Excessive Drinking - Women

Excessive Drinking - Women in United States

United States

Excessive alcohol consumption is a leading cause of preventable mortality in the United States. An average of more than 43,000 women ages 20-64 die from alcohol-related causes each year. Among younger women ages 20-49, 1 in 6 deaths are attributable to excessive alcohol use. 

Although the prevalence of alcohol use remains higher among men than women, the gender gap is narrowing. Females absorb alcohol quicker and metabolize it more slowly than males, which can lead to accelerated development of adverse health outcomes even at lower levels of alcohol consumption. 

Among women, alcohol consumption is associated with an increased risk of liver disease, heart disease, breast cancer and hypertension. Moreover, binge drinking is associated with an increased prevalence of using other substances such as marijuana, stimulants and cocaine and misusing prescription drugs. Among pregnant women, alcohol use is associated with preterm birth, stillbirth and miscarriage and can cause fetal alcohol spectrum disorder. Combined use of alcohol and cigarettes during pregnancy may also increase the risk of sudden infant death syndrome (SIDS). Very heavy alcohol consumption (14 or more drinks a week) may make conception difficult.

Excessive drinking is associated with losses in workplace productivity and increases in health care expenses, criminal justice expenses and expenses related to motor vehicle crashes and property damage. The estimated cost of excessive drinking in the United States was $249 billion in 2010, or about $2.05 per alcoholic drink consumed.

According to America’s Health Rankings data, the prevalence of excessive drinking is highest among:

• Women ages 18-24 and 25-34 compared with women ages 35-44.
• Non-Hispanic white women compared with Asian women. Hawaiian/Pacific Islander women also had a high prevalence, while Hispanic women and women who identified as other race also had a low prevalence.
• Women who are college graduates or have some post-high school education compared with women with less than a high school education.
• Women with household incomes of $50,000 or more compared with women with lower household incomes.
• Women living in metropolitan areas compared with those in non-metropolitan areas.

Using moderation when consuming alcohol can reduce the risk of adverse short- and long-term health outcomes. Drinking any amount of alcohol while pregnant is dangerous. Alcohol passes to the baby through the umbilical cord and can cause lifelong disabilities. The Centers for Disease Control and Prevention (CDC) also recommends against drinking for women who are sexually active and do not use effective birth control, as the alcohol exposure might affect an unplanned pregnancy. The CDC has a tool that allows adults to anonymously evaluate their drinking behaviors and identify barriers and motivators to reducing alcohol consumption. Learn more about the benefits of drinking less alcohol here.

The U.S. Preventive Services Task Force recommends that clinicians screen adults ages 18 and older for unhealthy alcohol use and provide brief behavioral counseling interventions. The Community Preventive Services Task Force (CPSTF) has published findings on several evidence-based interventions to prevent excessive drinking. Interventions that have been found effective include dram shop liability laws, electronic screening and brief interventions (e-SBI) and increasing alcohol excise taxes.

Healthy People 2030 has multiple goals related to excessive drinking, including:

• Increasing abstinence from alcohol among pregnant women. 
• Reducing the proportion of adults who engage in binge drinking.
• Reducing the proportion of people who had alcohol use disorder in the past year.

Elliott, Amy J., Hannah C. Kinney, Robin L. Haynes, Johan D. Dempers, Colleen Wright, William P. Fifer, Jyoti Angal, et al. “Concurrent Prenatal Drinking and Smoking Increases Risk for SIDS: Safe Passage Study Report.” EClinicalMedicine 19 (January 20, 2020): 100247. https://doi.org/10.1016/j.eclinm.2019.100247.

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Fan, Dazhi, Li Liu, Qing Xia, Wen Wang, Shuzhen Wu, Guo Tian, Ying Liu, et al. “Female Alcohol Consumption and Fecundability: A Systematic Review and Dose-Response Meta-Analysis.” Scientific Reports 7, no. 1 (October 23, 2017): 13815. https://doi.org/10.1038/s41598-017-14261-8.

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White, Aaron M. “Gender Differences in the Epidemiology of Alcohol Use and Related Harms in the United States.” Alcohol Research: Current Reviews 40, no. 2 (2020): 01. https://doi.org/10.35946/arcr.v40.2.01.

Wilsnack, Sharon C., Richard W. Wilsnack, and Lori Wolfgang Kantor. “Focus on: Women and the Costs of Alcohol Use.” Alcohol Research: Current Reviews 35, no. 2 (2013): 219–28. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3908713/.