According to the National Institute on Mental Health the addiction to drugs or alcohol is a mental illness. Substance use disorder changes normal desires and priorities. It interferes with the ability to work, go to school, and the ability to have good relationships with family and friends. In 2014, 20.2 million adults in the U.S. had a substance use disorder and 7.9 million had both a substance use disorder and another mental illness.

More than half of the people with both a substance use and mental health issues were men (4.1 million). Having two illnesses at the same time is known as “co morbidity or dual diagnosis” and it can make treating each disorder more difficult.

Males and females differ in their ability to metabolize alcohol. The difference is due to variations in the amount activity of alcohol dehydrogenase, the enzyme responsible for metabolizing alcohol.

Males have highly active (fast) forms of ADH in their stomach and liver. The presence of ADH in the stomach of men can reduce the absorption of alcohol by 30%. By contrast, females have almost no ADH in their stomach. Consequently, females absorb more alcohol into their bloodstream. Additionally, the ADH in the liver of the females is less active than ADH in the male liver.

Taken together, these gender differences in alcohol metabolism result in increased BAC (blood alcohol concentration) for women compared to men if they both consume the same amount of alcohol. For the same number of drinks, it is easer for women to quickly become more intoxicated.

There are several physiological reasons why women will feel the effects of alcohol more quickly and strongly than a man. Women are often smaller than men, and thus have a smaller volume of blood, so consuming the same amount of alcohol as a larger man will resulting in a higher BAC. Even if a man and a woman are the same weight and drink the same amount of alcohol, the woman will still become more intoxicated. This is true for several reasons.

Women have less water in their bodies than men do, water making up 52% of a woman’s body, as compared to 61% of a man’s. Therefore, a man’s body can dilute more alcohol than a woman’s body can, and more alcohol stays in a woman’s body, increasing the BAC.

Women tend to have a higher proportion of body fat than men of the same weight, and this affects how the body processes alcohol. Alcohol can’t be dissolved in fat, so more alcohol becomes concentrated in a woman’s body fluids, like blood, raising her BAC to a higher level than that of a man of similar weight who drinks the same amount of alcohol.

Compared with men, women have less alcohol dehydrogenase, an enzyme in the liver and stomach that breaks down alcohol. Because the alcohol isn’t broken down as efficiently as a man’s, more alcohol enters a woman’s bloodstream and her BAC increases.

Hormonal differences between men and women can affect alcohol metabolism. During a woman’s menstrual cycle, changes in hormone levels affect the rate which a woman becomes intoxicated. Alcohol metabolism slows down during the premenstrual phase of a women’s cycle, which causes more alcohol to enter the bloodstream and the women get intoxicated faster. Birth control pills and some medications with estrogen also slow the rate at which women process alcohol.

Men are almost two times more likely to binge drink than women. Approximately 22% of men report binge drinking and on average do so five times a month, consuming eight drinks per binge. In 2019, 7% of men had an alcohol disorder compared with 4% of women.

The Centers for Disease Control and Prevention reports about 18% of women of childbearing age (18 to 44) binge drink. In 2019 about 32% of female high school students consumed alcohol compared with 26% of male students. In 2019, 8% of women aged 18 to 25 years old had an alcohol disorder.

Although men display a higher prevalence for alcoholism, it is women who suffer a much greater risk for alcoholism associated with bodily damage. Although women generally consume less alcohol compared to men, women suffer more severe brain and other organ damage following binge or chronic alchohol abuse. Injuries, sexual violence, cancers of the mouth, throat, esophagus, liver and colon to name a few.

“Do or do not. There is no try.” Yoda

Overfield is an advocate for the national Alliance on Mental Illness of Park County. 250-2978

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