A Love Story Between Women and Alcohol Until It’s Not

Written by Jen Liam, LCSW and Certified Personal Trainer

Jen Liam, LCSW, has a private therapy practice helping youth, adults, and families heal from anxiety, depression, trauma, and grief. She is also a Certified Personal Trainer and focuses on total body wellness, combining movement and her knowledge of physical and brain health to support her clients.

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The crisp ‘pop’ of a champagne bottle to celebrate a monumental achievement a cold, perspiring beer can in your hand on a hot, summer beach day swirling the first taste of a Cabernet before ordering a ‘nicer-than-usual’ meal. We all know the feeling, the one of alcohol somehow putting an exclamation point on what would otherwise be a ‘boring’ occasion. Alcohol is synonymous, for all intents and purposes, with virtually any and all celebrations. Yet alcohol also goes hand-in-hand with grief. In fact, when you think about it, basically every good and bad known human emotion can also be tied to alcohol: anticipation, finalization, productivity, relaxation.

Essentially, any emotion is touted to be either enhanced, dampened, remembered, or not remembered when this wonderful elixir is on board.

But what happens when, as becomes reality for so many, alcohol ceases to uphold its end of the bargain? What if, instead of offering tranquility and escapism as it once did, it now serves up anxiety, shame and guilt? What if each glass holds emptiness, compulsion and revulsion rather than excitement and purpose? This article will look at the delicate relationship between women and alcohol. Using current research, it will touch on how and why the relationship can become faulty and give practical tips to create an alcohol-free (AF) habit.

Is women’s consumption of alcohol on the rise?

According to the CDC, alcohol-related deaths in the US nearly doubled from 1999 to 2020, with the most significant increase observed among women aged 25 to 34. Women are drinking more frequently and in greater quantities than ever before. While historically, men have outpaced women in alcohol consumption, the gap is narrowing. This change can be attributed to cultural shifts, targeted marketing campaigns, socio-economic factors, and the normalization of alcohol (ab)use.

As explained in the unexpected joy of being sober: ‘alcohol is the only addictive drug that is still rampantly glamorized. ’ Just as cigarettes were once touted as socially acceptable and even good for you, so too is alcohol being marketed as something it’s not.

Could you imagine if heroin or crack cocaine were advertised as blatantly as wine, beer and spirits? What if tea towels that currently depict bottles of wine and read ‘Mommy Time!’, pictured a woman holding a needle to her arm, instead? Or if greeting cards that made fun of hangovers cracked a joke about overdosing, instead? That’s different, one might argue. But is it? Or are we simply steeped in a world that is obsessed with alcohol? Are we the fish who doesn’t know he’s in water, or the frog who doesn’t realize his pot is almost boiling? When it comes to women’s relationship with alcohol, that might be exactly the case.

Is alcohol really that bad for you?

Given all the positive hype we have been force fed about alcohol’s magic ability to bring us (insert some ultra-positive, yet somehow slightly unattainable goal: more money, happiness, sex, power, fun, purpose), surely this magic potion can’t be all that bad for us, can it? It might help to think of alcohol for what it is: ethanol. As in, the same ingredient put in perfumes, lotions, paint and yes, our cars. Even the old myth that a glass of wine can be good for you has been debunked. To quote the Amen Clinic: ‘Alcohol is not a health food.’ Virtually every organ and system in the body is negatively impacted when we consume this poison. (And yes, it is a poison.) As a depressant, alcohol slows our central nervous system, disrupts hormone production and suppresses immune function. It is also directly linked to high blood pressure, gastritis, hepatitis, several cancers and brain damage. (just to name a few maladies) And believe it or not, alcohol related deaths significantly outnumber deaths attributed to opioids and other drugs.

So, given all this, how is it possible that this substance remains a cultural icon, one that is not just tolerated but celebrated? Enter the power of marketing.

How does marketing affect our drinking culture?

Let’s imagine for a moment that, rather than commercials, billboards, and magazines advertising alcohol, they were instead pushing other addictive substances? Super Bowl commercials that highlight horses pulling bushels of cannabis, billboards depicting party-goers snorting lines of coke, elegant dinner parties on TV episodes being served with a side of benzodiazepines? Sounds ridiculous. Yet, isn’t this precisely the type of emotional wizardry that carefully crafted alcohol ads use to persuade their audiences? Alcohol marketing makes its message crystal clear: consuming alcohol will help one acquire a glorious lifestyle. These messages that influence consumption patterns and societal attitudes towards drinking are potent, particularly to vulnerable audiences such as our youth. (Who, by the way, are now being presented with a slew of fruit/candy-flavored alcoholic beverages meant to get them hooked early.)

