CDC Vital Signs - Binge Drinking: A Serious, Under-Recognized Problem Among Women and Girls
January 11, 2013
- One in eight adult women and one in five high school girls in the United States binge drink. Women who binge drink do so about three times a month, averaging six drinks per binge.
- Drinking too much alcohol results in about 23,000 deaths among women and girls each year, and increases risks for cancer, heart disease, sexually transmitted diseases, and unintended pregnancy.
- The Community Preventive Services Task Force recommends evidence-based strategies for preventing excessive alcohol use, including binge drinking.
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January 2013
Binge Drinking
A Serious, Under-Recognized Problem Among Women and Girls
Binge drinking is a dangerous behavior but is not widely recognized as a women’s health problem. Drinking too much – including binge drinking* - results in about 23,000 deaths in women and girls each year. Binge drinking increases the chances of breast cancer, heart disease, sexually transmitted diseases, unintended pregnancy, and many other health problems. Drinking during pregnancy can lead to sudden infant death syndrome and fetal alcohol spectrum disorders.
About 1 in 8 women aged 18 years and older and 1 in 5 high school girls binge drink. Women who binge drink do so frequently – about 3 times a month – and have about 6 drinks per binge. There are effective actions communities can take to prevent binge drinking among women and girls.
*Binge drinking for women is defined as consuming 4 ormore alcohol drinks (beer, wine, or liquor) on an occasion.
Problem
Drinking too much can seriously affect the health of women and girls.
Drinking too much can seriously affect the health of women and girls.
- Women’s and girls’ bodies respond to alcohol differently than men’s. It takes less alcohol for women to get intoxicated because of their size and how they process alcohol.
- Binge drinking can lead to unintended pregnancies. It is not safe to drink at any time during pregnancy.
- If women binge drink while pregnant, they risk exposing their developing baby to high levels of alcohol, increasing the chances the baby will be harmed by the mother’s alcohol use.
Drinking is influenced by your community and your relationships.
- Alcohol use in a community is affected by alcohol’s price and availability.
- Underage drinking is affected by exposure to alcohol marketing.
- Underage drinking is also influenced by adult drinking, and youth often obtain alcohol from adults.
Who's At Risk?
Binge Drinking Infographics
What Can Be Done
Federal agencies and national partners are:
- Recognizing that binge drinking is an important women’s health issue.
- Working with states and communities to support Community Guide recommendations to reduce binge drinking.
- Informing people about the US Dietary Guidelines on alcohol consumption (see box).
- Helping states and communities to report on how many people binge drink, how often and how much they drink when they binge, and whether health care providers are screening and counseling for excessive alcohol use.
- Reporting on youth exposure to alcohol marketing because it influences underage drinking.
We know what works
The Guide to Community Preventive Services(Community Guide) recommends effective policies to prevent binge drinking.
Learn more at
www.thecommunityguide.org/alcohol
.
States and communities can:
- Follow Community Guide recommendations to reduce binge drinking. The same approaches that work in the population as a whole can work for women and girls.
- Increase enforcement of laws on the sale and consumption of alcohol.
- Develop partnerships with a variety of groups, including schools, women’s and girls’ organizations, law enforcement, and public health agencies to reduce binge drinking.
- Report on how many people binge drink, how often, and how much they drink when they binge.
Key Points on Alcohol Consumption from the 2010 US Dietary Guidelines for Americans
- Don’t begin drinking or drink more frequently on the basis of potential health benefits.
- If you do choose to drink, do so in moderation. This is defined as up to 1 drink a day for women or 2 for men.
- Don’t drink at all if you are under age 21, pregnant or may be pregnant, or have health problems that could be made worse by drinking.
Doctors, nurses, and others who treat patients can:
- Ask women about binge drinking and counsel those who do to drink less (see Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse). This screening and counseling can also be effectively done using the internet, telephone, or other electronic methods, as recommended by the Community Guide.
- Advise women who are pregnant or might be pregnant not to drink at all.
- Recognize that most binge drinkers are not alcohol dependent or alcoholics, but may need counseling.
- Support effective policies to prevent binge drinking such as those recommended by the Community Guide.
