Jenny elaborated that her habit of relaxing with a glass of wine – late at night, alone, after a long day of work – had escalated to a bottle or more each night. “In the beginning, I would pour one glass of wine,” she admitted. “Then suddenly that one glass of wine turned into a hearty mug of wine, and soon the hearty much of wine became a bottle of wine, each and every night.”

Today, many studies have publicized the positive attributes of drinking alcohol in moderation. Conversely, other, perhaps less-publicized studies suggest women may be taking their relationship with alcohol too lightly. In fact, estimates predict that there soon may be as many female alcoholics as there are male ones. Moreover, this data supports a causal relationship between as few as two drinks (or even less) a day and health problems in women. There is direct evidence that women are more vulnerable than men to alcohol-related organ damage, trauma and legal and interpersonal difficulties.

Ironically, since the 1980s the number of adult women considered heavy-drinkers –defined as two or more drinks a day – has declined. However, drinking among certain groups of women has steadily increased. In 1993, the National Household Survey on Drug Abuse found that women who work outside the home are 67 percent more likely to drink heavily than homemakers. A more recent study by the National Center on Addiction and Substance Abuse puts that number even higher, at 89 percent. Of course, more American women are working than every before. In 1960, less than 20 percent of married women with children under age six worked outside the home; in the year 2000, that figure was approximately 65 percent.

An ongoing study by psychologist Sharon Wilsnack and sociologist Richard Wilsnack at the University of North Dakota School of Medicine and Health Sciences surveys a nationally representative sample of l,l00 U.S. women, 696 of whom have participated since l981. Their data finds that women in male-dominated occupations (measured by the U.S. Census Bureau as more than 50 percent male, including law and engineering) drink more than women in traditionally female professions such as teaching and nursing. “In a male-dominated environment, drinking may be symbolic of gender equality,” Wilsnack notes.

Similarly, another study of women reported in The Journal of Law and Health included a section that specifically targeted women lawyers; it found that “nearly 10 percent of the practicing Washington lawyer sample reported levels of alcohol use that are likely to indicate current alcohol-related problems.” Ominously, however, they continued:

As with male lawyers, however, this rate increases dramatically to 71 percent who are reporting a lifetime likelihood of alcohol-related problems. Over the career span, the data reveals that almost three-fourths of female lawyers (practicing up to and including ten years) are reporting a lifetime likelihood of alcohol-related problems.

Needless to say, this does not mean that women should give up their licenses to practice law in order to guard against alcohol abuse and dependence. What it does mean is that working women – especially women attorneys – should monitor their levels and frequency of consumption and fine-tune their radar for signs of growing dependence. “Drinking every night to relax is a major sign of trouble, even if you are not drinking that much,” Wilsnack says.

Alan Leshner, former director of the National Institute on Drug Abuse, explained in an article that, over time, individuals begin to depend on a substance to feel not just good but normal. Gradually, the occasional use of a drugs (including alcohol) turns into weekly – then daily – use. Eventually the person may come to the distressing realization that he or she is addicted.

According to Leshner, “Every drug-user starts out as an occasional user, and that initial use is a voluntary and controllable decision.” However, as time passes and drug use continues, changes in brain chemistry can produce compulsive and uncontrollable drug use. “While every type of drug abuse has its own individual trigger for affecting or transforming the brain, many of the results of the transformation are strikingly similar regardless of addictive drug used,” Leshner notes. “The brain changes range from fundamental and long-lasting changes in the bio-chemical make-up, to mood changes, to changes in memory processes and motor skills.”

Of course, not all people who use drugs (including alcohol) will experience such dramatic changes. Some people can use alcohol (drugs) occasionally and remain occasional users; those at high risk (family history, job, etc.) may start using casually but then progress quickly into dependence.

Men and women are created equal, but they do not respond equally to the effects of alcohol. When women and men drink at the same rate, women show a higher susceptibility to serious substance-related medical conditions that include liver, brain and heart damage. This increased risk is attributed to gender differences in metabolism but also could be the result of differences in brain chemistry, hereditary genetic factors, or other factors currently unknown.

Women achieve higher concentrations of alcohol in the blood and become more impaired than men after drinking equivalent amounts of alcohol. Ongoing research indicates that women also are more susceptible to trauma resulting from traffic accidents and interpersonal violence. In addition, women develop alcohol-induced liver disease over a shorter period of time and after consuming less alcohol than men. Finally, they are more likely to develop alcoholic hepatitis and are more likely to die from cirrhosis of the liver. Animal research suggests that this increased risk of liver damage is related to the physiological effects of the hormone estrogen.

The more we know about how alcohol and drugs affect us all, the better we will be able to treat these problems in all populations. Jenny got out before her use damaged her health and her professional standing; she is one of the lucky ones. For more information on alcohol abuse/dependence or other issues that affect your quality of life and quality of work, contact the MSBA Lawyer Assistance Program at (800) 492-1964 or (410) 685-7878, ext. 3041, or e-mail cwaldhauser@msba.org.

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Publications : Bar Bulletin: July, 2005