Alcohol Consumption Among Women Is on the Rise

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Laura McKowen says she enjoyed drinking alcohol before she became a mother and would imbibe a few times a week as part of a successful advertising career and active social life. But she says her problem drinking really started after she gave birth to a daughter in 2009.

“The drinking changed for me then,” she says. “I was struggling really hard to adjust to things: being a new mom, a cross-country move, losing my job. My nerves were shot, so I drank more, thinking it would help me sleep, help me cope, but it made me worse.”

McKowen, who lives in North Shore, MA, says as time went on, her drinking started earlier in the day and booze would be part of play dates. She and her friends would do yoga and then go out and drink wine. Her book club was all moms in their 30s, drinking like they did in their 20s. And alcohol even started to show up at birthday parties for 1- and 2-year-olds.

“It didn’t matter that I had to go and breastfeed or parent when I got home. It didn’t stop anything,” she recalls.

McKowen didn’t realize it at the time, but she had joined an unenviable — and growing — group: Women with alcohol disorders. Recent research has shown the gap between men and women with drinking problems is shrinking. Female alcohol use disorder in the United States more than doubled from 2002 to 2013, according to the National Institute on Alcohol Abuse and Alcoholism.

Even though she didn’t drink all day, every day, McKowen says alcohol was a daily habit and she knew she relied on it too much. Hangovers were common. So was blacking out for hours at night after putting her daughter to bed and self-medicating by combining wine with the sleep medication Ambien. “I didn’t know how to be in my own skin without drinking,” she explains.

She separated from her husband, got a DUI, and knew she was headed down a bad path. But she says she didn’t start to consider getting sober until an incident with her daughter. She got drunk and blacked out at a wedding, and her family had to step in to watch over her child.

“I put her in danger at the wedding. I left her unattended for a long period of time. She was 4,” McKowen says. “I knew eventually, I would lose custody of my daughter if I kept drinking. It was inevitable. I knew I would lose pretty much everything.”

Even so, it took McKowen a year to get serious about sobriety. She eventually started going to AA meetings, returned to the practice of yoga, and began chronicling her recovery on a blogand podcast that connected her to other moms going through the same thing. She now has nearly 30,000 followers on Instagram and has become an advocate for changing a culture she believes encourages moms, and women in general, to drink.

“It’s so socially acceptable. Even if you drink a lot, it’s not seen as weird,” McKowen says. “People just say — of course you drink. We do too. Moms need it. Cheers.”

The Rise in Drinking Among Women

The data on the rise of alcohol consumption and abuse by women are staggering. Historically, men have been the ones to drink far more alcohol, but numerous studies show that is changing on a variety of fronts: alcohol use, binge drinking, alcohol use disorders, driving under the influence of alcohol, and more. Studies differ on the percentage increase, but all support a clear and troubling trend of more alcohol consumption among women:

  • Female alcohol use disorder in the United States increased by 83.7% between 2002 and 2013, according to a 2017 study sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
  • High-risk drinking, defined as more than three drinks in a day or seven in a week for women, is on the rise among women by about 58%, according to a 2017 study comparing habits from 2001-2002 and 2012-2013.
  • A 2018 study found a steep rise in the rate of alcohol-related ER visits between 2006 and 2014, and increases were larger for women than men.
  • Death from liver cirrhosis rose in women from 2000 to 2013.

“Males still consume more alcohol, but the differences between men and women are diminishing,” says Aaron White, PhD, senior scientific advisor to the director of the NIAAA. Female drinking is starting earlier, too.

Another 2017 study, funded by the National Institute on Drug Abuse, found narrowing gender gaps as early as high school and middle school. Male drinking used to far surpass female drinking at all levels from eighth through 12th grades, but that’s changed dramatically over the last 20 years.

“Now, by eighth grade, more females than males are drinking. Females are now, for the first time in history, more likely to drink in 10th grade than males; and by 12th grade, where there used to be a big gap 10 or 15 years ago, it’s now dead even,” White says .

