I met with a thirty-something therapist last week who said she was concerned about her peers and their drinking habits. The “Moms who Need Wine” crowd: Starbucks cups filled with iced KJ at the soccer games. Play dates replete with chardonnay and imported cheese… Even baby-carriage walking groups with iced wine in the cup holders.
It got me thinking about the fact that women, especially younger women, who are self-medicating the stress of motherhood, might benefit from a bit of advice from someone who’s been there/done that. I call them “pink flags”. Those warning signs, not quite red, I know now, I wish I had known then.
No Judgement Here…
God knows, I’m not being judgmental. When my children were young, I committed every offense my above colleague listed as concerning. In fact, if there had been such a thing as a Facebook group called “Moms Who Drink and Swear” fifteen years ago, I would have been on the board of directors. (1 million followers on Facebook.)
It took me about ten years to progress from alcohol misuse into a full-blown substance use disorder. My divorce was the catalyst, but I was well on the way to addiction before the papers were signed. My drinking was not the cause of my divorce. But, it was certainly a mitigating factor…
For years I ignored the signs. I under-reported my drinking and even filled the wine bottle with water if it seemed like my watchful husband would notice how much I was drinking. I don’t remember this part per se, but my children and ex-nanny tell me I had a repair kit in the garage: a quart-sized baggy with sand paper, a black felt marker and a jeweler’s hammer. Apparently, I operated a sort of illegal bump shop – involving my kids and babysitter – to make interim repairs to any car I drove.
Because I drove tipsy, scratched and gouged and misjudged hazards, and I didn’t want my husband to know I had damaged another car door or rear-view mirror.
What is a Substance Use Disorder?
The criteria for a substance use disorder (SUD) according to the DSM 5 occurs “when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home”. A diagnosis of substance use disorder is based on “evidence of impaired control, social impairment, risky use, and pharmacological criteria.[and it ] may include problems controlling intake of alcohol or other drugs, continued use despite problems resulting from drinking or using, development of a tolerance, drinking or using that leads to risky situations, or the development of withdrawal symptoms”.
In a nutshell, “addiction” means the substance use becomes more important than anything else, and the use is continued despite the negative consequences.
Here’s the kicker. For women, heavy or problematic drinking is defined as 8 or more drinks per week. A “drink” of wine is 5 fl oz. I don’t know about you, but I used to fill my wine glass to the rim. By my non-scientific calculation, that is more like 11 oz. And I didn’t stop at one.
For women, binge drinking is defined as 4 alcoholic “drinks” on one occasion…I’m thinking about the number of times I used to belly up to the open bar at parties – enough said about that...
A Compass, Barometer or Alarm…
If only there was a way to know when substance use was about to become a disorder. If I could invent a compass or a loud alarm at the cusp of addiction there would be a parade in my honor. Alas, there are only warning signs, “pink” flags and educating folks on the prevention of SUDs.
The Surgeon General’s Report on Alcohol, Drugs & Health says, “The clear implications of these data are that a comprehensive approach to reducing the misuse of alcohol and drugs—one that includes the implementation of effective prevention programs and policy strategies as well as high-quality treatment services—is needed to reduce the problems and costs of substance misuse in the United States. In fact, greater impact is likely to be achieved by reducing substance misuse in the general population—that is, among people who are not addicted—than among those with severe substance use problems”
So, I’m really just doing what the Surgeon General told us to do. I’m attempting to “reduce substance misuse” in women “who are not addicted yet.”
