Women experience alcohol addiction differently than men! You might start drinking for different reasons, engage in different behaviors, and face different consequences. Rehabs that offer women-only treatment address those differences head-on. They put your addiction into the context of your life experience as a woman. These supportive communities provide a safe place for you to begin healing.
Understanding Alcohol Addiction in Women
Studies show that alcohol addiction among women is on the rise.1 While drinking can be a problem for people of every gender, it has pronounced risks for women. For example, women have higher rates than men of emergency room visits due to alcohol use. This could be because cis women tend to be more sensitive to the effects of alcohol.
Why Alcohol Affects Women Differently Than Men
While men are at a higher risk of alcohol addiction, women are more likely to face alcohol-related problems, even when they drink less than men.
This is partly because of differences in size and metabolism. On average, women are physically smaller and weigh less than men. If both a smaller and a bigger person drink the same amount of alcohol, the smaller person’s blood alcohol concentration will be higher. They’ll feel more drunk and be more likely to experience hangovers or blackouts.
Even for men and women of the same size, hormonal differences contribute to the increased effects of alcohol on women.1 Because sex hormones are part of brain chemistry, they can directly affect the way your body responds to alcohol.
Societal and Cultural Factors in Women’s Drinking Behaviors
As a legal substance, alcohol is often socially acceptable. But social pressures can change the way people—and especially women—choose to drink. For example, women are more likely than men to drink in secret,2 which can prolong their addiction.
Women are also more likely to experience traumatic events3 like physical or sexual assault. And it’s very common for survivors of sexual and physical violence to use alcohol4 to cope with traumatic memories and distress.
While it’s socially acceptable for men to express negative feelings, women are expected to internalize stress,5 depression, and anger. This makes women more likely to use drinking as a coping mechanism.
Alcohol’s Effect on Women’s Mental Health
Alcohol affects everyone’s mental health, but women with alcohol addiction face a higher risk of developing certain diagnoses:6
- Mood disorders like depression and bipolar disorder
- Anxiety disorders like panic disorder and social anxiety disorder
- Antisocial personality disorder (ASPD)
We need more data to understand whether alcohol addiction causes mental health problems, or vice versa. Either way, there’s a strong link between these issues.
The Impact of Alcohol Addiction on Women’s Physical and Reproductive Health
Women are more likely to develop physical health problems1 from alcohol addiction:
- Liver disease, including alcohol-related hepatitis. This can lead to permanent liver scarring (cirrhosis), a serious and life-threatening condition.
- Heart disease
- Brain damage, especially for women who began drinking heavily as teenagers.
- Memory loss, including blackouts while drinking and permanent memory loss
- Breast cancer
Alcohol addiction also affects women’s reproductive health. Studies show that heavy drinking may decrease your chances of getting pregnant.7 Conversely, women who face infertility issues are more likely to drink heavily in response to unsuccessful attempts.
If you do get pregnant, alcohol is not safe in any amount during pregnancy.8 Drinking while breastfeeding can also pose a risk.9 But studies show that while not drinking is the safest option, moderate drinking and waiting 2 hours before nursing can reduce harm to the baby. Heavily drinking and nursing right away can harm your baby’s development, growth, and sleep health. Plus, high alcohol consumption can decrease milk production and limit your ability to breastfeed.
Challenges of Alcohol Addiction as a Woman
In Western culture, women addicted to alcohol face certain unique challenges, which may impact the way you approach treatment. Each of these challenges can get more extreme due to the overwhelming social stigma against women with alcohol addiction.
Increased Risk of Violence and Sexual Assault
Drinking alcohol as a woman increases your risk of experiencing violence.10 Data shows that for survivors of domestic violence, this is more related to your abuser’s drinking than your own. That’s because women with addiction are more likely to be in relationships with other people who also have addiction. Women with alcohol addiction face a lower risk of violence when they have partners without addiction.
Drinking is also risk factor for sexual assault.11 That’s true whether the perpetrator or the survivor has been drinking. Perpetrators purposely target women who are drinking heavily because they’re more vulnerable. This can also lead to and victim-blaming and stigma against survivors of sexual assault. It’s important to remember that regardless of your drinking, you are never responsible for someone else’s choice to commit violence.
This stigma against women who drink while pregnant is even stronger. One woman explained how social stigma contributed to her drinking while pregnant:12 “I am an alcoholic. I couldn’t stop and was shamed to look for treatment.” Another woman said that her fear prevented her from seeking treatment. “I was afraid to look for help,” she explained. “I was afraid I would be arrested, and I would lose my children.”