While marketing makes alcohol publicly appealing, marketing simultaneously makes publicly denouncing it ten times more difficult. In fact, when you think about it, alcohol is the only substance for which stopping it indicates you have a problem. Giving up smoking? Good for you! Deciding to forgo your OxyContin habit? Well done! Cutting back on your internet porn? Bravo! But not drinking at Sally’s wedding? Clearly, you are an alcoholic.

How does alcohol affect women differently from men?

Due to a combination of biological, hormonal, and metabolic factors, alcohol affects women differently. These differences can lead to women feeling the effects of alcohol more intensely, experiencing health consequences to greater degrees, and becoming alcohol dependent at faster rates than their male counterparts who consume the same amount. One major difference is that women tend to have less muscle mass/higher body fat percentages than men, and thus less water in their tissues. Since alcohol is water-soluble and not stored in fat, it becomes more concentrated in a woman's bloodstream. Another difference that leaves women with higher concentrations of alcohol in their bloodstream is that they have lower levels of alcohol dehydrogenase (ADH), the enzyme that breaks down alcohol in the stomach and liver. Fluctuation in estrogen levels is another variable that impacts a woman’s ability to process ethanol. For these reasons and more, even at lower levels of consumption, women are more susceptible to alcohol-related liver, heart and brain damage. Research also shows that women progress from initial use to addiction faster than men. Unfortunately, when it comes to the topic of alcohol, equality isn’t something to be celebrated.

Can anyone become addicted to alcohol?

The good news is that only a very specific type of person can become addicted to alcohol. Only anyone with a brain, who chooses to drink, can become addicted. So, yes, the answer is anyone. While there certainly are contributing, predetermined factors that come into play (genetics and a history of trauma being the most prevalent), the reality is that alcohol can make any brain become dependent with prolonged exposure. It does this by hijacking the brain’s reward system, altering neurotransmitter function, and changing brain structure over time. This is not a matter of finding fault with a person’s will power or character; this is a matter of brain chemistry and neuroscience.

When alcohol enters our system, it stimulates the release of an unnatural amount of dopamine (a neurotransmitter linked to pleasure and reward). To maintain homeostasis, our brain responds by increasing the activity of GABA, a neurotransmitter that produces calming effects. It also inhibits glutamate, which normally increases brain activity.

Over time, the brain adjusts to this imbalance by reducing GABA sensitivity and increasing glutamate activity, ultimately leading to increased tolerance and dependence. Nobody begins their drinking career with the goal of becoming addicted. And yet, very few current drinkers would say that they drink less than they used to. By nature and design, our brains are wired to want more of what makes us feel good.

Is the term ‘alcoholic’ helpful?

There are many differing opinions on the question, and in fact, entire books have been written on the topic. Ultimately, the short answer is: the term is helpful if, and only if, you find it helpful. Meaning, some find comfort in the label, as it can bring camaraderie, structured support and guidelines, per se, regarding next steps. Once someone declares themselves an alcoholic (or someone else claims it on their behalf), the path to follow is relatively clear, as it has already been paved by so many before. Find a 12-Step program, get a sponsor, and by all means, never ever plan on having another drink again, once an alcoholic, always an alcoholic.

In recent years, however, there has been a growing trend to move away from the term, as it can lead to misunderstanding and stigma. As Holly Whitaker asks in her book, Quit Like a Woman: ‘Who wants to be labeled an alcoholic? No one!’ No human in the world wants that as their identity. Furthermore, widespread use of the word highlights the common misconception that one needs that label to receive treatment. This ultimately is a roadblock for many who might otherwise reach out for help, as it creates an ‘us vs them’ mentality. An alcoholic needs help. Whereas a soccer mom who fills her water bottle with vodka is just ‘relaxing’. Furthermore, this black and white thinking (either you are or you aren’t) is in stark contrast with the most recent medical and psychological model.

