Threat behind the party-girl image

IN recounting her battles with alcohol, author Koren Zailckas doesn’t skimp on the details -- her first drink at 14, the years of blackouts and hangovers, waking up in a strange man’s apartment and, finally, her embrace of sobriety at the ripe old age of 22.

Her story is notable because she crafted it into a bestselling book, “Smashed: Story of a Drunken Girlhood,” not because it’s rare.

Recent surveys suggest that today’s girls and college-age women are abusing alcohol in ways not seen in previous generations -- by binge drinking more often and at earlier ages. As a result, students such as Zailckas can be found in every high school and college in the nation.

Such drinking patterns have immediate consequences for young people of both sexes: They can lead to failure in school, increase the chances of a car accident and may even cause subtle brain damage.

For girls and women, however, the effects may be particularly dire.

They’re much more likely than boys or young men to experience physical and sexual assault while intoxicated. And studies show that alcohol takes a much greater physical toll on women than on men -- in a much shorter time. A rising rate of heavy drinking among today’s teen girls may signal a future women’s health crisis.

“Girls’ drinking absolutely has implications for their long-term health,” says David Jernigan, executive director of the Center on Alcohol Marketing and Youth. “They are hurting their odds -- a lot.”

Although the majority of adolescent girls and young women do not binge drink (estimates of those who do range from 16% to 27%), three reputable, national surveys suggest binge drinking is holding steady or increasing among girls even as such behavior is declining somewhat in boys. Binge drinking is usually defined as five or more drinks consumed in one setting.

Moreover, surveys show younger girls are starting to drink around the same age as boys and with similar drinking patterns.

Their choices are changing too. In 1991, 14% of the girls who binged said they drank hard liquor, said Jernigan, citing unpublished data from the most recent Monitoring the Future survey, a national poll conducted annually by the University of Michigan. But that figure had risen to 18.2% in 2004. The survey also showed eighth-grade girls with a higher binge drinking rate than eighth-grade boys: 11.8% versus 10.8%.

“The gender gap for young kids has effectively closed,” says Susan Foster, vice president and director of policy research at the National Center on Addiction and Substance Abuse at Columbia University. “If you look at eighth- and ninth-grade girls, they are drinking, smoking and using drugs at the same rates as boys are. But the main problem is that the physiological impact is much stronger on girls than on boys.”

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Gender-specific effects

Alcohol is dispersed in the body by water. The more water in the body, the more diluted the alcohol. Women have less water in their bodies and more fat, which holds alcohol. An enzyme, alcohol dehydrogenase, that helps metabolize alcohol is less active in women.

Thus, drink for drink, women’s brains and organs are exposed to a higher concentration of alcohol compared with men. For that reason, women are more likely to develop inflammation of the liver and to die of cirrhosis.

“We know that two years of a woman’s drinking equals 10 years of a man’s,” says Becky Flood, executive director of New Directions for Women, a nonprofit substance abuse treatment center in Costa Mesa. “What alcohol does to the body of a woman in her developmental years is very damaging. We even see cognitive impairment in women.”

Women are also more likely to become dependent on alcohol faster than men, says Foster -- which is why the statistics that show girls drinking at younger ages and drinking heavily by college age are of particular concern. A girl who starts drinking before age 14 is four times more likely to become an alcoholic than someone who didn’t drink before age 21.

Moreover, in one of the few long-term studies of college-age binge drinkers, researchers at the University of Washington found a link between bingeing in college and bingeing at ages 30 and 31.

“What our study suggests is adolescent girls who binge drink are three times more likely to binge drink in adulthood compared with adolescent girls who don’t binge drink,” says Carolyn A. McCarty, a research assistant professor of pediatrics at the University of Washington and lead author of a study that appeared in 2004 in the journal Pediatrics.

The rapidity with which alcohol problems can escalate in women should serve as a warning to girls and their parents, experts say. Episodes of getting drunk, throwing up, passing out or worse could be the start of long-term health problems.

“Alcoholism is a progressive disease. It’s very hard to define it in its early stages,” Flood says. “There is a fine, gray line of where it turns from abuse into alcoholism. But when you binge drink and have blackouts and can’t remember what happened or get a DUI, then the binge drinking already is a problem.”

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A search for answers

The changing face of alcohol use among girls has led to efforts to better understand why girls drink, how their drinking differs from boys and what measures are successful to prevent alcohol abuse.

Many substance abuse organizations have criticized the alcohol industry for advertising and marketing that, they say, may entice more girls to drink. The trend in sweet alcoholic beverages, such as “alcopops” (malt liquor drinks) and packaged cups of fruit-flavored gelatin and alcohol, may appeal more to girls and young drinkers, experts say.

Several other factors may lead adolescent girls to drink, including the desire to feel less inhibited in social situations, to control their moods and to compete with boys by showing they can drink as much.

Zailckas says alcohol helped her avoid some of the critical, but difficult, lessons of growing-up -- how to be socially adept, make close friends and become independent from her parents.

“I learned early on that those things were tough, and alcohol was a shortcut,” she says.

Foster says girls appear to be more influenced by their friends’ drinking behavior than boys are.

A majority of high school kids may not be drinking, says Elizabeth D’Amico, a clinical psychologist at Rand Corp. in Santa Monica, “but what gets talked about on Monday morning is who passed out or threw up in the bushes.

“What is really important to kids is what they think their peers are doing,” she says. “The key thing is perception -- it’s not necessarily reality.”

Problem drinking in women may also be more likely to escape attention from medical professionals. Women are less likely to seek or be referred for treatment than men -- and only 38% of substance abuse programs in the U.S. are designed for women, despite research that shows women do better in gender-specific programs, Foster says.

“We know a lot more now about women and alcohol. But the knowledge that has been generated has not made it into our medical practice,” she says.

Even doctors who treat teen-agers, she adds, need to be aware of the trends.

Adolescents need to be told that the dangers of drinking extend beyond drinking and driving, says Zailckas, who adds that the alcohol-abuse education she received in school and from adults was limited to warnings about drunk-driving.

“No one ever told me that alcohol affected me differently because I was female,” she says.