Women’s Problem Drinking Is Catching Up to Men’s

Women are closing a gender gap, but it isn’t a good one: They’re catching up to men when it comes to problem drinking.

Women’s drinking, on the rise for the past two decades, jumped during the pandemic as women reported more stress. Although men still drink more alcohol than women and have higher alcohol-related mortality rates, doctors and public health experts say women are narrowing that divide.

Alcohol-related emergency department visits, hospitalizations and deaths are increasing faster for women than for men. And studies suggest that women are more susceptible to alcohol-related liver inflammation, heart disease and certain cancers. 

“There used to be a large gender gap in alcohol use and alcohol use disorder between men and women,” says Dawn Sugarman, a research psychologist at McLean Hospital and assistant professor of psychology at Harvard Medical School. “That is shrinking.”

Over the past couple of decades, problem drinking has risen most among 30- and 40-something women, says Aaron White, senior scientific adviser to the director of the National Institute on Alcohol Abuse and Alcoholism, or NIAAA. Rates of drinking among teen girls has been declining, he says, but go up once women hit their 20s. 

Binge drinking among women has gradually lost its social stigma over several generations to the point where it is almost a rite of passage in college. In recent years, a growing culture of mom drinking escalated during the pandemic, as some mothers juggling remote school and work drank more to cope with stress, and the habit stuck, doctors say.

How much drinking is too much is a popular topic of discussion among both men and women, with an emergent “sober curious” movement and more open conversations about abstaining from alcohol. Others contend that moderate drinking, which people define in different ways, can be part of an enjoyable, healthy life. 

Federal dietary guidelines recommend that women consume one drink or less a day, or not drink at all. NIAAA defines heavy drinking for women as having more than three drinks a day or more than seven drinks a week.

Signs of problem drinking include consuming for longer or taking in more than you intended, or struggling to scale back or abstain from alcohol if you’re trying to. Having cravings or symptoms of withdrawal, getting sick or hung over frequently and noticing that drinking interferes with your daily family life or job are also warning signs, says Sugarman. Contact your doctor or a health professional if you experience any of these issues or suspect you have a problem.

Pandemic drinking 

The Covid pandemic accelerated years of rising alcohol use among women. 

During pandemic lockdowns in 2020, the number of days that women reported drinking to excess—four or more drinks in a few hours—increased significantly, by 41% compared with the same period a year prior, a 2020 study in the medical journal JAMA Network Open found.

A follow-up study by the same researchers examined alcohol consumption between May 2020 and March 2021 and found that men reported drinking less over the period while drinking levels remained stable for women.  

“By the third wave in the pandemic, men’s and women’s drinking average in terms of the number of drinks per day was similar,” says Joan Tucker,

Alcohol-related deaths are rising faster among women than men, a July study in JAMA Network Open found. Researchers analyzed data from more than 600,000 alcohol-related deaths that occurred between 1999 and 2020. 

While more men die from alcohol than women do, women’s average rate of alcohol-related death increased 14.7% a year since 2018 compared with 12.5% for men, says Ibraheem Karaye, an assistant professor of population health at Hofstra University and lead author of the study. 

“It’s concerning that women are dying at a higher rate in recent years,” says Karaye.

Biological differences

Drinking affects women’s bodies differently than it does men’s.

Women tend to store more body fat than men. Fat contains less water than muscle, so women’s bodies tend to have less water. That difference means women’s bodies feel the effects of alcohol more quickly. 

Women also have higher levels of estrogen than men do, and the hormone affects the liver in a way that makes its cells and tissue more vulnerable to damage from alcohol, says Dr. G. Scott Winder, a psychiatrist who works in the hepatology department at the University of Michigan.

Winder, who treats mental health conditions in patients awaiting liver transplants, says alcohol-related liver problems in women in their 20s and 30s were growing more common before Covid-19 but became starkly apparent during the pandemic.

“This gradual scarring of the liver that used to be a disease stereotypically of men in their 60s now is a disease increasingly of women in their 30s,” says Winder.

Dr. Akhil Anand, an addiction psychiatrist at Cleveland Clinic’s alcohol-related liver disease clinic, says he is seeing more women receiving addiction treatment for alcohol than ever before. 

He has seen more women do something called “telescoping,” where they quickly escalate their drinking level over a short period. That run-up in drinking, combined with biological differences, can result in women developing alcohol-related health problems more quickly than men do, he says.

Less attention from doctors

Doctors also tend to be better at and more accustomed to detecting drinking problems in men than in women, studies show, so some of women’s issues go unnoticed.

A March study in the journal Addiction found that doctors were less likely to have a conversation with women who had problem levels of drinking than men. The study examined nearly 300,000 patients of Kaiser Permanente Northern California whose responses to screening questions indicated they may be drinking too much. 

Doctors were particularly less likely to intervene with middle-aged women compared with same-age men, says Stacy Sterling, a senior research scientist with the Kaiser Permanente Division of Research and lead author of the study. 

“Physicians in all kinds of settings may be less likely to think about women as having drinking problems,” says Sterling.

Write to Sumathi Reddy at [email protected]