Women, Alcohol, Anxiety—and Why AA Might Not Work

More Women are Suffering from AUD and anxiety than ever before
Photo by Sascha Berner for Unsplash

Women are drinking alcohol more than before. But the most common treatment option for addiction, Alcoholics Anonymous (or AA), may not be of much help for women with anxiety.

Last year, the medical community and news media alike learned about a recent, alarming development in women’s drinking habits. According to a study published in JAMA Psychiatry, the number of women who drank alcohol rose sharply between the early 2000’s and the early 2010’s. More women were drinking at risky levels. And women with Alcohol Use Disorder—what many people commonly refer to as “alcoholism”—jumped 84 percent, one of the largest leaps of any subgroup.

It’s unclear why the number spiked, but it could be because there were many more women in the workforce than before, perhaps increasing stress levels. One analysis of alcohol-dependent men and women revealed that more than 60 percent of women also had anxiety, while only about a third of men did. This suggests that women are more likely to use alcohol to treat the issue.

If those 60 percent of anxious women drinkers want to overcome their addiction, they have another big problem. The most popular treatment option may not be the best suited for them. The option? Twelve-step programs, the most common being Alcoholics Anonymous.

A 2010 study found that women with social anxiety had much higher relapse rates than men and non-anxious women after completing a 12-step program. Forty percent of men both with and without social unease relapsed into drinking by the end of the program. For women without these issues, the percentage was the same. But for women with social anxiety, the relapse rate was 60 percent. Statistically, that’s a huge difference.

So why don’t socially anxious women get as much out of AA?

It seems their anxiety interferes with the program’s core elements of participation. A good chunk of AA’s benefit comes from its social elements—speaking up in group sessions, obtaining a sponsor, and reaching out to that sponsor when you fear you’ll relapse. But multiple studies have found that mere attendance at AA sessions doesn’t have a significant effect on drinking patterns. You tend to get a lot out of AA only when you actively engage in it.

Engaging in group therapy isn’t easy for everyone, especially socially anxious women. One study found that those with social anxiety were significantly less willing to speak up in group situations or to seek out a sponsor. The 2010 study about relapse rates linked a lower likelihood of obtaining a sponsor with socially anxious women’s hesitance to speak up.

What are the alternatives to Alcoholics Anonymous?

We know that 12-step programs like AA can work for some, but they don’t work for all. AA was created in 1933, and since then, there have been many advances in understanding how addiction works on the brain. As addiction specialists, we approach alcohol dependence in a way that’s proven to be more effective than 12-steps or abstinence alone.

At Ria Health, our medically managed program lets us move away from an abstinence-only-based model. We opt for a more individualized approach, focused on achieving your goals, rather than someone else’s. Meetings with our medical team are done one-on-one from your phone, wherever and whenever you feel comfortable. Our registered recovery coaches are there as your confidants and lifeline. They support you, encourage you, and help you with whatever setbacks you may encounter along the way.

To learn more about how Ria Health helps people to moderate their drinking, visit here. Interested in getting started in the program? Click here.

What do you think? Want to hear about how alcohol impacts a different group of people? Feel free to leave a comment below.

John E. Mendelson, MD is the co-founder and chief medical officer of Ria Health

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