Friday 9 December 2016

What happens when the glass is always half empty?

More women in their 40s and 50s are drinking - alone - more than previous generations - and suffering far greater health consequences. Katie Byrne explores the complicated relationship between women and wine

Published 02/08/2016 | 02:30

Irish woman are suffering greater health consequences from drinking alcohol
Irish woman are suffering greater health consequences from drinking alcohol

We all know that Irish women are drinking more - and more frequently - than previous generations. We only have to look at the empirical research presented in the media and anecdotal experiences of Friday nights.

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What many of us don't know, however, is that a specific demographic of women are drinking the most - and it's not alcopop-drinking teenagers, footloose and fancy-free 20-somethings or disillusioned 30-somethings.

Perhaps surprisingly, women in their 40s and 50s are drinking more than any other age group, and the pattern has been observed by both researchers and healthcare professionals.

The Rutland Centre, a private addiction rehabilitation facility in Dublin, has noted a rise in the number of admittances of middle-aged women, especially those in their 40s.

Addiction counsellor Gerry Cooney says the pattern began to emerge seven or eight years ago, but has become more prevalent in the last half decade.

Consultant gastroenterologist Dr Orla Crosbie, who spoke at the recent conference Girls, Women and Alcohol, has also noticed excessive drinking within this age bracket. She attributes it to the increased consumption of wine.

There are certain social stereotypes about women that drink to excess, but it's important to remember that the women most affected aren't necessarily bored housewifes. According to the research, they are ambitious working mothers who are struggling to keep all the balls in the air.

As psychologist Allison Keating of the bWell Clinic notes: "The more educated and well-off a woman is, the more likely she is to have an unhealthy relationship with alcohol."

Recovering alcoholic and author Ann Dowsett Johnston writes about the complicated love affair between women and wine in her book Drink: The Deadly Relationship Between Women and Alcohol. She describes wine as the "modern woman's steroid".

"It enables her to do the heavy lifting of a complex life," she explains.

"We see wine as a way to decompress after a busy day. By that I mean you rush home with the groceries after a hard day at the office. You then have more emails and work ahead of you that evening.

"You're probably overseeing some homework and you have a meal to prepare. The easiest thing to do - far easier than going to a yoga class or a walk around the block - is to pour yourself a glass of wine after which you start to feel your shoulders come down from your earlobes."

"You can just crash for a while, switch off and forget your worries," adds Gerry. "The nothingness is better than something, I suppose."

In many ways, wine is a form of self-medication for busy women, but the trouble with self-medication is that we often dose incorrectly - especially when you consider the goblet-sized glassware we're using.

One unit of alcohol is 76ml of standard 13pc wine. However, as Dr Crosbie pointed out in her talk: "I rarely recall being served such a mean glass of wine at receptions and parties".

"What you're pouring at home is dramatically different," adds Allison. "You think you're just having the one whereas you're actually having two or even three."

"Wine is cheap and very accessible," agrees Gerry. "It's very easy to get a bottle on the way home from work." He adds that women undergoing treatment at the Rutland Centre were usually drinking alone in their homes.

"Women tend to isolate, especially if their problem escalates," explains Ann. "They tend to have rituals: I drink at this time and out of this glass and I don't even tell my best friend.

"Women know that it is shameful and they may do what I did, which was to drink at my book club the same as other people but then, when I got home, I would open a bottle of wine and drink alone."

Drinking in isolation can be one of the early warning signs of a problem, says Gerry. "They may also pull back from friends, stop going out as much and make poor excuses.

"In other cases, there is a loss of control or a change of behaviour. Things are not happening so easily. Maybe the kids aren't being collected from school or kids aren't bringing friends home because they are concerned about how mum will be.

"Sometimes you're out and everyone is having a few drinks but one member of the party is a having a little more than most. They want the party to keep going, they are always the last to leave and their friends have to keep an eye to make sure they get home safely.

"The extreme form of it would be a sense of oblivion," he continues. "When it gets too extreme they would have to be helped to bed."

Gerry says that women have usually "crossed the line" by the time he meets them. "Very few people come before they get to that point."

Interestingly, he notes that female admittances often have a much more pronounced problem than men in a similar situation.

"When husbands are drinking, women tend to be more proactive and supportive and willing to make sacrifices," he says. "With women, the problem tends to be more chronic when they seek help because an intervention hasn't happened when it should have.

"In my experience, women are more supportive to their drinking husbands. When women have a problem, their husbands are either not able to cope, too busy or not sure what to do about it. Meanwhile, somebody who needs help doesn't get the help they need."

So where exactly is this line that Gerry talks about when Irish women drink more than our female counterparts in any other European country?

The low-risk guideline for alcohol consumption is 11 units, spread out over the course of a week, with at least two to three alcohol-free days.

We should also remember that women's bodies process alcohol differently to men's. We have lower body weights, less body water and higher percentages of body fat, hence we don't metabolise alcohol as efficiently.

"The female body cannot deal with alcohol in the same way as men," says Allison Keating. "Yet sometimes there is a keeping-up-with-the-boys mentality. Also, women are integrating into higher levels of work and there may be a culture where there are harder levels of drinking and stress."

Women should also know the health risks - and myths - surrounding alcohol consumption. Ann points out that the advice about the health-promoting effects of a glass of red wine has since been debunked. "It was disproven in the journal Addiction three years ago. Yes, a glass of red wine is good for a 40-year-old couch potato male - but it's no good to women."

Alcohol also poses far greater health risks to women than it does to men. A man who drinks six or more standard drinks a day is 13 times more likely to develop cirrhosis of the liver compared to a non-drinker. Four standard drinks a day increase a woman's risk to the same degree.

Elsewhere, a study by Harvard University found that having one drink a day increases the risk of breast cancer in women by 15pc. It should also be noted that 12pc of all breast cancers in Ireland are associated with alcohol.

This is all in vast contrast to the way wine is marketed to women. "We glamorise wine," says Ann. "If you're sophisticated, you're supposed to know your wine. And I would go further for women: we see wine as a food group. We don't really see it as a drug."

"We know our downward dog and our gluten-free recipes. So it's really simple: you measure and count your drinks just like you count your calories," says Ann.

The advice for everyone else is to find a stress-reduction tool that isn't served in a glass. "Fundamentally, women are hardwired to look after and nurture those around them so they can often be the last person being minded," says Allison. "The alcohol becomes that ally for them - and they don't even need to leave the house for it.

"We need to give women the tools to realise that they are wired and tired all the time, and we need to help them find other mechanisms to release that stress, whether it's through exercise or engaging in self-care.

"It's about carving out some time for yourself that is nourishing rather than depleting."

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