According to the DSM IV (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) Alcohol Use Disorder encompasses a spectrum of problematic drinking behaviors and dependence that can be categorized as mild, moderate, or severe. The term ‘alcoholic’ can serve to reduce a complex medical issue that exists on a continuum to one of moral failing, lack of self-control, or irresponsibility. This can reinforce the idea that addiction is a fixed part of someone’s identity, rather than a treatable health condition. That’s likely why terms such as ‘methoholic’ or ‘weedoholic’ don’t exist.

When might it be time to evaluate one’s relationship with alcohol?

Despite the common (albeit sometimes true) belief that one needs to hit a proverbial rock bottom before rethinking their drinking, more and more people are questioning their relationship with the substance well before their lives are in shambles. Some are realizing that they don’t need to reach the point of unemployment or homelessness to take a look at their reckless behaviors (driving the kids while buzzed, arriving late to work because of hangovers, compromising family relationships, etc). An authentic evaluation can be enough to make one question their current drinking habits. While the frequency and or amount of alcohol consumed might be a good indicator of a current or budding problem, other people are more troubled by the emotional and cognitive toll drinking can have.

How much time does one spend thinking about drinking? Do they organize their lives and daily/weekly activities around buying, drinking and recovering from alcohol? Because this is such a personal journey, one can only decide for themselves if and when alcohol is getting in the way of personal goals. Frequent, honest check-ins on the topic can prove helpful.

What can be gained by drinking less or living alcohol free?

While at first it may sound scary, if not impossible, to imagine a world in which alcohol is not a focus, the reality remains that there is a wide range of physical, mental, social, and financial benefits to be gained from rethinking drinking. Because alcohol hijacks the brain’s reward system, its prolonged use actually numbs the brain’s ability to experience pleasure from activities that once held joy. Food, hobbies, and even sex become less pleasurable once the brain is forever trying to achieve the dopamine levels afforded it through alcohol. So, first and foremost, removing or decreasing alcohol actually serves to make all activities more enjoyable. Ironic, isn’t it? Secondly, a life free from hangovers, regrets and embarrassment offers one the opportunity for more authentic relationships that aren’t clouded by a social lubricant. Greater confidence, sharper thinking, and more money in your wallet are all additional benefits of living a sober curious lifestyle.

Are AA/12-Step programs the only option?

Since its inception in 1935, AA has been the standard of recovery care, if not the only option available. Such 12-step programs provide a clear template for maneuvering the alcohol-free process and a proven track record of helping individuals achieve abstinence. However, in recent years, more people want increased freedom and personal choice to create a more individualized sober path. The one-size-fits-all recovery model is quickly becoming a construct of the past, as recovery options that rely on psychological and medical facts make themselves readily available. Whereas some models rely heavily on spirituality or religion (AA, for instance, relies on a Higher Power and Refuge Recovery on Buddhist principles), SMART Recovery leans on secular science and self-empowerment as its backbone. Women for Sobriety, Rational Recovery and Soberistas are all alternative alcohol-free focused supports. Also, there is no shortage of ‘quit lit’, inspirational books and stories about people’s experiences living alcohol-free. For those who are sober-curious, there is likely an approach out there for you. And if there isn’t, create one for yourself!

Here are 8 simple steps to creating alcohol-free habits

Clarify your ‘why’

As previously mentioned, there are a multitude of reasons to cut back, or cut out completely, alcohol consumption. Some reasons might be universally understood (health, mental clarity, relationships, finances, sleep, etc), while others are more personal. Regardless of the reason(s) it will be important to write them down and keep them handy. Refer back to them from time to time, especially in moments when you might feel tempted to veer off path.

Change your environment

In an attempt to avoid triggering situations, many people find it helpful to remove alcohol from as many areas of life as possible. For instance, some find it necessary to purge the home of any alcohol. Other people find it helpful to avoid people and places that may remind them of old habits, especially early on in the journey of sober curiosity. Be aware of environments that are high-risk and plan accordingly (bring your own beverage, etc).

Likewise, have your own form of transportation to and from new environments when possible. This will make it easier to set and adhere to boundaries.

Create new routines

Instead of focusing solely on what you are giving up, think of all the new routines and activities you can add to your life. Now that your time and energy are not being consumed by alcohol, you will have the bandwidth to create new experiences for yourself. Try a new hobby or reacquaint yourself with an old one. Replace drinking rituals with healthier, but fun, alternatives. Because every sip crossing your lips doesn't have to be intoxicating, there is a whole host of fun drink options available. Replace a trip to the liquor store with a pop-in to the local coffee shop. Or try one of the many AF (alcohol-free) beers or seltzers that have sprung up in recent years. Even better, rather than grabbing for a bottle, try journaling, meditation, or a hot shower to unwind. Change can be difficult, but after a few weeks, new patterns can and will become seamless.

