Alcohol Use Disorder Treatment in Women

Shelly F. Greenfield, MD, MPH, reflects on increased rates of binge drinking and alcohol use disorder (AUD) among women. AUD is a medical condition in which a person has an impaired ability to stop or control alcohol use, despite its negative impact on their health, relationships or work. The pandemic-related rise in heavy drinking builds on a concerning three-decade trend narrowing the gap in alcohol use among women and men.

Dr. Greenfield is a Mass General Brigham addiction psychiatrist, clinician and researcher. She is chief academic officer and director of the Alcohol, Drug, and Addiction Health Services Research and Education Program at McLean Hospital. Dr. Greenfield’s research focuses on treatment, gender differences, and health services as they relate to substance use.

“It's really important for women to educate themselves about drinking and the health effects,” says Dr. Greenfield. “If women have more knowledge, they can make decisions about their own health and well-being. There are many treatment resources that you can use to get well and stay well and to live a healthy life.”

Learn about AUD treatment options, including gender-responsive therapy tailored to women’s unique experiences.

The pandemic’s upheaval has deeply impacted American women, who are more likely than men to shoulder child-rearing and caregiving responsibilities. Lost child care support and remote learning for children forced women to juggle increased stresses at home. Many had to leave the workforce due to these new demands.

“In one study we have seen a 17% average increase in drinking days in women over the pre-pandemic baseline,” Dr. Greenfield says. “In addition, we've also seen in another study that as women's psychological distress to the COVID-19 pandemic increased, so did their consumption and that relationship was not observed in men.”

In The U.S. National Pandemic Emotional Impact Report, women younger than 50 reported more changes relative to men of the same age in terms of sleep, health worries, productivity, mood, and frustration with not being able to do as many enjoyable activities. Women with children younger than 18 also reported elevated rates of anxiety symptoms compared to women with no minor children, as well as compared to men who had children of similar ages.

If you’re concerned that you’re drinking more alcohol to cope with stress during the pandemic, you’re not alone. Use this tool to screen for unhealthy alcohol use and talk to your primary care provider (PCP) or mental health care provider. Together, you can develop a plan to reduce or stop drinking alcohol.

Treatment plans for alcohol use disorder

There are several evidence-based treatments available for AUD. Your health care team works together with you to develop a treatment plan tailored to your condition and needs. Personalized plans are important because one treatment approach may work for some people with AUD, but not for others.

“Women often cite lack of child care or financial resources as barriers and obstacles to their getting treatment,” Dr. Greenfield notes. “Family members, such as children and other loved ones, also can be powerful motivators for seeking treatment and getting well.”

AUD treatment plans may include one or more of these approaches in outpatient and/or inpatient settings:

• Medications
• Behavioral treatments (also called alcohol counseling or talk therapy) including group therapies, such as gender-responsive therapies or family group therapy
• Mutual-support groups

People in treatment for AUD can experience setbacks to their recovery. Seeking professional help earlier can prevent return to drinking and enable longer-term recovery.

The U.S. Food and Drug Administration (FDA) has approved three medications to help people stop or reduce their drinking and prevent relapse: naltrexone, acamprosate, and disulfiram. These medications may be used alone or combined with behavioral treatments including group therapies and mutual-support groups.

Some people with AUD who decide to stop drinking require medications to help manage alcohol withdrawal symptoms safely. In some cases, alcohol withdrawal can be a life-threatening process if not appropriately treated and managed. This can happen when someone who has been drinking heavily for a lengthy period of time suddenly stops drinking.

Licensed therapists offer these treatments to help people change their drinking behavior. Behavioral treatments may include:

• Brief interventions and reinforcement approaches
• Group therapies including gender-responsive treatments or family group therapy
• Treatments that build motivation and teach skills for coping and preventing relapse
• Mindfulness-based therapies

“For many women, gender-responsive therapies will be helpful and effective,” says Dr. Greenfield. “At McLean and Mass General Brigham, with the support of funding through the National Institute on Drug Abuse, we have developed a gender-responsive group therapy for women with alcohol use and other substance use disorders called the Women's Recovery Group or the WRG. This women's recovery group is based on research that shows that it's an effective approach for treating women with alcohol use and other substance problems.”

Gender-responsive group therapies for women use content focused on women’s unique experiences and needs. Group members may have a variety of substance use challenges, co-occurring mental health conditions, or be in different stages of life.

Family group therapy is another treatment option that may involve spouses, partners, caregivers, children, siblings, and even friends. These types of programs can help improve relationships and provide additional support for the person in treatment or recovery.

In mutual-support group meetings, like Alcoholics Anonymous (AA), participants provide peer support for stopping or reducing drinking. Group meetings are available in most communities, at no cost. They may meet up in person at convenient locations or virtually. Support from others with similar experiences can be especially helpful to people at risk for relapse to drinking.