This isn’t just a U.S. problem. A 2016 publication by Australian researchers who pooled  information from 68 studies in 36 countries with a total sample size of more than 4 million men and women found similar results.

Their analysis showed that while men born in 1891 were almost 2 ½ times more likely than women to drink alcohol, men and women born in 1991 were almost equally likely to drink. And of the 42 studies that showed converging alcohol use, most reported this was driven by higher rates of female drinking.

“This matters because often, the focus in the media and public debate is on young men and alcohol,” says lead author Tim Slade, PhD, an associate professor at the National Drug and Alcohol Research Centre in Sydney, Australia. “It matters because, while women seek treatment for almost every other physical and mental health problem at higher rates than men, women who experience problems related to alcohol generally don’t seek treatment.”

The NIAAA says evidence of rising female alcohol use is also concerning because women are more likely than men to have a variety of alcohol-related health effects, including liver inflammation, cardiovascular disease, neurotoxicity, and cancer, says Deidra Roach, MD, medical project officer of the NIAAA Division of Treatment and Recovery Research. She says they are statistically more likely to black out from drinking too.

“Women are generally smaller than men and have less total body water and more total body fat,” Roach explains. “Blood alcohol level rises more quickly and stay elevated longer in women, so the harmful effects of alcohol, even if a man and woman drink same amount, will show up sooner in the women.”

“This is a very serious issue for women,” she says. “We need to do more in terms of getting this message out to young women and medical providers who work with young people. Because once you end up on the slippery slope of harmful drinking, it becomes difficult to reverse.”

A Cultural Shift?

The big question is: “Why?” What is behind the rise in women’s problem drinking? Roach says this isn’t fully understood, but she says some smaller studies and anecdotes show cultural norms around women’s drinking have changed dramatically over the past 100 years. “It’s gone from being taboo for women to drink at all to being expected in some settings, professional groups — even to drink to intoxication,” she says.

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Applications are OPEN: Sterling Clarren FASD Research Award

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The CanFASD Sterling Clarren Research Award has been named in honour of Dr. Sterling Clarren to recognize his pioneering contribution and leadership in the field of Fetal Alcohol Spectrum Disorder (FASD).

The award is presented annually to a Canadian Early Career Researcher or student in recognition of a completed study that has made a substantial contribution to the FASD field.Preference will be given to work conducted in one of Canada FASD Research Network’s (CanFASD)member provinces/territories (BC, Alberta, Saskatchewan, Manitoba, Ontario, New Brunswick, NWT, Nunavut, and Yukon). However, Canadian researchers conducting work in other jurisdictions may also apply.

Projects must also include a knowledge translation component. Applications may be submitted by:

  • A student working in the field of FASD near the completion of their studies, or
  • An early career investigator (within 5 years of first Faculty appointment)

The study must be intended to integrate research, policy, and practice to improve the lives of individuals with FASD, their families, and communities through advanced knowledge and/or training. This could include intervention, prevention, diagnostics, epidemiology, policy, justice, or basic biomedical research.

The following criteria will be considered in the review of all Research Award applications:

  • Relevance and scientific merit of the proposed research project to addressing human dimensions of FASD;
  • Potential to inspire future research and attract additional funding support;
  • Publication activity of the applicant;
  • Other research activities of the applicant; and
  • Demonstrated commitment to improving the lives of those affected by FASD.

The 2019 Award recipient will be required to participate at the 8th International Conference on Fetal Alcohol Spectrum Disorder (FASD): Research, Results and Relevance in Vancouver, BC, March 6-9, 2019. The recipient will be recognized at the conference in the plenary session and will be provided the opportunity to present their research in a concurrent session. Travel expenses and conference registration will be part of the Award, and the recipient will also be awarded a $2000 cash prize. As a condition of the award, recipients will also be required to submit a short plain language summary of their research findings suitable for a lay audience to be posted on the CanFASD website.