Build a support system

We are, as they say, the sum of those with whom we surround ourselves. Just as one might take the time and energy to clear out their living space, so, too, might it prove helpful to ‘clear out’ your support systems. Those who are not adding value to your life might have to go. Let close family and friends know about your choice to decrease alcohol consumption so they can support you (or at least not sabotage you). It will quickly become evident who is in your corner and who is not. Hopefully, telling someone that you are cutting back on alcohol will elicit a response on par with that if you told them you were cutting back on cigarette use. Choose wisely those with whom you choose to share your precious time and energy. Only you can make this life change for yourself, but you can’t do it alone.

Consider that it might actually be easy

Without putting too much critical thinking into a response, the average American would likely surmise that a life without alcohol would be miserable at best, if not quite possibly impossible, if being completely honest. However, once alcohol’s actual impact on the brain/body is understood and the cycle of addiction is comprehended, the choice to abstain can actually become quite easy. Take the title of the book: ‘Allan Carr’s Easy Way for Women to Quit Drinking’, in which he describes this exact phenomenon. When the myths regarding what alcohol provides are debunked and it is understood to be the poison it truly is, the choice to drink it or not becomes one of free will based on rationality, not one of willpower, impulse, or habit. This ability to think critically and thus act intentionally is one of humans’ greatest gifts. Applying it to this topic may yield some surprising (ie, ‘this is easy’) results!

Anticipate cravings & plan responses

Even the best-laid plan, supplemented with the most recent facts and well-meaning intentions, can occasionally find itself with more holes than a slice of Swiss cheese when it comes to the issue of a brain that is intensely craving a dopamine boost. As we all know, the brain wants what it wants, when it wants it. Relinquishing to a craving can often feel like the only viable option when trying to maintain some semblance of sanity. Instead, attempt to employ the four D’s: delay, distract, dispute, and deep. Delay the action of pouring a drink. The longer the action is delayed, the greater the chance the craving will dissipate. Distract yourself with a game, a funny video, a phone call, a shower, a walk, or any number of alternate activities. Next, use logic to dispute old, habitual thoughts.

Finally, take some deep breaths. Over time, when employed intentionally and methodically, a planned response to anticipated cravings can turn wavering indecisiveness into commitment and resolve.

Practice self-compassion

Imagine treating yourself with the same kindness, understanding, and patience you’d offer a close friend in distress. Imagine doing this even when, if not especially when, feeling frustrated with yourself. In a world that often rewards productivity over well-being and self-criticism over self-care, this may seem like an untenable goal. However, with consistent practice, self-compassion is a muscle that can be exercised and strengthened. For example, try thinking, “I made a mistake, but I’m learning.”, rather than “I’m such a failure.” Cultivating this mindset will not only help your sober-curious journey but can promote emotional resilience, reduce anxiety, and improve overall mental health.

Consider professional help

Just the fact that you have read this whole article indicates that you might be ready for a change of some sort. Yet as we all know, even when fully committed, change can be quite difficult. Professional support significantly increases the chances of long-term recovery. It does this by helping uncover and treat the root issues of addiction (trauma, anxiety/depression, life stressors). It also provides accountability, ongoing support and life skills all in a non-judgemental environment.

Sober curious?

Are you ready to thoughtfully explore your relationship with alcohol without rigid rules or expectations of total abstinence? Does a life lived with an intentional, reflective approach to alcohol consumption sound appealing? I'm here to guide you every step of the way.

Let's work together to create a personalized roadmap tailored to you. Contact me today to take the first step towards exploring a sober-curious lifestyle.

Visit my website for more info!

Read more from Jen Liam

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Jen Liam, LCSW and Certified Personal Trainer

Jen Liam has been in private practice in the Atlanta area for over 25 years. She is well known and respected for her unique approach to wellness, focusing on total body/brain health and healing. She was a two-time American Ninja Warrior competitor and combined her passion for overcoming physical and emotional obstacles to best support her clients. Her approach to whole-self therapy offers clients the opportunity to work on both their emotional and physical selves simultaneously.