I like to drink. I usually have a glass of wine (or two) with dinner, or to unwind after a long day. I like a good bourbon, an interesting amaro, a creative cocktail. Most of my favorite hangouts are bars. I drink to celebrate and to socialize. I even work for a vermouth company. Drinking, for me, is one of life's fundamental pleasures. So I was fascinated by Ann Dowsett Johnston's "Drink: The Intimate Relationship Between Women and Alcohol," a combination alcoholism memoir and investigation into the female world of boozing. Dowsett Johnston uses her own dawning realization that she has an alcohol problem to look at female alcoholics, and what she believes to be an under-recognized epidemic of women drinking to excess. She's correct that female alcoholism doesn't get the public health and media recognition it deserves, and that female problem drinkers face a different set of challenges and circumstances than men. She's correct that the alcoholic gender gap is closing.
The overarching problem with women and alcohol, though, doesn't seem to be an epidemic of female alcoholism. The problem is a drinking culture that increasingly looks like American food culture: prioritizing excess over enjoyment, mass-marketing cheap processed products, blaming consumers for the bad outcomes of products pushed on them by large companies, and promoting over-consumption as a substitute for pleasure. And it's a sexist culture that wrings its collective hands over female "bad behavior" and uses the specter of sexual assault to keep women fearful, while simultaneously applauding recklessness and aggression in men.
Dowsett Johnston is Canadian and focuses many of her interviews on Canadian women, but she's right that more women in the United States are problem drinkers than ever before. That said, "more women than ever before" doesn't translate into "as many women as men." Men still drink much more in volume and more often than women, and are more likely to be binge drinkers and alcoholics. Nearly half of American men -- 42 percent -- have at least three drinks per day. Only one in five women drink that much. Of course, women tend to weigh less than men, and our bodies metabolize alcohol differently, meaning that on average, it takes fewer drinks to get us drunk. But only about half of Americans are even regular drinkers, and 35 percent don't drink at all. As far as epidemics go, I'm not sure women drinking heavily is one of them.
That said, alcoholism is a real problem, accounting for 2.5 million deaths annually across the globe. Even where alcoholism doesn't kill, it damages -- alcohol abuse has a litany of potential consequences, including cirrhosis of the liver, early death, increased risk of suicide, alcoholic hepatitis, gastrointestinal problems, increased vulnerability to other addictions, and a long list of others. The problems stemming from alcohol abuse shouldn't be whitewashed or downplayed, and much of the conversation and imaging of alcoholism revolves around men. That Dowsett Johnston is trying to turn our collective gaze toward women is commendable.
But the lines between use, abuse and addiction are not always totally clear, and there's a marked lack of nuance (not to mention honesty) in discussions of alcohol use. Admit to having three or four drinks on one particular night, and some who have been through the hell of alcoholism will insist that you have A Problem. Push back against frat boy drinking culture and you're a Puritan. Recognize that nearly all of us will get a little too liquored up a handful of times in our lives and, if you're a woman, expect someone to wag their finger at you and insist that by getting drunk you're going to get yourself raped.
The link between alcohol and sexual assault is well-established, with drinking involved in about half of assaults. But the takeaway from that statistic is often misguided, with women told to avoid drinking in order to avoid rape. In fact, it's sexual assault that often leads to problem drinking: Dowsett Johnston points out that the No. 1 indicator of whether a person will begin drinking at a young age -- a major predictor of alcoholism -- is a history of sexual abuse or trauma. She quotes one researcher as saying that "sexual abuse accounts for twenty percent of binge drinking, and sexual harassment for fifty percent. If we want to get a handle on problematic drinking in adolescence, we have to focus on violence in our society."
I'd rephrase that slightly: If we want to get a handle on problematic drinking in adolescence, we have to focus on gendered violence in our society.
Another alcohol treatment counselor for young people tells Dowsett Johnston she sees young women who have survived "a lot of sexual trauma, whether they were sober or under the influence. They think if they were drunk, it doesn't really count because it was their fault. A lot of rape. Certainly, a lot of PTSD. And we can see a rise in substance use right after the event."
In other words, for a lot of women, sexual assault didn't happen because they were drinking heavily. They were drinking heavily as a reaction to sexual assault. Lecturing women about how drinking will get you raped doesn't seem to have convinced women to give up drinking en masse, but it has added another level of shame and self-blame for women who are sexually assaulted after drinking.
