It comes as no surprise that it takes less alcohol, nicotine, illegal or prescription drugs for females, when compared to males, to feel the effects.
But it’s quite another revelation to learn that females can become addicted to these substances in significantly lower quantities and over shorter periods of time than males.
So says “Women Under the Influence,” a new book from the National Center on Addiction and Substance Abuse at Columbia University in New York City.
“Our failure to confront the special needs of girls and women with substance abuse problems is inexcusable,” says Joseph A. Califano Jr., chairman and president of CASA and former U.S. Secretary of Health, Education and Welfare, in a statement.
“The one-size-fits-all approach, largely driven by male substance abuse, has condemned millions of girls and women to tragic episodes of abuse and addiction that have ruined too many lives.
“This book reveals that substance abuse affects all kinds of women — rich and poor, young and old, urban and rural, professional and homemaker.”
Susan Foster supervised the book’s research as CASA’s vice president and director of policy research and analysis. She says the 6 million women who drink alcohol, the 15 million who use illicit and prescription drugs and the 32 million women who smoke cigarettes run a greater chance than men to develop heart disease, stroke, cancer, cirrhosis and hypertension from alcohol consumption, brain damage from drug use and emphysema and chronic bronchitis from smoking.
“When it comes to alcohol, women metabolize differently,” she says. “Women’s bodies contain less body water and more body fat (than men’s bodies). Water dilutes the alcohol in the bloodstream while the fatty tissue stores it longer.” Alcohol dehydrogenase, a digestive enzyme that breaks down alcohol in the stomach, she adds, is also less active in women than in men.
Complicating matters for women is the declining body water and estrogen levels that comes with age. “Apparently, (estrogen) levels are somewhat protective for women from puberty to probably mid-30s,” says Foster. “(Estrogen) seems to have some protective influence in the way alcohol is metabolized and released from the body.”
That women who are moderate to heavy drinkers run an increased risk of breast cancer is emphasized in the book, as supported by the research, which also says older women who abuse alcohol experience memory loss and mental deterioration sooner and more severely than men.
The bottom line: One drink for any woman typically has the same physiological effect as two for a man. The same ratio applies to tobacco.
Another well-known health risk, that smokers who take oral contraceptives run an increased risk of heart disease and stroke, is stressed. Other key points include greater and faster dependence on nicotine among women, a greater risk of breast cancer the younger smoking begins and more serious cardiac and respiratory diseases than those experienced by male smokers.
“When you ask boys, alcohol and drug use is largely related to sensation. Girls are more likely to use it to control weight, relieve stress, reduce sexual inhibitions. Their reasons are more inwardly directed. They are more vulnerable to stress,” Foster says.
It’s the type of information that was known, but can inform how to detect a potential problem or an established dependence in girls and women.
“It’s about learning to recognize the signs and understanding what those signs are,” says Foster.
Some of the risk factors for substance abuse in girls and women might span generations, such as co-occurring depression or anxiety, trauma, preoccupation with appearance and weight, eating disorders, stress, family history of substance dependence and/or sexual abuse.
Other signs are specific stresses associated with age, such as peer pressure, early puberty and transitions to middle and high school in girls, getting older, divorce and caring for elderly parents in middle-aged women and loneliness, empty nesting or grief in the elderly.
“Girls (and women) are more likely (than boys and men) to turn to substances to medicate negative feelings and cope with a crisis,” Foster says, adding that girls are more easily influenced by adult role models who smoke and/or drink than boys might be.
Older women are less likely to seek help than younger women because of the shame and stigma attached to substance dependence and addiction.
“When it comes to chemical dependency, a lot of people go unreported because of the issue of denial,” says Barry Kerner, physician in chief at Silver Hill Hospital in New Canaan, Conn., which specializes in psychiatric illnesses and addictive disorders. “Also because of the stigma attached to reporting that you are.
“It would be a lot easier if we could collect collateral information from people who know the people (with a chemical dependency.)”
It is therefore incumbent upon parents, teachers, family members, friends and medical professionals, say Foster and Califano, to recognize gender-specific co-occurring elements that might point to a potential or evolving problem, particularly when 92 percent of women and girls who need treatment do not receive it, Califano notes in the book’s foreword.
Foster says medical professionals, particularly pediatricians, are in a position to help identify the problems in girls and women, but surveys in the book indicate there’ is less chance a woman will get a diagnosis of substance abuse than men, a prospect that increases with age.
“But a woman walking into a doctor’s office is 48 percent likelier to receive a narcotic or anti-anxiety or mood-altering drug,” she says. “If a doctor doesn’t recognize the sign (of substance abuse), and chooses to medicate the problem with another potentially addictive drug, then you’re dealing with (other) physiological problems.”
But Kerner notes that women, in spite of greater health risks and obstacles to treatment, are more likely than men to seek treatment on their own.
“Most men won’t show up for treatment unless they have hit rock bottom,” he says. “There usually is more outside pressure for men to get treatment, whether from a job or a spouse. Women will voluntarily recognize a problem.”
Foster, in a separate statement, says women’s greater understanding of the gender differences in health risks associated with use and abuse of alcohol, drugs and tobacco can be a powerful force in dealing with them.
“At the same time, we can no longer tolerate a lack of training and knowledge about substance abuse and women among health professionals,” she says.
Most common addictions for women
* Gambling (including casinos, lottery and online)
* Compulsive shopping
* Food (binge, compulsive or certain foods)
Source: Revolution Health News and The National Center on Addiction and Substance Abuse at Columbia University
Are you addicted?
Signs and symptoms your indulgence could be a problem:
* Preoccupation with the substance or pastime
* Loss of control, unable to stop, walk away or stay away
* Moodiness: Dependency on anything often causes mood-altering side effects when the addicted user is separated from the addictive substance or activity.
* Dishonesty in regard to use
*Failed attempts to control the use or behavior
* Loss of boundaries or inhibitions
* Psychological dependence
* Physical changes (especially if addiction is to a substance such as glassy eyes, eye changes or nasal congestion
* Loss of a significant relationship, problems at work or school, less time to devote to things you enjoy such as hobbies, all due to the use of the substance or the behavior
* Absenteeism or school truancy
* Decreased ability to cope
* Continuing to use the substance or engage in the behavior even though you know it is damaging for you and your life