Alcohol is killing more women than ever – we need to talk about why

I was offered “mommy juice” for the first time about a dozen years ago, when my son was old enough to want to hang out with his own friends but not yet old enough for a "drop-off playdate." It’s a situation that’s awkward for everyone too old for diapers: You’re spending time with a stranger while nervously hoping your child doesn’t expose you as an “imperfect” mom. So although I have never been much of a day drinker, I eagerly accepted a frosty glass of Sancerre, and as the crisp liquid hit my throat, I viscerally appreciated the meaning of “mommy juice”: Alcohol did feel like the perfect pairing with the all-consuming endeavor of motherhood. 

And not just the overwhelming role of motherhood — alcohol can seem to instantly soften the edges­ of the burdens of womanhood more generally. While our culture’s reactions to this reality careen from celebration of rosé-infused girls’ weekends to complacency about college binge-drinking to condemnation of women who get “sloppy drunk,” a new CDC study shows that women of all ages and backgrounds are drinking and dying of alcoholism in greater numbers than they were 20 years ago. In order to move forward, we urgently need to understand how we got here.

First, the data: In the approximately two decades this study surveys, men and women are all drinking more, and dying of alcohol-related disease with greater frequency. While men are nearly three times more likely to die of alcohol-related causes than women, this gender disparity has recently been narrowing especially rapidly: From 2018 to 2020, women’s rate of alcohol attributed deaths increased by 14.7 percent, while men’s jumped by 12.5 percent. More recent shorter-term studies and qualitative accounts suggest that the increased care labor borne by women and “claustrophobic mania” of the pandemic, as author Angela Garbes poignantly describes it, have only intensified these trends. Notably, this acceleration is not limited to affluent “wine moms” (a group condemned as negligent even as they’re marketed cutesy merch) but is evident across race and region, and is especially pronounced among women over 65.

What’s going on? The study makes no claims as to causality, only gesturing to “the normalization of alcohol use for female individuals in society.” This normalization, and our deep ambivalence about it, goes back to the 19th century, when our current moment would have been unfathomable. Temperance was a key organizing issue for women’s rights activists, and women reformers (some already self-described feminists) located “demon rum” at the root of many social ills: wages squandered at the saloon, infidelity and domestic violence. But they considered excessive alcohol consumption as mostly men’s concern, and combating it as the responsibility of inherently virtuous women whose highest purpose was to defend the domestic sphere. But the underlying assumption — that women were too morally pure (and fragile) to abuse alcohol — was not exactly feminist. And it was often expressly classist and racist, as temperance reformers and their “dry” candidates caricatured working-class immigrants and Black people as undisciplined drunks in need of civilizing through sobriety.

Women were never entirely absent as consumers (or producers) of alcohol, but the Prohibition era of the 1920s, ushered in soon after women won the vote, radically reshaped notions of femininity in ways temperance advocates could hardly have anticipated. Illicit economies around alcohol opened up social spaces for men and women to drink together and, along with higher hemlines and smoking cigarettes, ironically linked alcohol consumption with liberation.

More recently, as the spirits industry has expanded, alcohol consumption has become not only acceptable but has been aggressively marketed to women as a form of empowerment — arguably intensifying social pressure to imbibe. Fruity wine spritzers, clear low-calorie liquors and Cosmopolitans are only a few of the options sold to women as liquid signifiers of fun, freedom and sophistication. Even grabbing a beer or slugging shots with the guys can carry invaluable "cool girl" cred, Sarah Hepola suggests in her memoir "Blackout."

This framing of libation as liberation, mixed with historical ignorance of the insidious obstacles women face, has long been a way to survive a sexist society rather than remake it. Teen girls — who already navigate subtly shifting social messages to be sexually available but not too available — understandably may binge drink as a way to alleviate such pressures. “Ladies’ nights,” fueled by drink discounts, are presented as a boon to women who want to let loose like men, but are often a way for bar owners to use buzzed women as bait to lure male customers. The workplace, which still favors men in virtually every regard, from presence in management to earning power, can create extra pressure to network at events where alcohol flows. Social expectations to marry and have children persist, but now alongside an expectation to stay “fun,” such that bachelorette parties and even baby showers can come with signature cocktails. 

It’s an American tradition to sell individual women ways to induce a chemical calm rather than actually address the larger systemic imbalances that produce their stress and anxiety. In the 1950s, doctors prescribed Valium (known colloquially as “mother’s little helper”) to anxious homemakers who were told their unease was a symptom of psychological maladjustment rather than a rational response to the constraints of an unequal society. Today, a raft of cannabis products, like bath bombs and baking accessories, are marketed to women in hip packaging, but make the same promise to ease the unremitting pressures of womanhood. Few of these products are problematic on their own, but in the aggregate they suggest how insufficient a few (more) drinks are as a solution to feelings of overwhelm, yet how understandable it is to resort to them.

A path forward can be hard to discern. Sobriety — in the spirit of “clean” consumption — is apparently a hot wellness trend, even as Americans continue to drink. Studies show even small amounts of alcohol can be harmful, while much popular advice settles on the old saw that moderation (apparently up to half a bottle of wine a day!) is perfectly fine for most people. Cold-turkey programs like Alcoholics Anonymous can be life-saving, but are also criticized as oppressively moralizing and even as perpetuating patriarchy. By contrast, harm reduction approaches can fail to highlight the unique risks of intoxication to women.

What is clear is that women are at unique risk for alcohol-related illness, a risk that’s exacerbated by the fact that many interventions are designed for men, and our deep-seated ambivalence and historical ignorance about women’s relationship to alcohol is not helping. Acknowledging and addressing this public health emergency means letting go of outdated notions about women’s inherent virtue and purity, along with equally shallow ideas that link women’s empowerment to the consumption of alcohol. There is no one answer to this crisis, but refusing to reckon with its historical roots — or the structural factors that make alcohol so appealing — is not an option.