For nearly a century, men consumed alcohol at much higher rates than women, putting males at a greater risk for alcohol-related illnesses and accidents. But in recent decades, women have closed the gap in drinking and relative risk for alcohol-related harms.
An October study published in BMJ Open found that beginning in the early 1900s, women began slowly catching up to men in rates of alcohol consumption, problematic drinking behavior and alcohol-related harms. By the 1960s, women started catching up to men in all three categories at a much higher rate.
“Across the board, when we talk about any alcohol use, binge drinking, or alcohol use disorder, generally males have a higher prevalence than females,” study author Tim Slade told STAT. “But there’s a change in patterns of substance use.”
Compared to women, men born between 1891 and 1910 were:
- 2.2 times as likely to consume alcohol
- 3.0 times as likely to have problematic drinking symptoms
- 3.6 times as likely to experience alcohol-related harms
In contrast, men born between 1991 and 2000 were:
- 1.1 times as likely to consume alcohol
- 1.2 times as likely to have problematic drinking symptoms
- 1.3 times as likely to experience alcohol-related harms
The findings do not provide data on whether men are drinking less, women are drinking more or if a combination of both factors is contributing to the shrinking gap.
The article analyzed 68 studies that met four criteria:
- Measured alcohol use or harm
- Included a regionally or nationally representative sample
- Measured cohort effect or provided data on at least two birth cohorts
- Included separate data on males and females or compared both sexes
Almost 40 percent of studies were conducted in Europe, and 37 percent were in North America. About 7 percent were from Oceania, 6 percent from Asia and about 10 percent were conducted in multiple regions or other regions of the world.
The ratio of alcohol consumption between men and women dropped by 1.2 percent in successive generations born between 1891 and 1966, and it dropped by 10.1 percent in successive generations born between 1966 and 2000.
Some evidence in the studies indicated that the decline in drinking ratios was spurred by increases in alcohol consumption among women, but there was not enough data to draw a firm conclusion.
“It could be that increased participation in higher education and the work force came with increased pressure to drink,” Slade said. “It could be that women are under more strain or experiencing more stress. We’re not sure.”
The article speculated that the decreasing gap may have been caused by changes in how women are viewed in society. A 2009 study published in JAMA Psychiatry found that the gap between the number of men and women with substance use disorders was narrowing in countries with progressive views on the role of males and females in society.
The results of the BMJ study indicate that alcohol-related prevention and intervention programs should focus equally on men and women, as rates of consumption, problematic drinking and risk of alcohol-related harms begin to even.
Opioid Abuse, Overdose Gender Gap Decreasing
The gap between the number of men and women who abuse and overdose on opioids also decreased during the last two decades, according to a 2013 report from the Centers for Disease Control and Prevention.
More than 10,000 men died from overdoses involving opioid pain relievers in 2010, compared to 6,600 deaths among women. But the number of women who overdosed between 1999 and 2010 increased 400 percent, while the number of men increased 265 percent.
That may be because women are more likely than men to experience chronic pain, receive opioid prescriptions, be prescribed higher doses and to use them for longer durations, according to the CDC.
Women are more likely to doctor shop for prescription drugs than men, but it seems that men are much more likely to turn to heroin. More than four times as many men died drug heroin-related drug overdoses than women in 2013, according to a 2015 CDC report.
The number of men who died from drug overdoses in 2014 also increased more rapidly than women. A total of 28,812 men died from drug overdoses that year, an age-adjusted increase of 7.6 percent from 2013. During the same time frame, 18,243 women died from drug overdoses, an age-adjusted increase of 4.7 percent from the year before.
Women with substance use disorders should receive treatment specific to their condition, according to the National Institute on Drug Abuse. They are more likely to have a history of physical or sexual trauma than men, meaning treatments for PTSD may be more effective for them.
They’re also more likely to seek help from a physician or therapist than men, so health care providers should be aware of those issues.