Barriers to Treatment for Women
Social stigma has very real consequences. Women are less likely to receive treatment13 for alcohol addiction than men. In addition, women face many more barriers to alcohol addiction treatment:6
- Fear of legal consequences
- Concern about childcare and children, including worrying about losing them
- Feelings of guilt, denial, and shame
- Difficulty receiving referral from primary care physician
- Lack of independent financial resources or insurance coverage to pay for treatment
- Social acceptance of certain women’s drinking behaviors like #winemom culture
((Harding KD, Whittingham L, McGannon KR. #sendwine: An Analysis of Motherhood, Alcohol Use and #winemom Culture on Instagram. Subst Abuse. 2021 May 5;15:11782218211015195. doi: 10.1177/11782218211015195. PMID: 34017175; PMCID: PMC8114293.))
A lack of community support can make recovery that much harder. If you can’t get the help you need from your loved ones, you might have more success in residential rehab.
Treatment Options for Women With Alcohol Addiction
Gender-specific addiction treatment6 accounts for the unique needs of women with addiction. These programs have some priorities you might not find in other rehabs:
- Emphasizing the importance of social relationships in women’s health
- Acknowledging how gender roles and societal expectations of women affect addiction
- Accounting for the different experiences of people with intersectional identities including women of color, women with lower socioeconomic status, pregnant women and mothers
- Actively preventing the exploitation of women by having higher security protocols
- Addressing common issues for women in treatment by offering childcare and trauma-informed care when possible
Women-Only Support Groups and Therapy Sessions
By the time they begin treatment for alcohol addiction, many women have a history of trauma at the hands of men. That might make mixed-gender group therapy sessions intimidating. Women-only groups can feel a lot safer.
Women are more likely to actively participate in group sessions without men. And that’s not just because single-gender groups feel safer. Data also shows that men often dominate group conversations. This can make it difficult for women to get the support they need in group settings.
Generally, women in recovery have positive experiences in women-only group therapy14 sessions. And women-only groups are also more likely to be more accommodating to the specific needs of women in treatment. For example, the schedule may account for women’s work and family responsibilities by avoiding busy times like school pick-up.
Trauma-Informed Care for Women in Recovery
Most women seeking treatment for alcohol addiction have experienced trauma.15 Trauma-informed care (TIC) recognizes how trauma affects addiction, recovery, and other parts of your life.
In TIC, your care team pays special attention to your unique triggers, needs, and boundaries. For example, you can call for a break during a therapy session or a physical exam. You may also have access to trauma-specific therapies like eye movement desensitization and reprocessing (EMDR) or exposure therapy.
Co-Occurring Mental Health Disorder Treatment
More than men, women addicted to alcohol are at risk for co-occurring mental health issues.16 So alcohol treatment programs for women usually address issues like depression, anxiety, eating disorders, and post-traumatic stress disorder (PTSD) head-on.
In a rehabs that specializes in co-occurring disorders, your treatment plan will account for your complex recovery goals. Simultaneous treatment is the most effective option17 for people with alcohol addiction and co-occurring mental health issues. In these programs, you’ll have access to a range of therapy methods:
- 1:1 talk therapy
- Group therapy
- Family therapy
- Behavioral therapies like cognitive behavioral therapy (CBT) or contingency management (CM)
Addiction Medications for Women
Medication is another treatment option for women recovering from alcohol addiction.18 The 3 most common medications are disulfiram, naltrexone, and acamprosate. And while they can be effective for both men and women, there are some differences. For example, studies show that naltrexone is more effective for men than women. It also depends on whether you have a co-occurring diagnosis.
Very little research exists about the safety of these medications for pregnant women.19 Some studies show that disulfiram may cause serious harm to a fetus, while acamprosate and naltrexone appear to be relatively safe. However, the lack of research makes it hard to predict the effects of these drugs.
If you’re interested in medications for alcohol addiction, talk to your doctor about your options. They’ll consider your mental health history, physical health and more to make the safest decision.
Benefits of Gender-Specific Treatment for Women
Studies show that gender-specific treatment is the most effective option20 for women recovering from alcohol addiction:
- Women are more likely to engage with gender-specific treatment.
- Secondary outcomes are also better, including social, mental, and physical health.
- Women-only treatment has fewer barriers like fear of judgment, concerns about safety, and practical matters like childcare.
Gender-specific programs address the specific challenges women face while recovering from alcohol addiction. And being surrounded by other women on a similar journey means you’ll have a safe and supportive community. You won’t have to justify yourself to anyone, which can be incredibly empowering.
Amy R., a member of Women for Sobriety, explains that attending a women-only support group, “is deeply, personally empowering!21 I can bare my soul here, and I am continually supported and uplifted, not judged. This collective of women’s wisdom has become my ‘tribe.’ We are greater together than the sum of our parts.”
Everyone deserves an empowering, validating experience in recovery—including women with alcohol addiction. Search rehabs for women to find the type of treatment you need.