Women and girls can:
- Avoid binge drinking. If you choose to drink alcohol, follow the US Dietary Guidelines.
- Choose not to drink alcohol if you are underage or if there is any chance you could be pregnant.
- Be cautious about consuming drinks if the alcohol content is unknown to you.
Science Behind this Issue
Fact Sheets
Excessive Alcohol Use and Risks to Women’s Health
Although men are more likely to drink alcohol and drink in larger amounts, gender differences in body structure and chemistry cause women to absorb more alcohol, and take longer to break it down and remove it from their bodies (i.e., to metabolize it). In other words, upon drinking equal amounts, women have higher alcohol levels in their blood than men, and the immediate effects occur more quickly and last longer. These differences also make women more vulnerable to alcohol’s long-term effects on their health.
1
Reproductive Health
- National surveys show that about 1 in 2 women of child-bearing age (i.e., aged 18–44 years) use alcohol, and 15% of women who drink alcohol in this age group binge drink.2
- About 7.6% of pregnant women used alcohol.2
- Excessive drinking may disrupt menstrual cycling and increase the risk of infertility, miscarriage, stillbirth, and premature delivery.3, 4
- Women who binge drink are more likely to have unprotected sex and multiple sex partners. These activities increase the risks of unintended pregnancy5 and sexually transmitted diseases.6
Alcohol and Pregnancy
- Women who drink alcohol while pregnant increase their risk of having a baby with Fetal Alcohol Spectrum Disorders (FASD). The most severe form is Fetal Alcohol Syndrome (FAS), which causes mental retardation and birth defects.
- FASD are completely preventable if a woman does not drink while pregnant or while she may become pregnant.
- Studies have shown that about 1 of 20 pregnant women drank excessively before finding out they were pregnant.7 No amount of alcohol is safe to drink during pregnancy. For women who drink during pregnancy, stopping as soon as possible may lower the risk of having a child with physical, mental, or emotional problems.
- Research suggests that women who drink alcohol while pregnant are more likely to have a baby die from Sudden Infant Death Syndrome (SIDS). This risk substantially increases if a woman binge drinks during her first trimester of pregnancy.8
- The risk of miscarriage is also increased if a woman drinks excessively during her first trimester of pregnancy.9
Other Health Concerns
- Liver Disease: The risk of cirrhosis and other alcohol-related liver diseases is higher for women than for men.10
- Impact on the Brain: Excessive drinking may result in memory loss and shrinkage of the brain.11 Research suggests that women are more vulnerable than men to the brain damaging effects of excessive alcohol use, and the damage tends to appear with shorter periods of excessive drinking for women than for men.12
- Impact on the Heart: Studies have shown that women who drink excessively are at increased risk for damage to the heart muscle than men even for women drinking at lower levels.13
- Cancer: Alcohol consumption increases the risk of cancer of the mouth, throat, esophagus, liver, colon, and breast among women. The risk of breast cancer increases as alcohol use increases.14-17
- Sexual Assault: Binge drinking is a risk factor for sexual assault, especially among young women in college settings. Each year, about 1 in 20 college women are sexually assaulted. Research suggests that there is an increase in the risk of rape or sexual assault when both the attacker and victim have used alcohol prior to the attack.18, 19
References:
- Ashley MJ, Olin JS, le Riche WH, Kornaczewski A, Schmidt W, Rankin JG. Morbidity in alcoholics. Evidence for accelerated development of physical disease in women. Arch Intern Med 1977;137(7):883–887.
- Centers for Disease Control and Prevention. Alcohol use and binge drinking among women of childbearing age – United States, 2006-2010. MMWR 2012;61:534-538.
- Mendelson JH, Mello NK. Chronic alcohol effects on anterior pituitary and ovarian hormones in healthy women. J Pharmacol Exp Ther 1988;245(2):407–412.
- Wilsnack SC, Klassen AD, Wilsnack RW. Drinking and reproductive dysfunction among women in a 1981 national survey. Alcohol Clin Exp Res 1984;8(5):451–458.
- Naimi TS, Lipscomb LE, Brewer RD, Gilbert BC. Binge drinking in the preconception period and the risk of unintended pregnancy: Implications for women and their children. Pediatrics 2003;111(5):1136–1141.