A Few Facts About Women & Addiction You Should Know…
Women are closing the gender gap on addiction
- An estimated 4.5 million women in the United States have a SUD
- Women are the fastest growing population of alcohol and drug users
- 83% of all the wine sales in the US are by women
- 200,000 women die each year as a result of SUDs
Both men and women say “stress” is the primary reason they drink
- Alcohol is often used as “medication” for anxiety and depression
- But women are twice as likely as men to experience anxiety and depression
- Women are exposed more often to the type of trauma that results in SUDs (rape, child abuse, spousal violence)
- Women have unique social pressures and influences, including social media, advertising and peers
- There are communities springing up, like Moms Who Need Wine (728 thousand followers on Facebook), who create a false sense of connection and a solution that could become the problem
The stigma of an SUD is still greater for a woman
- Women are still the primary care givers for children
- And use alcohol to “cope” with the stress of motherhood
- The years when there are young children in the house are the easiest years to hide misuse of alcohol and to justify not getting treatment
- Only 33% of those in treatment for a SUD are women
- Gender specific programs are most effective for women
A woman’s path to addiction is faster than a man’s
- It’s called telescoping – from first use, a woman has an accelerated path to addiction
- Basic biology tells us that women can’t drink like a man
- Women blackout more than men
- Pound for pound women’s bodies have less water than a man’s, so there’s higher alcohol content in the bloodstream
- Women are more susceptible to heart disease, liver damage and breast cancer
- And women have unique issues associated with reproduction and pregnancy
- Women often enter treatment with more medical, behavioral, psychological and social issues than men
Here’s the good news…
- Women who receive treatment for a SUD tend to fair better than men
- Women relapse less frequently than men
- They are more likely to stay abstinent over long periods of time
- With greater gender specific research and specialized programs, women who seek treatment have a good prognosis for recovery
5 “Pink” Flags
If stress is a factor in drinking and women buy the lion’s share of wine, and women and children have play dates and women feel the need to spend quality time with adults while the children play, it is understandable that drinking and motherhood might go hand-in-hand. And no one is saying you can’t have a drink with your friends if you want one.
But 1 in 12 people develop a substance use disorder, and I think there are some things to watch for, when drinking with peers – especially around the children. Here they are:
1. Do Not Ignore the Negative Consequences
I’m not talking about your significant other sitting you down and telling you, “I’m leaving you if you don’t stop drinking.” That’s further down the road to addiction. I am thinking about the more subtle concern. Perhaps your spouse asks the question, “What happened to the car? There’s another dent in the door. Did you try to fix it?” As you know, I lied, made my children complicit in the cover-up and continued to drive tipsy. Even though it was obvious I should not have been operating heavy machinery…
When the signs are there, take a moment and take stock.Try to answer honestly.
2. Do Not Drive Tipsy
Have you seen those police billboards that say, “DRIVING TIPSY IS DRIVING DRUNK”? If you go to your child’s soccer game with a sippy cup (you know what I’m talking about), do not drive yourself. And certainly do not load the kids and the neighbor’s kids into the car and drive them home afterwards.
And while I’m at it, try not to use euphemisms for alcohol or drinking paraphernalia. Sippy cup, mommy juice, mother’s little helper. Words have power. And the fact is, you are secreting wine in a Starbucks cup with a top and taking it to your child’s school.
3. Be Aware if You Drink More or Differently Than Your Friends
Or if someone in your crowd always seems to need to “be taken care of” when she starts drinking. I’ll tell you another story (if you promise not to think less of me). When my children were young we had a foursome of moms who went to lunch together. We’d have two glasses of wine each and share a third. By the time lunch was over we had the better part of a bottle of wine on board. My friends would go home and “sober up” get work done and not think about drinking during the day until the next outing. I, on the other hand (and it began ever so slowly) went home and poured another…
4. Do Not Schedule Yourself Around Substance Use
Your partner and the children come to you on a Sunday afternoon and want to go for a hike, and you bow out. Not because you think they all need one-on-one time together. Even though that’s what you say. It’s because if you go hiking at 3, you’ll miss your 5 o’clock (wine o’clock) glass of plonk. Dangerous behavior – dark pink flag.
5. If You’re a Heavy Drinker, Watch Out for Triggers
For me it was my divorce. But, it can be the death of a loved one, a job loss, even feeling slighted. When you are a heavy drinker, an emotional trigger can push you over the edge. When I first got divorced, I went to see a brilliant psychologist. I didn’t listen to him. And I eventually stopped going to him, because I lied to him every time he asked a difficult question, and it seemed like a waste of money. Fifteen years later, I think about some of the things he said to me and wish I had listened. He told me, “It is always dangerous to not be accountable to anything or anybody.”
That was me – left to my own nefarious devices. Accountable to no one. Watch out for changes in accountability.
That Wasn’t So Bad…
I promise you I am not some modern-day Carrie Nation wielding an ax at your good time. But, I do believe that awareness is your best strategy for prevention of a substance use disorder. If you stop and think before you get in the car after that second glass of wine. Confront a friend who is drinking more and differently than the others. If you face stressors soberly. And most of all, if you are not afraid to ask for help when things are getting a little rocky. Subtle changes in rote behavior can make a large impact on the rise of addiction in women.