Application Deadline: October 12th, 2018
Award recipient will be notified by November 30th, 2018

Award Application Instructions
Award Application Form

Past Winners of the Dr. Sterling Clarren FASD Research Award

In The News: Winemakers revolt against health tags on bottles, say move labels wine as a ‘criminal product’

PARIS — French ministers’ plans to require bigger health warnings on bottles of wine have provoked a furious response from leading chateaux, which say the move would damage “the soul of France” and turn wine into a “criminal product”.

The winemakers united to criticize the proposal, intended to reduce alcohol consumption among pregnant women and minors. Agnes Buzyn, the health minister, wants to make two two centimetre-wide labels obligatory on the front of each wine bottle — one warning women against drinking any wine during pregnancy and the other a reminder that wine is illegal for under-18s.

Domaine de la Romanee-Conti, which makes the world’s most expensive wine, is among the signatories against the proposals, sent to industry officials three weeks ago. The ministry wants the changes to come into force “by the end of the year”.

Bottles of wine must already carry pictograms or a message advising zero alcohol consumption during pregnancy but there is no legal minimum size or rules on colour. They do not currently have to warn against under age drinking.

The proposals come as a quarter of pregnant French women continue to drink alcohol, according to the National Institute for Health and Medical Research, and as France struggles with an increase in teenage binge drinking.

French Minister for Solidarity and Health Agnes Buzyn attends a session of questions to the government at the National Assembly in Paris on June 26, 2018. THOMAS SAMSON / AFP

Sixty-four of France’s most illustrious vineyards and champagne houses accused the ministry of seeking to “spread fear”.

“We are the guardians of an exceptional heritage: French winemaking,” they wrote. “Every day, by exporting our produce, we share with the world, novices and wine buffs alike, a part of the soul of France.”

The government risked “sacrificing” all their endeavours by turning wine into a “criminal product”, they warned.

Pierre-Henri Gaget, of Maison Louis Jadot, said, “We don’t carry the plague and don’t want to be tarred with the same brush as cigarette manufacturers.

“To stick two warnings on the front label with a red line through them is unbearable. Next they’ll be slapping photos with cancer victims and saying wine is to blame.”

Retrieved from https://vancouversun.com/news/world/winemakers-revolt-against-health-tags-on-bottles-say-move-labels-wine-as-a-criminal-product/wcm/f55334e3-7eaa-4acf-873e-640b65c6fbb7

Drinking and smoking during pregnancy more deadly than we knew – study

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The danger of even low levels of drinking and smoking by a pregnant woman have been researched in an extensive new study conducted in South Africa and America.

Alarmingly‚ the researchers said‚ many mothers-to-be are smoking and boozing.

Between 2007 and 2015‚ the international study followed the drinking and smoking behaviour of nearly 12‚000 South African and American women during pregnancy.

Researchers at Stellenbosch University were involved in the study‚ which showed that the combined effect of drinking and smoking in pregnancy compounds the risk for stillbirth and Sudden Infant Death Syndrome (SIDS).

“This is the first study to show that combining these risk factors strengthens the negative effects on stillbirths and SIDS‚” said Professor Hein Odendaal of the Department of Obstetrics and Gynaecology at SU’s Faculty of Medicine and Health Sciences‚ who led the South African chapter of the Safe Passage Study.

Pregnant Woman Sitting On Bed

The researchers found that women who both drank alcohol and smoked during pregnancy had an almost three times higher risk (2.83 relative risk) of stillbirth compared to women who completely abstained from these behaviours.

Smoking alone had a relative risk of 1.6 for stillbirth‚ while drinking alone had a relative risk of 2.2. This risk increased when these behaviours continued beyond the first trimester of pregnancy (12 weeks gestation).

The study also found a 12 times higher risk for SIDS in cases where women drank and smoked during pregnancy.

