Would it surprise anyone to know that men are more likely than women to drink to excess?
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According to the CDC (Center For Disease Control) “Men are more likely than women to drink excessively. Excessive drinking is associated with significant increases in short-term risks to health and safety, and the risk increases as the amount of drinking increases. Men are also more likely than women to take other risks (e.g., drive fast or without a safety belt), when combined with excessive drinking, further increasing their risk of injury or death.
Drinking levels for men
- Approximately 63% of adult men reported drinking alcohol in the last 30 days. Men (24%) were two times more likely to binge drink than women during the same time period.
- Men average about 12.5 binge drinking episodes per person per year, while women average about 2.7 binge drinking episodes per year.
- Most people who binge drink are not alcoholics or alcohol dependent.
- It is estimated that about 17% of men and about 8% of women will meet criteria for alcohol dependence at some point in their lives.
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For the past 30 some years, I have been witnessing the dynamics between men and women when it comes to addictions and recovery. Ever since I was a wet behind the ears newbie to the field in the early 1980’s, providing substance abuse prevention education via the S.O.B.E.R (Slow On The Bottle Enjoy The Road) Project to teachers so that they in turn could teach their students, I had been fascinated with the differences. Later on, as a therapist, it lent itself to the possibility of becoming more adept at reaching male clients who might otherwise not respond to a cookie cutter, one size fits all approach to treatment.
when the pleasure of living a sober life is more powerful than the pain of remaining in the throes of addiction, it will become easier to do what is necessary to put down their drug(s) of choice.
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These days, I spend much of my time sitting in an office with male and female clients; some one on one, some with their significant others and some in groups in my role as a therapist at Rehab After Work . An outpatient treatment center for those desiring recovery from addictions, it is a flexible program that adapts to work and school schedules. The reasons for walking through the doors are as diverse as the people seeking treatment.
A cautionary note: what you are about to read constitute observations rather than hard and fast rules for men and women, knowing that there are exceptions to every rule.
What I have noted is that male clients are more likely to schedule appointments as a result of contact with the legal system, having been charged with DUI (Driving Under The Influence), possession, some type of violent crime or because their employer, partner or spouse has given them an ultimatum. Female clients are more inclined to come in because they are receiving pushback from family members. Not that women don’t incur legal or professional impact, but these incidents are in the minority. When I have worked with those factors in mind, I have been able to tailor responses.
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Some in treatment have gone through the dizzying revolving door numerous times, wondering when they will pass through it for a final time and choose to remain on this side of their ingrained patterns. What I tell them is that when the pleasure of living a sober life is more powerful than the pain of remaining in the throes of addiction, it will become easier to do what is necessary to put down their drug(s) of choice. I know that sounds counterintuitive, but when someone is accustomed to pain, their ‘rock bottom’ becomes cavernous and goes to what may seem like the Earth’s inner core.
I recently spoke with my co-worker Glenn Gausz, CADC, CCDP (alphabet soup letters that stand for Certified Alcohol and Drug Counselor and Certified Co-Occurring Disorders Professional) who has been in the field for 26 years, and we mused about the differences between the male/female factors that play into addictive behaviors and healing through them. Glenn is my go-to guy when I want to get into the nitty gritty of why our clients continue to engage in destructive activity, despite running through the cost-benefit analysis that I have them do with the cost of using far outweighing any potential benefit. He knows the dynamics inside and out and can pull a metaphor, slogan or AA concept out of thin air. One of his specialties is working with men who are facing the addictive demons that roar seemingly unceasingly and walking with them through to the other side. He neither takes credit for their recovery, nor blame for their relapse.
Men tend to drink in bars and at sporting events, so the behavior is ‘normalized’, tribalized and reinforced.
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In our conversation, we observed:
Men’s addictions are more multi-generational which while they may be genetic in origin, they are also social, since men tend to drink more in groups while women tend to drink more alone.
Men tend to drink in bars and at sporting events, so the behavior is ‘normalized’, tribalized and reinforced.
Men often equate drinking and being able to ‘hold their liquor’ as a measure of machismo.
Women are more inclined to drink wine, while men indulge in beer and hard liquor; although I have seen exceptions to the rule.
Women are more likely to misuse prescription pills (benzos and opiates) while men go for street drugs such as heroin and cocaine, although of course, there are exceptions.
Getting to the emotions that underlie substance abuse comes more readily to women than to men, since women are encouraged to express feelings, while men are societally sanctioned if they do so, unless the emotion is anger.
Although both genders self medicate, men more often do so to manage work and financial stressors, while women do so to deal with family pressures.
In each case, childhood trauma can play a role, with many drinking or drugging to mask feelings that would otherwise be too painful to face.
Denial of addiction seems to be stronger in men since, as long as they can ‘function’; ie: go to work and pay the bills, then the problem is not seen as severe enough to warrant change.
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I remind my clients that sobriety/abstinence and recovery are not the same thing. My take on it is that recovery is a mind-body-spirit endeavor that engages every aspect of their lives. For some, it is the first time they have ever expressed self compassion, taken responsibility for choices, prayed, meditated, eaten healthfully, really been present with the people around them. I tell them that there are no taboo subjects since every thought either feeds or starves the addiction. Although single sex support groups with a therapist of the same gender lends itself to greater disclosure (I facilitate a weekly women’s group and mixed gender recovery skills group that at the moment, consists only of men), I have discovered that some male clients are willing to bare their souls to this female therapist. Discussions have run the gamut from regaining a sense of self worth after losing nearly everything to having sober sex; since some men have expressed only feeling comfortable approaching a woman if either or both of them are under the influence.
I often ask them, if they happen to be in a relationship, if they are committed to monogamy. Although I’m sure I have seen clients who are in poly relationships, most assure me that they are monogamous. I shake my head and tell them that as long as there is a substance between themselves and this other person, then it is like having another partner that the other person didn’t agree to, or if they did, had no clue how much havoc it would wreak in their relationship. If they both have an addiction, then it is like four people in a relationship and that gets really complicated! Some shake their heads in amazement and say they never thought of it that way. We then talk about breaking up with the substance and the behaviors that allowed it to take precedence in their lives.
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Many men in the recovery process find the concept of surrender to a Higher Power; whatever that means for them, to be as terrifying as bungee jumping off a bridge. In fact, some would rather do that than to admit they ‘were powerless over’ their addiction or anything else for that matter. Although women certainly have their share of control issues, I have felt that more of my male clients have difficulty relinquishing the reins. God talk is equally challenging, since they may feel that that is the very ‘entity’ that put them in their situation in the first place, or didn’t rescue them from it. I then remind them about the 12 step concepts of The God of Our Understanding (and mine changes from moment to moment) and GOD as Good Orderly Direction.
What’s encouraging is that I have seen what occurs when a man is willing to take that same determination with which he fiercely held onto the addiction that was really holding on to him and surrender to the reality that “sobriety is a journey, not a destination”.
photo credit: everystockphoto/hildgrim
Edie – Thank you for continuing to write such great content for GMP. Your no-nonsense, based on observation approach is refreshing and clear. Thank you. Blessings for your brothers at the ManKind Project.