While men have historically always consumed more alcohol than women, that gap has been slowly closing for decades. Now, for the first time, women are drinking more than men, based on data compiled by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) from 2021.

For nearly a century, women have been closing the gender gap in alcohol consumption, binge drinking and alcohol use disorder. What was previously a 3-1 ratio for risky drinking habits in men versus women became nearly identical after a 2016 analysis of several dozen studies. Additionally, in 2019, U.S. women in their teens and early 20s reported drinking and getting drunk at higher rates than their male peers. That data lines up with data pulled from the NIAAA’s research which showed college-aged women are leading the pack.

But why? We spoke with Emily Jones, M.D., a family medicine physician on the medical staff at Texas Health Dallas and at Texas Health Family Care, a Texas Health Physicians Group practice, for her insight on what may be playing a role in the rise.

What is Binge Drinking?

First things first, it’s important to classify what binge drinking is. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 percent (the legal limit) or higher.

For a typical adult, this pattern of alcohol misuse corresponds to consuming 4 or more drinks for women, or 5 or more drinks for men in about 2 hours. However, research shows that fewer drinks in the same timeframe can result in the same BAC in younger people.

Frequent heavy drinking or binge drinking can also increase the risk of alcohol abuse or alcohol use disorder.

Reasons for the Rise

There may be a few reasons behind the rise in heavy drinking in women, particularly young women, but Jones notes many women may be drinking in order to cope.

“I theorize that increased amounts of stress seem to have a large influence on the trend for increased alcohol intake in general. I think alcohol is often seen as a quick and easy way to feel better quickly or release some of the tension these competing interests place on our lives,” Jones explains. “More than ever, women are balancing ‘it all’ with careers, caregiving, child-rearing, social responsibilities, financial worries, increasing amounts of education, etc.”

Research suggests that people who drink to cope — as opposed to drinking for pleasure — have a higher risk of developing alcohol use disorder. And while every individual's reasons for drinking are different, studies have found that women are more likely to drink to cope than men.

One study that looked at alcohol's effects on college students early in the pandemic found increased alcohol use among those who reported higher levels of stress and anxiety. And several studies found women were more likely to report rises in drinking during the pandemic, especially if they experienced increased stress.

Jones notes that the way women have been marketed recently when it comes to alcohol consumption may also have something to do with it.

“I think as the new millennium arrived, women in their 20s and 30s began to be targeted more for consumption of alcoholic beverages,” she explains. “We started seeing beverages particularly targeted at women and these items made drinking as a social activity a more approachable and pleasurable activity for women. Whereas before a woman who heavily drank more ‘manly’ type drinks might have been viewed negatively in a social aspect.”

Jones adds that women should also be mindful that many of these drinks that are geared toward a younger crowd or “feminine” tastes can often be packed with sugar while also having a high alcohol by volume (ABV), making the alcohol hard to taste and easier to drink, and potentially riskier.

“While it may initially feel like you are just drinking 2-3 cans of lemonade, you are in fact drinking 2-3 drinks with hard liquor in the span of just a couple of hours,” she explains. “ABV is an important thing to pay attention to when selecting drinks in a setting in which you may be drinking more than one drink. It can vary even within the same type of drink such as beer or wine but should be clearly stated on the label of a pre-packaged drink.”

Jones notes that social media may also play a big factor, from the normalization of “wine mommy” culture to the various drink recipe trends that pop up online. 

“These have all sort of made everyday alcohol use seem normalized to the average young female,” she adds.

George Koob, the director of the NIAAA, says it may have something to do with alcohol deprivation that some young people may experience outside of school, such as spending the summer or winter break back at home with family where drinking is either discouraged or they have fewer outlets to drink. When they come back to campus, they may ramp up their drinking to make up for “lost time.”

“It's what we call the alcohol deprivation effect,” he says. “People tend to really rebound in drinking after a period of not drinking.”

The Risks of Binge Drinking for Women

There are several women-specific risk factors for binge drinking, including:

1. Lower body weight: Women typically have a lower body weight than men, which means that they can become intoxicated more quickly when consuming the same amount of alcohol as a man.
2. Hormonal changes: Hormonal changes throughout a woman's menstrual cycle can affect how alcohol is metabolized by the body, making women more susceptible to the negative effects of binge drinking.
3. Mental health issues: Women are more likely to experience mental health issues such as anxiety and depression, which can increase the risk of binge drinking as a coping mechanism.
4. Sexual assault and violence: Women who have experienced sexual assault or violence may turn to alcohol as a way to cope with trauma.
5. Societal pressure: Women may face societal pressure to conform to certain expectations, such as being the "life of the party," which can lead to binge drinking.

Women are also at greater risk for hangovers, blackouts, liver disease, alcohol-induced cardiovascular diseases and certain cancers. One study found that alcohol-related visits to the emergency room from 2006 to 2014 increased by 70% for women, compared with 58% for men. Another paper reported that the rate of alcohol-related cirrhosis from 2009 to 2015 rose 50% for women, compared with 30% for men.

When to Get Help

While this post focuses on the rise of binge drinking in women, signs of a problem are universal. Someone should consider getting help for binge drinking if they are unable to control their drinking habits and find themselves regularly consuming large amounts of alcohol in a short period of time.

Some signs that someone may need help for binge drinking include:

1. Regularly consuming large amounts of alcohol in a short period of time, leading to intoxication and impaired judgment.
2. Frequently experiencing negative consequences as a result of binge drinking, such as blackouts, hangovers, or conflicts with friends and family.
3. Finding it difficult to stop drinking or to cut back on alcohol consumption, even when wanting to do so.
4. Developing a tolerance to alcohol, requiring larger amounts to achieve the same level of intoxication.
5. Feeling ashamed or guilty about drinking habits.

“People who excessively drink will sometimes start to drink at strange times such as in the early morning when they first wake up or when no occasion is present,” Jones adds. “They will sometimes go to great lengths to hide the amount of alcohol they are consuming such as hiding alcohol, pouring some in their water, coffee, etc. If someone seems to be ill frequently or frequently making decisions or choices that you feel they would not be making while not drinking, it is a good time to encourage them to seek professional assistance.”

If you are concerned about your drinking habits or the drinking habits of a friend or loved one, there are plenty of treatment options available, such as therapy, medication, support groups, or rehabilitation programs.

“We have a wonderful Behavioral Health department at Texas Health staffed by licensed counselors and social workers that are wonderful at audit and intake assessments of patients who are at risk of substance misuse and often are able to help triage patients within 24 hours of contact to the appropriate professionals or treatment,” Jones says. “Patients are able to contact the Behavioral Health department directly, or a referral can be initiated by their primary care provider.”

It is important to note that binge drinking can have serious negative consequences for both men and women, including an increased risk of accidents, injuries, and long-term health problems. It is important for both men and women to be aware of the risks of binge drinking and to consume alcohol in moderation.

“Seeking treatment shouldn’t be a source of shame as overuse is quite common and thankfully, treatable, with the proper therapy and/or medication,” Jones adds. “Alcohol overuse has real, lasting social, financial and health consequences and the sooner that treatment for overuse is pursued the more likely the success.”

If you or someone you know is struggling right now, visit Texas Health Behavioral Health or call the helpline at 682-549-7916, which is available 24/7.