In cases where the women drank but did not smoke‚ the risk for SIDS increased by four‚ and when they smoked but did not drink‚ there was a five times higher chance for SIDS.

“What’s particularly alarming is that these behaviours were quite common among study participants. More than half used alcohol (52.3%) sometime during pregnancy‚ and 17% continued drinking throughout the entire pregnancy. Almost half of them smoked (49%) sometime during pregnancy‚ and a third (33%) continued smoking for the duration of the pregnancy‚” said Odendaal.

The majority of women in the study (59.1%) were recruited from a prenatal clinic in Bishop Lavis in Cape Town‚ South Africa‚ while the remaining 40.9% of participants were recruited from two sites in North and South Dakota in the United States.

The study was done in collaboration with the Boston Children’s Hospital and Harvard University in Boston‚ Columbia University in New York‚ the University of South Dakota in Vermillion‚ the University of North Dakota in Grand Forks‚ and a data collection and analysis centre in Boston.

Retrieved from https://www.heraldlive.co.za/news/2018-07-06-drinking-and-smoking-during-pregnancy-more-deadly-than-we-knew-study/

 

How do state policies on alcohol use affect pregnant women and infants?

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EurekAlert: It is well known that if women drink while they are pregnant, they increase the chances that children may be affected by alcohol, including a broad range of serious defects referred to as Fetal Alcohol Spectrum Disorder. Many states have enacted laws aimed at pregnant women intended to reduce these risks. But do the laws have the intended effects? A new, first of its kind study helps answer that question.

Approximately 21% of pregnant women in the United States report that they used some alcohol during pregnancy and approximately 3% reporting binge drinking (defined as 4 or more drinks on at least one occasion). States have adopted a variety of policies in recent decades to try to reduce alcohol use by pregnant women. The policies included in this study were:

  • Mandatory warning signs posted in locations where alcoholic beverages are sold, as well as healthcare facilities where pregnant women receive treatment.
  • Priority treatment for pregnant women and women with children, which makes access to substance abuse treatment for pregnant and postpartum women who abuse alcohol priority.
  • Reporting requirements for data and treatment purposes, which specify either mandated or discretionary reporting of suspicion of or evidence of alcohol use or abuse by women during pregnancy to either Child Protective Services or a health authority.
  • Prohibitions on criminal prosecution, which prohibits use of the results of medical tests, such as prenatal toxicology tests, as evidence in the criminal prosecutions of women who may have caused harm to a fetus or a child.
  • Civil commitment, which is mandatory involuntary commitment of a pregnant woman to either treatment or protective custody of the state for the protection of a fetus from exposure to alcohol.
  • Reporting requirements for child protective services purposes, and child abuse/child neglect. This topic addresses the legal significance of a woman’s conduct prior to birth of a child and of damage caused in utero and, in some cases, define alcohol use during pregnancy as child abuse or neglect.

These policies have a variety of rationales. Policies such as mandatory signage are designed to inform women about possible dangers of alcohol; some policies, such as priority treatment, are designed to expedite substance abuse treatment for pregnant women so they are not on waiting lists than can be longer than the term of pregnancy. Other policies punish women for drinking while pregnant. The intent of these policies was likely to deter pregnant women from drinking, but researchers have found that they might have the unintended effect of making women avoid prenatal care to evade detection of their alcohol use.

The researchers analyzed birth certificate data from 148,048,208 births in the United States between 1972 and 2013. The data examined from the birth certificates included whether the infant had a low birthweight, was a premature birth (before 37 weeks), whether the woman used prenatal care, whether she used prenatal care late in her pregnancy, and whether the infant had a normal Apgar score (which is a method to quickly summarize the health of a newborn).

