Download CHAPTER 5: Alcohol Use in Women

CHAPTER 5:
Alcohol Use in Women
Introduction
• Alcohol use in women has important physical
and psychological effects on women’s health.
• Recent large nationally representative
population samples have greatly increased our
understanding of women’s alcohol use.
• Yet, it is important to continue to investigate
women’s drinking across the lifespan.
Introduction
• Majority of women who meet criteria for an
alcohol use disorder do not perceive a need
for treatment.
– Reason for very low utilization of alcohol
intervention programs
• However, when engaged in treatment,
women’s treatment completion and success
rates equal or exceed men’s rates.
Definitions of Alcohol Use
• According to the National Institute on Alcohol
Abuse and Alcoholism (NIAAA), a “drink”
refers to:
– a 12-ounce regular beer,
– a 5-ounce serving of wine, or
– 1.5 ounces of 80-proof distilled spirits
Patterns of Alcohol Use and Alcohol
Problems in Women
• Almost 60% of adult women report drinking in
the past year.
• Women are more likely to abstain from
alcohol use.
• Women are less likely to drink at moderate or
heavy levels.
• Women’s alcohol use fluctuates across the
lifespan.
Patterns of Alcohol Use and Alcohol
Problems in Women
• “Risky” drinking is defined as four or more
drinks per day for women.
• Overall rate of risky drinking for women is
14.2%.
– Almost 30% of women ages 18–24 reported at
least one episode of risky drinking.
Patterns of Alcohol Use and Alcohol
Problems in Women
• Alcohol use disorder (DSM-IV-TR)
– Continued use of alcohol despite distress or
impairment in several areas, including role
impairment, legal problems, hazardous use, or
social and interpersonal problems
– Includes physiological tolerance, withdrawal
symptoms, and a desire or unsuccessful efforts to
cut down on use
• 4.9% of women meet criteria for an alcohol
use disorder
Health and Social Consequences of
Women’s Drinking
• Potential Health Consequences:
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Cirrhosis of the liver
Cardiovascular disease
Alcohol-related cardiomyopathy
Epilepsy
Cognitive impairment
Nerve damage
Type 2 diabetes mellitus
Reproductive health problems
Cancer
Health and Social Consequences of
Women’s Drinking
• Potential Psychosocial Consequences:
– Increased risk for sexual assault/IPV
– Car accidents due to DUI/DWI
– Comorbidities with mood, anxiety, and personality
disorders
Risk Factors for Women’s
Problem Drinking
• Women’s problem drinking is associated with:
– Younger age
– White or American Indian race/ethnicity
– Family history of alcohol problems
– Their partners’ heavy drinking
– Child and adult victimization
– Certain comorbid disorders
Assessment, Intervention, and
Prevention of Alcohol Problems
• Identification of women’s problem drinking
occurs:
– Through self-assessment
– By significant others/family/friends
– At the workplace
– By the legal system
– By healthcare professionals
Assessment, Intervention, and
Prevention of Alcohol Problems
• Screening in healthcare settings is the most
effective way to assess women’s alcohol use
problems.
– NIAAA recommends screening along a continuum.
– “How many times in the past year have you had
four or more drinks per day?”
– For patients who report one or more times, assess
frequency, quantity, and maximum number of
drinks on one occasion.
Assessment, Intervention, and
Prevention of Alcohol Problems
• Evidence-based Interventions:
– Brief interventions
– Motivational interviewing
– Cognitive-behavioral interventions
– Alcoholics Anonymous and other support groups
– COMBINE study
Assessment, Intervention, and
Prevention of Alcohol Problems
• Targets for prevention:
– Increase alcohol prices to lower youth
consumption.
– Restrict number of alcohol outlets.
– Strengthen enforcement and laws.
– Reduce and control alcohol advertising.
– Increase screening and assessment in healthcare
settings.
Conclusions and Future Directions
• Women under 25 remain a high-risk group for
alcohol use problems.
• Once engaged in treatment, women are
generally successful.
• More training is needed for healthcare
professionals on comprehensive assessment
of and interventions for women.