When it comes to alcohol, we live in a culture of denial. With alcoholics representing just a tiny fraction of the population, it’s the widespread normalization of heavier consumption that translates to serious trouble. In the Western world, the majority of us drink. And the top 20 percent of the heaviest drinkers consume roughly three-quarters of all alcohol sold. Episodic binge drinking by a large population of nondependent drinkers has a huge impact on society.
Most of us understand the major role that excessive alcohol use plays in family disruption, violence, and injury. Death? When compared to illicit drugs, there are many more deaths due to alcohol. According to Robert Brewer, leader of the alcohol program at the National Center for Chronic Disease Prevention and Health Promotion at the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, excessive drinking is the third leading preventable cause of death in the United States, after smoking and a combination of bad diet and inactivity. By conservative estimates, it’s responsible for roughly 80,000 deaths each year: of those, 23,000 are female. Of the 23,000, more than half are related to binge drinking. For women, binge drinking is defined as four or more drinks on one occasion in the past month; for men, it’s five.
According to a recent CDC Vital Signs report, female binge drinking is a serious, underrecognized problem: almost 14 million American girls and women binge drink an average of three times each month, typically consuming six drinks per bingeing episode. Meanwhile, one in five high school girls binge drinks. Among those who consume alcohol, the prevalence of those who binge drink rises from roughly 45 percent of those in their first year of high school to 62 percent of those in their senior year.
Women most likely to binge drink: those between the ages of 18 and 34 (in other words, those in their prime childbearing years), and those with higher household incomes. Binge drinking not only increases the risk of unintended pregnancies: if pregnant women binge, their babies are at risk of sudden infant death syndrome and fetal alcohol spectrum disorders. Meanwhile, for all women, binge drinking increases the risk of breast cancer, heart disease, and sexually transmitted diseases, among other health and social problems. “People who binge drink tend to do so frequently,” says Brewer. “Most people who drink too much aren’t addicted to alcohol. Most of these people are not dependent. What’s the big picture? This is a major public health problem.”
The United States is not alone in naming alcohol abuse a major health challenge. In Britain, Prime Minister David Cameron has declared binge drinking a national “scandal.” Deaths from liver disease have risen 20 percent in a decade. Last year, Britain’s chief medical officer, Dame Sally Davies, pronounced: “Our alcohol consumption is out of kilter with most of the civilized world.” In a recent report by the Organisation for Economic Co-operation and Development, British girls were cited as the biggest teenage drinkers in the Western world: half of fifteen-year-olds said they had been drunk twice in the past year, as compared with 44 percent of British boys the same age.
Says Sir Ian Gilmore, past president of the Royal College of Physicians: “In the thirty years I have been a liver specialist, the striking difference is this: liver cirrhosis was a disease of elderly men—I have seen a girl as young as seventeen and women in their twenties with end-stage liver disease. Alcohol dependence is setting in when youngsters are still in their teens. This mirrors what we saw with tobacco, when women caught up with men on lung cancer.”
If leaders in Britain are concerned, so too is much of the world. In 2010, the World Health Organization passed its landmark Global Alcohol Strategy, with 193 signatories. In the developed world, where noncommunicable diseases pose the greatest health threat, alcohol abuse is moving much higher on the health-risk agenda, and will continue to do so.
Is alcohol the new tobacco? In many ways, it is: a multibillion-dollar international industry dealing with market-friendly governments, enjoying a virtually unrestricted market for advertising, despite growing evidence that the substance has significant health risks.
In fact, recent research has revealed that alcoholism is a more serious risk for early mortality than smoking—and more than twice as deadly for women than men. German researchers found that compared with the general population, alcohol-dependent women were 4.6 times as likely to cut their lives short. The rate for men: 1.9 times higher than the general population. On average, both women and men died roughly twenty years earlier than those who were not dependent on alcohol.
“It is just like Virginia Slims,” says David Jernigan, director of the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health. “Alcohol is a carcinogen, and it’s particularly risky for women. Breast cancer is the poster child for that position. But the alcohol industry is selling young women on the notion that only really, really good things happen when there’s alcohol. And to have really, really good things happen, you have to drink.”
I came of age in the seventies, a heady time for women in North America. Smack-dab in the middle of second-wave feminism, my baby-boom peers and I headed off to university in our miniskirts and tie-dyed T-shirts, assured by Gloria Steinem and a host of others that the world was ours for the taking. We could, in Steinem’s words, “grow up to be the men we wanted to marry.”
Not for us the confining roles of our fifties mothers, harnessed to aprons, and what seemed like cookie-cutter lives. Not for us the quiet desperation, the Valium, the acquiescence.
And for me? Not the path of my mother. Sitting in my dorm room at Queen’s University, unpacking my things—a brand-new copy of Joni Mitchell’s Blue, a not-so-new edition of A Room of One’s Own—I was unequivocal on one point: my life was going to look different. Very different. (Of course, it already did: I had rose-colored aviator glasses custom-made for this new chapter. I kid you not.)
If there was one trap I was determined I would never fall into, it was alcoholism. Risky drinking? Maybe. It was frosh week. There were keg parties and buckets of what we called Purple Jesus in my immediate future. I was five minutes from meeting my first serious boyfriend. Most conveniently, the legal drinking age had just been changed to eighteen, my age exactly.
But alcoholism? Never. Three times my family circled the residence, eager to get one last glimpse of me before they headed home. Not once did I look out the window. Not because I didn’t love them, but because I did. Too much: I was deeply entwined in the family drama. I was ready to set out alone.
I was in good company: my whole generation wanted to start fresh. This was the school year of 1971–72. Politically, we were well steeped in the My Lai Massacre, just a heartbeat from Watergate. Ramparts was still alive and well on the newsstands, and the first issue of a new women’s magazine was having its debut: it was called Ms.
Nothing, we were certain, would ever be the same. And frankly, nothing was—especially if you were female. Ours was the generation that would have it all: careers, families, freedom of expression, equal rights. Fulfillment on every level.
Did we have it all? With courage, endless creativity, and gusto, we certainly tried. Without a blueprint, many of us established excellent careers while raising children and nurturing marriages, juggling deadlines, child care, and housework. We experimented with full-time, part-time, flextime, and freelance work, nannies, day care, and shared babysitters, home offices, and virtual offices.
In many cases, our marriages were strained, and failed. Mine certainly did.
Could we have it all? Could we be the mothers we wanted to be and rise to the top? Many of us said yes—albeit sequentially. Or with enough help. Others said no, ditch the cape. The jury was out.
Today, more than thirty-five years after I graduated, women outstrip their male counterparts in postsecondary participation. “We Did It!” crowed a cover of the Economist, featuring Rosie the Riveter. “Women’s economic empowerment is arguably the biggest social change of our times,” trumpeted the article. An enormous revolution, with enormous ramifications. As the magazine warned, dealing with the social consequences