If you ask an old-timer in recovery if there are any differences between men and women when it comes to alcoholism and drug addiction, you’re most likely to hear a resounding “of course not!” That may have been the belief years ago, but more is now known about the physiological aspects of the disease and how it manifests.
Genderization and societal roles still leave women carrying extra shame and guilt about the disease – creating a barrier in seeking treatment. If a husband and wife drink side-by-side for years, it is the wife’s drinking problem the comes to the forefront first. Because women are still the main caretakers of children and family, the alcoholic mother tries hardest to maintain the appearance of normalcy at all costs. Add to that the fact that many women have to work outside the home and you can begin to see how the pressure to be superwoman can set the stage for escaping into addiction.
It’s not all in your head – physiological women’s issues in recovery
Let’s first explore the physical issues, the most obvious being body size and metabolism. If you pour eight ounces of booze in a pint container of soda, then pour the same amount of booze in a liter of soda, which would have the strongest concentration? A man’s size affects how much he can drink, but let’s eliminate that by comparing men and women of the same size. The results still show that the woman gets a stronger concentration of alcohol! That’s due to the fact that women in general have less body fluid than men, which increases the concentration of alcohol absorbed in the bloodstream.
Women also have a higher percentage of fatty tissue, in breasts and other areas, affecting absorption and creating another factor in increased concentration. Then women have less of an enzyme called dehydrogenase, which breaks down alcohol in the stomach. This means a woman metabolizes 30% less alcohol than a man of the same size, meaning again a higher BAC (blood alcohol concentration) for the woman. So a 140 lb. Male who has two drinks in an hour has a blood alcohol concentration of .038, whereas a woman weighing the same gets a concentration of .048 for those same two drinks.
It appears that women’s bodies and alcohol are at odds in many other ways. Women alcoholics are subject to many of the same health issues as men as a result of their drinking, but the disease process hits women harder and earlier. Alcoholic liver disease, cardiovascular issues, osteoporosis, and brain damage are more accelerated; the brain damage in women drinkers (which is irreversible) begins to show itself earlier and the long-term effects are more severe. Dementia (wet brain) is the inevitable result for those who don’t address the issue. Women drinkers develop breast cancer and obstetric complications more so than non-drinkers. Because women demonstrate more severe health implications than the men, who may drink the same quantity starting at the same time, it is believed that the gap between starting to drink and developing an addiction problem is vastly shorter in females. Translated, that means women progress through the disease faster and have a shorter window of time before intervention is needed.Read more: Women’s Rehab
Hormonal or Postal?
It is also thought that hormones play a role in the absorption process and breast cancer rates may be higher in female alcoholics than in the general population. Animal studies have shown a disruption of the female reproduction cycle occurs with chronic alcohol consumption, as does ovulatory failure, affecting fertility. Menstrual problems such as PMS, painful or disrupted cycles are common for women alcoholics and there is speculation that early menopause may be another side effect. So drinking to alleviate menstrual problems may be creating them instead!
One can expect a significant amount of brain damage in late stage alcoholics, but here’s another important difference in how alcohol effects women more than men. A 2001 University of California, San Diego study found that even young female alcoholics exhibited cognitive and memory dysfunction comparable to that of older male alcoholics with a drinking history of many years. The areas of the brain involved were the areas having to do with spacial tasks like working puzzles, mechanics or figuring out problems in one’s head. These significant abnormalities involve the brain’s right side, frontal lobe and parietal lobe, located in the upper back portion of the brain. It is thought that these differences are about the changes in blood and oxygen use in the brain. The brain shrinkage that happens to all alcoholics happens much earlier in women, explaining the earlier onset of dementia for those who don’t receive help.
Mental Health Issues
Another issue that hits home for many women is the mental health aspect of addiction. While men report having more legal and financial issues, women have more anxiety, depression, and family/relationship problems. One study found that compared to men, nearly half of the women entering treatment had previously attempted suicide. One third suffered from anxiety disorders. Single women and those who experience the loss of one of their roles (empty nesting or the loss of husband or job) are more prone to abusing alcohol and drugs.
Barriers to treatment
Since men more often have access to employer-paid treatment than women (it is the large industries typically dominated by a male work-force that are most likely to offer that), financial constraints may hinder a woman’s ability to seek treatment. Added to the cost of the treatment itself is the cost of childcare which could be significant even for a short-term rehab. If she has alienated family, there may be not much she can do. If you add to that the fear of losing custody if found to be an alcoholic or addict, she may feel forced to continue hiding her problem until the issue is somehow forced – through the courts or elsewhere.
Then there’s that shame issue… A woman’s worst nightmare is to be caught driving under the influence with her children in the car. The danger is obvious, but the societal implications of poor mothering can fuel the cycle of medicating the pain, thus compounding that pain, which leads to more self-medicating. Our society looks harshly upon women alcoholics as it is – they are the caretakers and nurturers. It’s easier for a woman to rationalize her drinking and hiding than it is to face the judgments that may come with identifying her alcoholism by seeking help. Guilt, shame… guilt, shame…. guilt shame… She’s stuck there. The paradox is, as the disease progresses, she may be actually doing more damage to her children in her efforts not to lose them.
Now that more is known about fetal alcohol syndrome and the effects of drug addiction on unborn children, a woman may now have a real fear of going to prison if her addiction is discovered – yet another reason to avoid disclosing her problem by seeking help. These obstacles don’ t occur for men at all, so this discriminatory angle doesn’t help the problem, but only compounds it.
Women, more so than men, tend to seek help in therapy first, where her secret is safer. Even though addiction is actually a medical condition, women often feel as if they’ve failed in their duties by not conquering the problem. She’s used to handling everything else, why not this? Shuffling all those responsibilities and expectations to keep appearances can be exhausting. Isn’t “mother’s little helper” a deserved respite at the end of a long day? How can she “do it all” without that reward to take the edge off? Most research is done using males as test subjects, but as these study flaws become more apparent, there may be more answers and more help specifically geared to address these areas.
Will I be less of a Woman?
A misconception that is often heard from women is a fear that their sexuality will be diminished without the use of a social lubricant. Although the part of the brain that has to do with inhibitions is deadened by the use of alcohol, one’s physiological responses are actually decreased rather that enhanced. The most probable reason for that particular misconception is that the psychological issues of sexual abuse or trauma may move closer to the surface without the deadening effects of alcohol. Self consciousness may be more apparent in early sobriety as well as low self-esteem. While those may pose a problem initially, in recovery women end up having a more fulfilling sex life in general once early sobriety issues diminish.There are gender-specific treatment centers available for those who were victims of rape or sexual abuse, and also for those who choose to work on their issues without the distraction of the opposite sex.
Speaking of Abuse...
Physical and emotional abuse affects both sexes. If a woman is in an abusive situation, both she and her children are at risk. Without a change in the situation, finding recovery will be difficult if not impossible. The abuser, of course, will have more control if his spouse is addicted to something, but the addiction also gives the abuser more ammunition in justifying his abusive behavior. It is unfortunate if you or a loved one are caught in that cycle but getting out is imperative!
In general, abusers try to isolate their victims from family and other sources of support. There is help available, however. Most women’ s shelters have knowledge of community resources and they recognize that the substance abuse of both partners are contributing factors. Women are encouraged to seek help through outpatient programs and other support meetings, with the benefit of childcare for those who need it. Abstinence may be required as a condition staying at the center, but if you truly want a happy, healthy life for both you and your children, finding recovery is the first step.
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