The results of the analysis that compared births to the state of the law in each U.S. state showed that six of the eight policies were significantly associated with birth outcomes. The other two had no significant effects. Unfortunately, all of the significant effects of these laws were in the direction of worse outcomes. The laws included mandatory warning signs, child abuse and neglect laws, civil commitment laws, prohibition of criminal prosecution, reporting requirements and priority treatment for pregnant women. Interestingly, the mandatory warning signs had the most effects. Women who lived in a state that requires these signs were more likely to have infants with low birthweight and to deliver prematurely. They were less likely to receive appropriate prenatal care and were less likely to have infants who had normal Apgar scores.

The study authors concluded that these laws, which were intended to reduce alcohol related birth problems, appear to have the reverse effect. Women in states with these laws appear to be reluctant to seek prenatal care and in this way, their babies are put at greater risk.

The authors point out that a very important finding from the study is that general alcohol policies intended to improve public health appear to benefit pregnant women and their babies. For example, policies that reduced alcohol consumption in the general population and government control over wine retail sales are also associated with improved birth outcomes. Policymakers and public health professionals who wish to improve birth outcomes through state-level policies should look to the broader alcohol policy field for lessons and approaches, rather than continuing with the types of policies currently in effect.

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Source: Subbaraman, Meenakshi S., Sue Thomas, Ryan Treffers, Kevin Delucchi, William C. Kerr, Priscilla Martinez, Sarah C.M. Roberts. “Associations between state-level policies regarding alcohol use among pregnant women, adverse birth outcomes, and prenatal care utilization: Results from 1972-2013 Vital Statistics. Alcoholism: Clinical and Experimental Research. https://doi.org/10.1111/acer.13804.

PIRE is an independent, nonprofit organization merging scientific knowledge and proven practice to create solutions that improve the health, safety and well-being of individuals, communities, and nations around the world.

The Prevention Research Center (PRC) of PIRE is one of 16 centers sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), of the National Institutes of Health, and is the only one that specializes in prevention. PRC’s focus is on conducting research to better understand the social and physical environments that influence individual behavior that lead to alcohol and drug misuse.

The Resource Link for Community Action provides information and practical guidance to state and community agencies and organizations, policy makers, and members of the public who are interested in combating alcohol and other drug abuse and misuse.

If you would like more information about this topic, please call Sue Thomas at 831.429.4084 or email her at thomas@pire.org

Retrieved from https://www.eurekalert.org/pub_releases/2018-07/pifr-hds070218.php

Drinktank: Alcohol and pregnancy – Why doesn’t it worry us?

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Following a call for submissions to the Food Regulation Standing Committee (FRSC) Pregnancy warning labels on alcoholic beverages public consultation, Australian governments will shortly decide whether to mandate alcohol pregnancy warning labels on all products sold in Australia.

Currently in Australia, alcohol companies are not legally required to include pregnancy warning labels on their products, and instead choose whether or not to include any information about the harm of alcohol and pregnancy on their labels.

New market research undertaken by Hall & Partners found that the alcohol industry’s current voluntary approach to warning of the dangers of drinking during pregnancy is misleading, confusing and fails to adequately raise awareness about the risks to the unborn child.

Off the back of this research, the Foundation for Alcohol Research and Education (FARE) has commenced campaigning for a new mandatory labelling system to complement its FRSC submission.

Today on Drink Tank, Louise Gray, Executive Officer of the National Organisation for Fetal Alcohol Spectrum Disorders (NOFASD) Australia, asks: Alcohol and pregnancy – Why doesn’t it worry us?


We worry about bagged lettuce, we are fearsomely opposed to smoking during pregnancy; we gladly take soft cheese off the menu and share information about the dangers of listeria.

Yet – Consider……

Summer 2017, Sydney, Australia. A group of upwardly mobile 30-somethings gather for a Christmas party. Plans to celebrate a year of campaigns, social media successes, work portfolio growth, and the benefits of quality education and living in a country like Australia.

