Harvard Women's Health Watch

Alcohol over time: Still under control?

For women, there's not much leeway between healthful and harmful drinking, especially as we get older.

Currently, the word is that moderate drinking can be good for you. Various studies suggest that it promotes longevity, helps prevent cardiovascular disease, and lowers the risk for dementia and other ills. What hasn't made as many headlines are the downsides for women, especially drinking that starts at a moderate level but eventually becomes a problem. Why this happens and to whom isn't fully understood. Most people who drink in moderation do so with little or no risk. But 1 in 13 adults in the United States has developed a serious alcohol problem, and at least six million of them are women. According to the National Center on Addiction and Substance Abuse (CASA) at Columbia University (www.casacolumbia.org), published figures are probably an underestimate of alcohol problems in women, in part because they don't take into account drinking patterns that are not serious enough to be called abuse or addiction but still have damaging physical and psychosocial consequences.

At every age, women develop drinking problems at lower levels of alcohol consumption and over shorter periods of time than men do. Women are also less likely to get medical attention for the problem, often because physicians don't recognize the signs in women. Older women are especially susceptible to alcohol's harmful effects and may be at particular risk. According to CASA's analysis of substance abuse in women, Women Under the Influence (Johns Hopkins University Press, 2006), about half the cases of alcoholism in older women begin after age 59.

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