such as teaching and nursing. "In a male-dominated environment," Wilsnack says, "drinking may be symbolic of gender equality."
Similarly, another study of women reported in the Journal of Law and Health included a section that specifically targeted women lawyers and found that "[n]early 10% of the practicing Washington lawyer sample report[ed] levels of alcohol use that are likely to indicate current alcohol-related problems." Ominously, however, the study continued:
As with male lawyers, however, this rate increases dramatically to 71% who are reporting a lifetime likelihood of alcohol-related problems. Over the career span, the data reveal that almost three-fourths of female lawyers [practicing up to and including ten years] are reporting a lifetime likelihood of alcohol-related problems.
This does not mean that women should give up their licenses to practice law to guard against alcohol abuse and addiction. Working women, especially women attorneys, should monitor their levels and frequency of consumption and fine-tune their radar for signs of growing dependence. "Drinking every night to relax is a major sign of trouble, even if you are not drinking that much," Wilsnack says.
Alan Leshner, director of the National Institute on Drug Abuse, explained in an article that, over time, individuals begin to depend on a substance to feel not just good but normal. Gradually, the occasional use of a drug, including alcohol, turns into weekly, then daily, use. Eventually the person may come to the distressing realization that he or she is addicted.
According to Leshner, "Every drug user starts out as an occasional user and that initial use is a voluntary and controllable decision." However, as time passes and drug use continues, changes in brain chemistry can produce compulsive and uncontrollable drug use. "While every type of drug abuse has its own individual trigger for affecting or transforming the brain," he explains in the report, "many of the results of the transformation are strikingly similar regardless of addictive drug used. The brain changes range from fundamental and long-lasting changes in the bio-chemical make-up, to mood changes, to changes in memory processes and motor skills."
Of course, not all people who use drugs, including alcohol, will experience such dramatic changes. Some people can use drugs occasionally and remain occasional users; those at high risk, however, may start using casually but then progress quickly to addiction.
Men and women are created equal, but they do not respond equally to the effects of alcohol. When women and men drink at the same rate, women show higher susceptibility to serious substance-related medical conditions that include liver, brain, and heart damage. This increased risk is attributed to gender differences in metabolism but also could be the result of differences in brain chemistry, hereditary genetic factors, or other factors currently unknown.
Women achieve higher concentrations of alcohol in the blood and become more impaired than men after drinking equivalent amounts of alcohol. Ongoing research indicates that women also are more susceptible to trauma resulting from traffic accidents and interpersonal violence. In addition, women develop alcohol-induced liver disease over a shorter period of time and after consuming less alcohol than men. They are more likely to develop alcoholic hepatitis and to die from cirrhosis of the liver. Animal research suggests that this increased risk of liver damage is related to the physiological effects of the hormone estrogen.
Research into the effects of alcohol and drug use has only recently began to recognize the importance of gender differences in how liquor is used, the consequences of use, and the development of alcohol dependence. The more we know about how alcohol and drugs affect us all, the better we will be able to treat these problems in all populations. Mildred got out before her use damaged her health or her professional standing-she is one of the lucky ones.
Carol P. Waldhauser is the program administrator/assistant director of the Maryland State Bar Association's Lawyer Assistance Program. Information regarding the research and statistics cited in the article is available from the author at 800/492-1964 ext. 252 or by e-mail at firstname.lastname@example.org.
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