I saw it in my new suburb with women who held high-pressure jobs, then downed a bottle of wine at dinner. I met moms who poured Baileys into travel mugs to swig after driving their kids to school. I saw it on TV: women hoisting oversize glasses of vino on Real Housewives, Cougartown, or Scandal. On Facebook, I found groups like Moms Who Drink and Swear and Moms Who Need Wine. I was so struck by the major—but unspoken—role played by alcohol that I spent three years researching the topic and wrote a book, the recent Her Best-Kept Secret.
My observations were borne out by 2011 figures from the Centers for Disease Control that showed binge drinking—consuming four or more drinks on an occasion—was common among women in the United States: One in eight women regularly binge-drinks. And as their alcohol consumption has increased, so have the negative effects. More women now are getting picked up for drunk driving, and more college-aged women wind up in ERs because they’re dangerously intoxicated.
Epidemiologists say that for many women excessive drinking begins in college, as they match their behavior to men’s, and continues as they get older. Women today have the means to drink—and the stress that can push them to overdo it. Alcohol may seem like a handy antidote to work deadlines, kids’ demands, and the challenges of aging parents. Add to this the fact that twice as many women as men are diagnosed with anxiety disorders, which they often medicate with alcohol, and it’s a combustible mix. Biology plays a role too. The intoxicating effects of alcohol are higher for women because women’s bodies contain more fat (which can’t absorb alcohol, causing it to enter the bloodstream) and less water (which dilutes alcohol). Women also produce less of the enzyme dehydrogenase, which helps process alcohol, and that means women get drunk faster.
In a study in the early 1980s, one in ten women said yes to the question “Are you concerned about your drinking?” By 2002, it was one in five. In the past decade, record numbers of middle-aged women have sought treatment for alcohol abuse. Others have gone to recovery groups. For many of them, that’s been Alcoholics Anonymous (AA).
AA is by far the biggest, best-known program for alcoholism in the United States. (As of 2013, its membership counts nearly 1.3 million Americans, of which one third are female.) But its model has been the same since the 1930s, when it was founded by two men based on their personal experience with problem drinking. Alcoholism, in AA’s literature, is defined as “a progressive illness that can never be cured,” and the organization’s goal for its members is “recovery,” which means total lifelong abstinence and adherence to the 12 steps as laid out in its Big Book. In the first of AA’s 12 steps, members must admit their powerlessness over alcohol; in the next step, they must state their belief that help rests in a “power greater than ourselves.”
AA has helped countless people, providing them with structure and community. Put off by its rigidity, though, some women have sought out newer groups that don’t consider alcohol abuse an incurable illness but rather an unhealthy behavior that can be changed. Like AA, the groups are free and offer meetings run by peers, but they differ in key ways: People can participate online, the techniques that the groups use are based on behavioral psychology and neuroscience, and they emphasize personal responsibility.
Many women find AA’s attitudes out of step with the times. Telling them that they have no power over alcohol, for instance, does not go down easily. Women recover more quickly from alcohol abuse when they’re able to take control of their situation, not relinquish it, says Minneapolis psychiatrist Mark Willenbring, MD, a former director of treatment research at the National Institutes on Alcohol Abuse and Alcoholism. “Assertiveness training and empowerment are healing to them.” Here are stories of women who rejected the AA orthodoxy for a better solution to their drinking problems.