Is There a Recent Epidemic of Women's Drinking? A Critical Review of National Studies

Abstract

Alcohol consumption is increasing in the United States, as is alcohol-attributable mortality. Historically, men have had higher rates of alcohol consumption than women, though evidence for birth cohort effects on gender differences in alcohol consumption and alcohol-related harm suggests that gender differences may be diminishing. We review studies using U.S. national data that examined time trends in alcohol consumption and alcohol-related harm since 2008. Utilizing a historical-developmental perspective, here we synthesize and integrate the literature on birth cohort effects from varying developmental periods (i.e., adolescence, young adulthood, middle adulthood, and late adulthood), with a focus on gender differences in alcohol consumption. Findings suggest that recent trends in gender differences in alcohol outcomes are heterogeneous by developmental stage. Among adolescents and young adults, both males and females are rapidly decreasing alcohol consumption, binge and high-intensity drinking, and alcohol-related outcomes, with gender rates converging because males are decreasing consumption faster than females. This pattern does not hold among adults, however. In middle adulthood, consumption, binge drinking, and alcohol-related harms are increasing, driven largely by increases among women in their 30s and 40s. The trend of increases in consumption that are faster for women than for men appears to continue into older adult years (60 and older) across several studies. We conclude by addressing remaining gaps in the literature and offering directions for future research.

Gender Differences in the Epidemiology of Alcohol Use and Related Harms in the United States

“…Specifically, alcohol use is declining faster for adolescent and emerging adult males than for females, whereas gaps are narrowing among adults because of increases in drinking by women but not by men. 15 , 16 …”

“…Differences are shrinking in drinking patterns, AUD, hospitalizations, emergency department visits, DUI, liver disease, and deaths. 5 , 14 – 16 , 31 …”

Sex differences in the amplification of responding to an alcohol-predictive cue by an alcohol-associated context

“…The differential learning and utilization of contextual information to predict a drug of abuse can have great implications on treatment in clinical settings. In humans, the gap in alcohol consumption between men and women is narrowing, especially with age (Keyes et al, 2019). Additionally, women with alcohol use-disorder are at greater risk of alcohol-related deaths, brain and organ damage, cognitive dysfunctions, and co-morbid mental health disorders (Ceylan-Isik et al, 2010;Walter et al, 2003).…”

“…The importance of assessing gender differences in the mechanisms promoting alcohol misuse is further highlighted by recent evidence in clinical studies. In recent decades, problematic alcohol use in women has drastically increased, from adolescence through older adult years (Becker et al, 2017;Keyes et al, 2019). Women are more sensitive to the pharmacological effects of alcohol (Miller et al, 2009) and are at a greater risk for alcoholism-related cognitive and bodily impairments, than men (Becker et al, 2017;Ceylan-Isik et al, 2010).…”

Corrigendum

“…THE article by Keyes et al () incorrectly states that the corresponding author Katherine M. Keyes is affiliated with “Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile.” The correct affiliation for this author is “Department of Epidemiology, Columbia University, New York, New York.”…”