Over the past fifty years, alcohol consumption has declined in France. However according to alcohol info service, the figures have not fallen since 2013. How can this be explained? This drop was “almost exclusively due to the decrease in wine consumption, especially at the table”, notes the site. In 2015, more than 41,000 deaths were still attributable to alcohol, 74% of which concerned men and 26% women. These would be at least 500,000 in France to suffer from alcoholism, according to the least pessimistic estimates.
“I have been seeing women in difficulty with alcohol for years. They represent 30 to 40% of our patients. But this figure has been increasing for 5 years”, observes Pr. Amine Benyamina, Head of the psychiatry and addictology department of the Gustave-Roussy hospital in Villejuif, contacted by Top Santé. Many professionals are sounding the alarm: alcoholism is not the prerogative of men, more and more women are now affected.
Alcoholism, the myth of “a man’s disease”
According to the website Addict’Aide.fredited by Fonds Actions Addictions, chaired by Amine Benyamina, it is estimated thatone woman in ten abuses alcohol in France. For the psychiatrist and addictologist, “The public authorities should carry out more campaigns, aimed at women in particular, on these diseases which are perceived as men’s diseases, but which also affect many women. This is the case for myocardial infarction for example, but also for alcoholism”, he complains.
What does the professional expect from such awareness campaigns? “It would allow these women to have the feeling of being heard”. And to come out of hiding. This is one of the characteristics of female alcoholism: hidden alcoholism. Because if a man drinks too much, he is perceived as a bon vivant, a woman who drinks too much is judged much more harshly. “Society does not forgive them. It sends back to these women the image of the unworthy wife, the unworthy mother… She is considered vulgar and depraved. Women live with their alcoholism even more difficultly, are ashamed and find themselves to be consulted late, sometimes at stages of somatic decompensation”explains Amine Benyamina.
Women more at risk of alcohol-related diseases
Women ask for help later than men, when faced with alcohol, they would be physically less well armed than the men. “Women share the same environmental vulnerabilities as men, but their individual vulnerability is greater than that of men. to alcohol more quickly and more severely than a man”underlines the addictologist.
Among these diseases attributable or related to excessive alcohol consumption: liver diseases such as alcoholic cirrhosis, cardiovascular diseases such as heart rhythm disorders, skin problems and diseases and certain cancers. “We now know with certainty that the prevalence of breast cancer increases in women alcoholics“, assures Amine Benyamina. What about neurological damage caused by alcohol? “From this point of view, the risks are equitably distributed between women and men.”
A less well detected addiction
Women are treated late, also because their alcohol dependence is less well detected by health professionals. “A woman is less suspected of being an alcoholic than a man. Some show no outward signs, no stigma, but suffer from real alcohol dependence. In these cases, detection and identification are more difficult to do and it is true that professionals have less of the reflex to ask the question. For men, identification is already complicated with a general practitioner, it is even more so with women”confirms the addictologist.
Psychiatric comorbidities
Other particularities of alcohol dependence in women, secondary alcoholism is more represented there than in men. What are we talking about ? “In secondary alcoholism, it is a question of using alcohol as an anxiolytic, to relieve depression, neurosis. Thus, in alcoholic women, we observe more psychiatric comorbidities, such as mood disorders , eating disorders, depressive syndromes”, says Amine Benyamina.
However, be careful not to oversimplify. Primary alcoholism, born of social and recreational consumption at the outset, also affects women. Moreover, the phenomenon of binge drinkingthis alcoholization which consists in quickly drinking several glasses of alcohol in a row during a party, affects young men as well as young women. “It’s a trend that has been around for several years now, alcohol remains the first drug available legally”, recalls our expert. However, these psychiatric comorbidities, as well as the late treatment of women, contribute to accentuate their vulnerability.
The need for better adapted care?
In 2018, the French Observatory for Drugs and Drug Addiction published the results of the Ad-femina survey on the specific reception of women in addictology. “Vulnerable populations identified as a priority”, women nevertheless only represented 23% and 18% of people cared for in addiction care, support and prevention centers (CSAPA) and in reception and support centers in harm reduction for drug users (CAARUD). However, note the authors, “these women testify, more than men, to numerous factors of socio-sanitary vulnerability (suicidal history, psychiatric comorbidity and excess mortality linked to narcotics, single parenthood, violence, etc.) and report a greater fear of stigma”.
The survey highlights in particular the low number of structures that offer specific support for women. However, targeted care, adapted to the specificities of their addiction, could encourage women to stop hiding.
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