The food on offer is the best that Australia can provide in this season – quality seafood, fruit, cheeses and meats – a wide variety with lots of alternatives. After all, some of the party attendees are pregnant and they need alternatives so that they can avoid raw seafood, camembert and the host of other items highlighted so that women who are pregnant won’t consume them. Even lettuce needs to be sourced and the origin identified to make sure that it didn’t come from a dreaded bag. Smokers, of course, won’t even make an appearance at this gathering and will be huddled outside in furtive groups.

Enter Nicole, a slight and well-exercised woman, five months into her long-awaited pregnancy. Nicole is brimming with health and vitality, perhaps with the glow that pregnant women are often reported to have, as she awaits this much-anticipated birth. Nicole has private health insurance and access to the best medical care in Australia.

She did not receive any advice about alcohol and pregnancy until she was five months pregnant and this was received in a package of information from her hospital. Finally, at this point, she was clearly told that no alcohol is the recommended health advice for pregnant women supported by the Australian government health guidelines, the World Health Organization, and most global health advisories.

Nicole heeded this advice from the moment she began planning her conception and pregnancy and has confidence that she has given her tiny baby the best chance to develop and create the complex systems which are required to keep a human body going.

Nicole, at five months, is visibly pregnant and her series of Christmas parties was a series of opportunities to refuse alcohol. Everyone offered alcohol, at every event and when she declined she was encouraged to “have just one”. Sometimes comments bordered on ridicule for her choices, while others offered ‘researched’ advice that a small amount of alcohol is good for you.

We don’t force cigarettes on people, we don’t encourage people to ignore risks with soft cheese, we don’t try to convince someone to eat just one piece of sushi – so why do we encourage and support alcohol in pregnancy?

Why don’t we think of interesting alcohol-free choices?

Why do we make alcohol-free the exception rather than the rule?

Does it matter if people don’t understand what happens when a pregnancy is exposed to alcohol?

Does it matter that there is no known safe limit of alcohol which can be consumed during pregnancy?

Does it matter that children risk a lifetime of disability and challenges?

It does matter because Fetal Alcohol Spectrum Disorder (FASD) is the most prevalent, preventable disability in the world.

Studies in mainstream populations in the US and Canada point to conservative estimates that between 2 – 5 % of the population is affected by FASD with higher numbers evident in at-risk communities.

We don’t know how much FASD there is present in mainstream Australia – it hasn’t been researched. However, newspaper headlines document increased incidence of serious behaviour issues in schools, increased incidence of emergency room incidents, unacceptable growth in prison populations, falling education standards and increases in disability numbers.

Australia needs to undertake effective FASD screening or we will never prevent FASD and we will never know the role which FASD has in these figures.

Finally, Australia needs to be serious about pregnancy warning labels on packaged alcoholic beverages. It would be impossible to find another product which causes such harm and is sold so widely and freely without a clear warning and reminder.

Mandatory labels are needed. It is negligent and irresponsible for Australia to remain complicit in a situation which exposes unborn children to unacceptable risk.


Postscript – Nicole (not her real name) gave birth to a healthy baby girl and was grateful she understood that alcohol should not consumed when planning a pregnancy and during pregnancy.


8th International Research Conference on Adolescents and Adults with FASD: Presentations

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Although there have been thousands of published articles on FASD, there remains to be limited research specifically on adolescents and adults with FASD. As individuals diagnosed with FASD continue to age, the “need to know” across a broad spectrum of areas continues to be critically important for identifying clinically relevant research questions and directions.

Continuing on the work of seven previous conferences, there remains a clear need to examine relevant global research, programs and policies. What does existing or emerging research tell us? Are the results transferable from country to country and/or from laboratory to real life? Are there clinical implications of results from any of these areas of which we should be aware? What are the changes in our thinking, practice and directions that will be required to improve outcomes? What are the implications for the future?

This interactive 2018 conference provided an opportunity to be at the forefront of addressing these relevant global issues.

To see the conference presentations and webcasts please click here

 

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