About half of men who commit sexual assault were under the influence of alcohol, often drinking with their victim. The overwhelming majority of men aren't rapists and don't use alcohol as an excuse for violence, but the small number who do tend to also hold regressive views about women (for example, that men should initiate sexual activity and women should resist it) and stereotypes about women who drink (that they're sexually available, that they're promiscuous, that they have poor moral character). The men who commit sexual assault and rape also tend to respond aggressively and angrily when they feel they've been sexually led on by a woman attempting to establish her sexual boundaries.
An aggressive, hyper-masculine drinking culture coupled with stereotypes about women, drinking and sex and the blame heaped on women who are assaulted while intoxicated gives those small number of rapists license to operate. Dowsett Johnston points to that disordered drinking culture as well, noting that women feel they have to go drink for drink with frat boy antics of downing shots of cheap liquor and pounding beers. It's a fundamental part of a sexist culture to denigrate things that read as "feminine" and therefore weak, and so few women want to be the girl who can't keep up with the boys. Most men and women drink responsibly. But in certain arenas -- college campuses, fraternities, Wall Street -- heavy drinking is a cornerstone of the bro culture.
Even outside of those enclaves of bro-dom, the values carry over. It's about drinking to get drunk, yes. But over-consumption and valuing having more over having better is hardly unique to boozing. Call it the Olive Garden-ization of drinking: taking pleasure in the ability to drink a lot for cheap, the same way we enjoy unlimited breadsticks of questionable nutritional value and taste mostly because they're cheap and there are a lot of them. Our pasta comes in huge bowls, covered with processed cheese and factory-farmed antibiotic-laden meat. Martini glasses come in enormous sizes, full of artificially flavored spirits. It's certainly not uniquely American, but the way Americans eat is a particular cultural trait (and one that we're rapidly exporting). That our drinking reflects that same valuing of low-cost high-volume consumption shouldn't be a surprise.
Neither should some of the Frankenstein products on the market, made with hyper-processed ingredients and unpronounceable chemicals and aggressively marketed to either men or women. That many beer and spirits brands lazily rely on titty ads to sell their products to men is not news. That many of those same brands now market cheesy low-calorie drinks to the many women who want to look like the girls in the titty ads is a more recent development. The production of bizarre, artificial-sweetener-heavy alcoholic beverages has paralleled the massive increases in consumption of sugary non-alcoholic beverages like soda and energy drinks. In the 1980s and '90s, while the cola companies were pushing for "supersizing" of their drinks and watching sales skyrocket, beverage manufacturers began to sell products like wine coolers (low-quality wine or malt mixed with sugar and fruit flavoring) and other flavored malt beverages (Smirnoff Ice, Zima, Mike's Hard Lemonade) in the United States and Canada. Their ingredients are cheap, and their saccharine sweetness fed the growing American taste for sugar -- it also covered up the taste of the alcohol, making it easier to consume larger quantities. The point isn't an alcoholic beverage to drink as an enjoyable part of a celebration or a relaxing indulgence; the point is an alcoholic drink that doesn't taste like alcohol, so you can get drunk faster. That the low-calorie versions of these products are marketed to women is the sexist piece of a bigger problem.
For women in particular, pleasure in indulgence is a fraught thing -- we're being "bad," we're "cheating" on our diets. So we drink Skinny Girl margaritas or bland vodka sodas, or we simply don't eat before a night out drinking to save the calories. Opening up space focused on enjoyment instead of consumption or keeping up -- to value complexity in taste, the effort put into the craft of a beverage -- shifts that frame away from self-loathing and toward an appreciation of booze as a remarkable and often delicious human creation.
That won't end alcoholism -- there will always be people for whom alcohol is an addiction, and for whom that reality must be met with care and empathy instead of shame. It won't end a culture of misogyny that contributes to alcohol abuse in women. But it just might lead to healthier and happier options for the women in the vast middle, who aren't the subject of Dowsett Johnston's or any other book on female alcohol abuse, but who nonetheless live in a disordered culture when it comes to gender and liquor.
A pleasure-centered drinking culture instead of a consumption-centered one isn't a magic booze bullet. But it's better than what we've got, and certainly far better than the portrait of North American drinking that Dowsett Johnston paints in her book. And I'll raise my glass to that.