Reviewed by Rajnandini Rathod
- Women and Alcohol | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/women-and-alcohol. Accessed 21 Apr. 2023. [↩] [↩] [↩]
- Blume SB. Alcoholism and women’s health. Public Health Rep. 1987 Jul-Aug;102(4 Suppl):38-42. PMID: 3120219; PMCID: PMC1478015. [↩]
- Minority Women and Alcohol Use. https://pubs.niaaa.nih.gov/publications/arh26-4/251-256.htm. Accessed 21 Apr. 2023. [↩]
- Ullman SE, Lorenz K, Kirkner A, O’Callaghan E. Postassault Substance Use and Coping: A Qualitative Study of Sexual Assault Survivors and Informal Support Providers. Alcohol Treat Q. 2018;36(3):330-353. doi: 10.1080/07347324.2018.1465807. Epub 2018 Apr 25. PMID: 30555208; PMCID: PMC6290351. [↩]
- “Alcohol Use Among Girls and Young Women: A WORRYING TREND.” Substance Abuse and Mental Health Services Administration (SAMHSA). https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP22-03-10-010.pdf [↩]
- Beckman LJ. Treatment Needs for Women With Alcohol Problems. Alcohol Health Res World. 1994;18(3):206-211. PMID: 31798108; PMCID: PMC6876404. [↩] [↩] [↩]
- Van Heertum K, Rossi B. Alcohol and fertility: how much is too much? Fertil Res Pract. 2017 Jul 10;3:10. doi: 10.1186/s40738-017-0037-x. PMID: 28702207; PMCID: PMC5504800. [↩]
- CDC. “Alcohol Use During Pregnancy.” Centers for Disease Control and Prevention, 4 Nov. 2022, https://www.cdc.gov/ncbddd/fasd/alcohol-use.html.
[↩] - CDC. “Alcohol and Breastfeeding.” Centers for Disease Control and Prevention, 4 Oct. 2022, https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html. [↩]
- Klein, Andrew. “Practical Implications of Domestic Violence Research.” US Department of Justice. https://www.ojp.gov/pdffiles1/nij/225722.pdf [↩]
- Maryland Collaborative to Reduce College Drinking and Related Problems. (2016). Sexual assault and alcohol: What the
research evidence tells us. College Park, MD: Center on Young Adult Health and Development. [↩] - “WHAT IS STIGMA?” Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/fasd/videos/fasd-primer/16-primer/video-16-trans-508.pdf [↩]
- Women and Alcohol | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/women-and-alcohol. Accessed 21 Apr. 2023.
[↩] - Barbara S. McCrady et al. Treatment Interventions for Women With Alcohol Use Disorder. Topic Series: Women and Alcohol. Volume 40 Issue 230 July 2020. Alcohol Research: Current Reviews (ARCR). https://arcr.niaaa.nih.gov/volume/40/2/treatment-interventions-women-alcohol-use-disorder [↩]
- Williams R. Downs Ph.D. “Alcohol Problems and Violence Against Women, Final Report.” U.S. Department of Justice. https://www.ojp.gov/pdffiles1/nij/grants/188266.pdf [↩]
- Anthenelli RM. Focus on: Comorbid mental health disorders. Alcohol Res Health. 2010;33(1-2):109-17. PMID: 23579941; PMCID: PMC3887501. [↩]
- Yule AM, Kelly JF. Integrating Treatment for Co-Occurring Mental Health Conditions. Alcohol Res. 2019 Jan 1;40(1):arcr.v40.1.07. doi: 10.35946/arcr.v40.1.07. PMID: 31649837; PMCID: PMC6799972. [↩]
- Jeremiah Fairbanks, et al. “Evidence-Based Pharmacotherapies for Alcohol Use Disorder: Clinical Pearls.” https://www.mcstap.com/Docs/Evidence-Based%20Pharmacotherapies%20for%20Alcohol%20Use%20Disorder-%20Clinical%20Pearls%202020%20Mayo%20Review.pdf
[↩] - Kelty E, Terplan M, Greenland M, Preen D. Pharmacotherapies for the Treatment of Alcohol Use Disorders During Pregnancy: Time to Reconsider? Drugs. 2021 May;81(7):739-748. doi: 10.1007/s40265-021-01509-x. Epub 2021 Apr 8. PMID: 33830479. [↩]
- Barbara S. McCrady et al. Treatment Interventions for Women With Alcohol Use Disorder. Topic Series: Women and Alcohol. Volume 40 Issue 230 July 2020. Alcohol Research: Current Reviews (ARCR). https://arcr.niaaa.nih.gov/volume/40/2/treatment-interventions-women-alcohol-use-disorder
[↩] - “Women for Sobriety.” Women For Sobriety, https://womenforsobriety.org/. Accessed 21 Apr. 2023. [↩]
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