- Thomas AG, Brodine SK, Shaffer R, Shafer MA, Boyer CB, Putnam S, et al. Chlamydial infection and unplanned pregnancy in women with ready access to health care. Obstet Gynecol 2001;98(6):1117–1123.
- Floyd RL, Decoufle P, Hungerford DW. Alcohol use prior to pregnancy recognition. Am J Prev Med 1999;17(2):101–107.
- Iyasu S, Randall LL, Welty TK, et al. Risk factors for sudden infant death syndrome among northern plains Indians. JAMA 2002;288(21):2717–2723.
- Kesmodel U, Wisborg K, Olsen SF, Henriksen TB, Sechler NJ. Moderate alcohol intake in pregnancy and the risk of spontaneous abortion. Alcohol & Alcoholism 2002;37(1):87–92.
- Loft S, Olesen KL, Dossing M. Increased susceptibility to liver disease in relation to alcohol consumption in women. Scand J Gastroenterol 1987;22(10):1251–1256.
- Hommer DW, Momenan R, Kaiser E, Rawlings RR. Evidence for a gender-related effect of alcoholism on brain volumes. Am J Psychiatry 2001;158:198–204.
- Mann K, Batra A, Gunthner A, Schroth G. Do women develop alcoholic brain damage more readily than men? Alcohol Clin Exp Res 1992;16(6):1052–1056.
- Urbano-Marquez A, Estruch R, Fernandez-Sola J, Nicola JM, Pare JC, Rubin E. The greater risk of alcoholic cardiomyopathy and myopathy in women compared with men. JAMA 1995;274(2):149–154.
- Baan R, Straif K, Grosse Y, Secretan B, et al. on behalf of the WHO International Agency for Research on Cancer Monograph Working Group. Carcinogenicity of alcoholic beverages. Lancet Oncol 2007;8:292–293
- Smith-Warner SA, et al. Alcohol and breast cancer in women: A pooled analysis of cohort studies. JAMA 1998;279(7):535–540.
- Thun MJ, et al. Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med 1997;337(24):1705–1714.
- Department of Health and Human Services. Tenth Special Report to the U.S. Congress on Alcohol and Health
[PDF-264KB]. Bethesda, MD: National Institutes on Alcohol Abuse and Alcoholism; June 2000.
- Mohler-Kuo M, Dowdall GW, Koss M, Wechsler H. Correlates of rape while intoxicated in a national sample of college women. Journal of Studies on Alcohol 2004;65(1):37–45.
- Abbey A. Alcohol-related sexual assault: A common problem among college students. J Stud Alcohol Suppl 2002;14:118–128.
Preventing Excessive Alcohol Consumption
Excessive alcohol consumption is the third leading cause of preventable death in the United States and is a risk factor for many health and societal problems. In 2006, the estimated economic cost of excessive drinking in the U. S. was $223.5 billion (Bouchery et al 2011).
Excessive alcohol consumption can take the form of heavy drinking, binge drinking, or any drinking by pregnant women or underage youth.
- Heavy drinking is defined as more than two drinks per day on average for men or more than one drink per day on average for women.
- Binge drinking is defined as five or more drinks during a single occasion for men or four or more drinks during a single occasion for women.
- Approximately 1 in 6 US adults binge drinks, about 4 times a month. On average, the largest number of drinks consumed during a binge is 8.
- Underage drinking is considered a form of excessive drinking because it is both illegal and often involves consumption in quantities and settings that can lead to serious immediate and long-term consequences.
- People aged 12 to 20 years drink 11% of all alcohol consumed in the United States. More than 90% of this alcohol is consumed in the form of binge drinks (OJJDP)
[PDF - 1.08MB] .
Task Force Recommendations & Findings
This table lists interventions reviewed by the Community Guide, with Task Force findings for each (
definitions of findings). Click on an underlined intervention title for a summary of the review.
Disclaimer
The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC.
Sample Citation
The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Preventing excessive alcohol consumption.
www.thecommunityguide.org/alcohol/index.html. Last updated: MM/DD/YYYY.
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