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By Liz Connors, Vicki Malick

The Office of Research on Women's Health recently sponsored a seminar on "Alcohol: A Women's Health Issue."

Dr. Mary Dufour, former deputy director, National Institute on Alcohol Abuse and Alcoholism, began the discussion by showing the audience staggering statistics on alcohol consumption in the U.S. Americans consume more than 6 billion gallons of beer per year, almost 547 million gallons of wine and nearly 355 million gallons of distilled spirits. She also provided statistics on per capita alcohol consumption, drinking status of women, how women handle alcohol differently from men (mostly due to body size and composition), how hormones affect tolerance and how tolerance decreases with age.

Dr. Mary Dufour Dufour explained some of the medical consequences of using alcohol and how it affects the liver, heart, brain, pancreas, nerves and bones. She indicated that for both men and women, about 50 percent of the risk of becoming an alcoholic is genetic but there appear to be differences between men and women as to which genes are involved. She stressed moderation and referred to the Dietary Guidelines for Americans 2000. Moderation is defined as "no more than one drink per day for women." Dufour said that there is much research to support a very strong association between moderate drinking in women and reduced risk of death from a heart attack as well as reduced risk of having a heart attack. Some of the possible mechanisms for this protective effect are decreased blood clotting and increased good cholesterol. More research is needed to determine if moderate drinking in one's 20s confers any added benefit over and above moderate drinking in one's 50s or 60s. Decreased blood clotting and increased good cholesterol are only two of several possible mechanisms now under investigation.

Dr. Karen Clay Rhines Dr. Karen Clay Rhines, assistant professor of psychology, Seton Hall University, focused on treatment issues and outcomes for alcohol-dependent women. She said the effectiveness of alcohol treatment in women has not been sufficiently studied. One of the problems is that, traditionally, men have been studied and the results extrapolated to women. Rhines clearly showed that women must be studied too. One of the concerns is that relatively few women seek alcohol treatment, perhaps because programs such as Alcoholics Anonymous are designed for male clients. The programs often do not take into account the special issues involved in treating women who are mothers or caregivers. Also, there are psychosocial differences between alcoholic men and women, which directly affect the type of alcohol treatment each sex needs. So while programs like AA might be beneficial for men, they may not be as effective for women.

In addition, providing treatment for women tends to be more challenging than for men because women suffer from many barriers that prevent them from seeking help. Some of these barriers are internal — women experience denial, fear of stigma, concern for losing their children, guilt, and shame. Barriers can also be external — opposition from family and friends, and social costs of trying to leave an abusing situation. Other barriers include a lack of standard referral patterns, inadequate training of health care providers, lack of services geared toward women, a lack of economic resources, inadequate insurance and a lack of child care facilities.

In order to make treatment more beneficial for women, Rhines said it is time to educate the public on this women's health issue, increase knowledge about women and drinking and increase availability of sensitive services for alcoholic women.

Dr. Kenneth Leonard Final speaker Dr. Kenneth Leonard of the State University of New York at Buffalo talked about alcohol and its correlation with domestic violence. According to the National Crime Victimization Survey, 1 million females are victims of intimate-partner violence a year. Other research suggests that 1.8 million women report severe violence and 6.2 million females are assaulted by husbands or partners each year. In addition, about one-third of couples experienced aggression related to alcohol before marriage. It is estimated that 250,000 victims of intimate violence are seen in hospital emergency departments a year, but most fail to seek treatment or to report the crime.

Leonard explained that heavy drinking among males is associated with domestic violence. Male batterers drink more and are more likely to be alcoholic. The role of female drinking in domestic cases is less clear. However, there is some evidence to suggest that females who drink do not show violence unless both the male and female spouse are drinking. Among alcoholics, the odds of violence occurring on a specific day are 10 times higher on days when both drink than on days that neither did. According to Leonard, there is research that shows that when an alcoholic batterer stops drinking, the violence is reduced considerably, and tends to occur if and when the alcoholic returns to heavy drinking.

Seminar speakers and organizers gather for a photo.