Is It Time To Give Up Alcohol?
A glass half empty? At what point does that glass of wine (or three) become a problem? For women of a certain age, it may be sooner than you think (or want)
To drink or not to drink?
It may sound glib, but that is the question that’s been plaguing me for the past few weeks, ever since I began researching this article about alcohol and its effects on older women. What I have learned has been sobering indeed. I am 62 and I drink every day and have been for (gulp) almost 30 years. Oh sure, I take a day off now and then but not very often. And those evenings without my two (okay, three) drinks are as flat as the surface of a dead planet. I have long felt I drink more than I should and have wanted to cut down. Now, considering the facts, I wonder if I should be drinking at all.
Like most menopausal and post-menopausal women, I have noticed that alcohol affects me differently than it did when I was younger. One glass of wine at lunch, and my day is shot; I have to go home and sleep it off. All my friends say the same thing: a glass of beer is all it takes to give them a buzz, and the effects last a lot longer than they used to. I asked Jürgen Rehm, a research scientist at Toronto’s Centre for Addiction and Mental Health (CAMH) and one of the people responsible for establishing Canada’s Low-Risk Drinking Guidelines released in 2011 (more on this later), why this is so.
Dowsett Johnston, who stopped drinking five years ago, told me her alcohol dependency was a gradual process. A successful journalist, writer and mother, she used it every day to transition from work mode to home life. “I would come home, have a glass of wine while making dinner and, for many years, it was just that.”
But eventually, over about a five-year period, one glass led to two, led to three and then four, and she knew she was in trouble. She tried to stop, found she couldn’t and, in 2008, checked herself into rehab. As I listen to Dowsett Johnston’s story, I think, “Wow. Rehab for four glasses of wine? That could be me or some of my friends. But I can stop. I’m not an alcoholic. Or am I?”
The Diagnostic Statistical Manual of Mental Disorders (DSM-V) lumps all alcohol dependencies under the label Alcohol Use Disorder (AUD). There’s a test developed by the World Health Organization, which you can take online, to determine if your alcohol consumption may be dangerous. It’s called the Alcohol Use Disorder Identification Test or AUDIT. A score of seven or more in women indicates “a strong likelihood of hazardous or harmful alcohol consumption.”
Epstein identifies a subset of women whose drinking problems develop in late adulthood. “People in the second half of life can develop a problem when they never had a problem before,” she says.
They may be adjusting to an empty nest, have more time on their hands and a feeling of less purpose in their lives so they drink to fill the time. Or they’re part of the sandwich generation caring for aging parents and adolescent children while holding demanding careers. “There are many pathways to alcohol dependence,” she says. And with women in general, there is what Epstein refers to as a “telescoping effect” compared to men. Women typically develop alcohol use disorders later than men but tend to develop physical and medical problems related to alcohol more quickly than men once they begin drinking.
As Dowsett Johnston observes: “Problems with alcohol are progressive. What was fine for me in my 40s was not fine in my 50s.” Epstein confirms this. “Women at any age are at a higher risk [than men] for developing alcohol-related physiological and psychological problems but, as women age, their vulnerability is heightened.”
All this has convinced me I probably do have an alcohol dependency. I tried another online test (they’re all over the Internet. Just Google “Do I drink too much?”), and it rated me as a “high-risk” drinker. Part of me wants to dismiss this as alarmist, a societal tendency to over-medicalize everything from shopping to sadness. But another part (the part that awakens at three in the morning in a cold sweat) knows I should do something.
It’s not just the fear of becoming an alcoholic that has me up at night though. I can still kid myself into believing I’ll manage that risk. Rather, it’s the health consequences of drinking that truly scare me. Drinkers are forever celebrating the fact that a daily glass of red wine lowers their risk of dying from heart disease (more than that, however, and your risk increases). But that “benefit” is pretty much cancelled out by alcohol’s harmful effects on your health. Rehm puts it succinctly. “Alcohol,” he says, “is a carcinogen.” For women, a big concern is the link between drinking and breast cancer. The Canadian Cancer Society says even moderate drinking (two drinks a day) increases the risk of breast cancer because alcohol is believed to increase estrogen levels and higher estrogen levels are linked to the disease. But drinking also causes many other cancers.
“Wherever alcohol touches the human body, there is a risk of cancer,” says Rehm. This applies to the pathway that daily martini takes on its way through your system: mouth, throat, larynx, esophagus, stomach, colon, rectum. And the more you drink, the higher the risk. As well, as we age, we are more at risk of developing such alcohol-related chronic diseases as liver cirrhosis, pancreatitis, hypertension and diabetes.
Okay, now I’m terrified. I remind myself that there are lots of other risk factors besides alcohol for getting cancer, but somehow it’s not a very comforting thought. Once again, with wistful resignation, I consider quitting drinking altogether.