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The ‘pinking’ of a problem

Women’s rates of alcohol use are a social problem not often discussed

In the dark times in Ann Dowsett Johnston’s life, alcohol was the uninvited guest at the table.

As Dowsett Johnston has described it, he starts as an elegant stranger in the corner, but turns into a stalker you can’t escape, no matter how many times you move or change the locks.

When you’re an addict, alcohol will find you.

He found Dowsett Johnston early. As the daughter of two alcoholics, she learned young about the demon booze. She knew it wasn’t always found on skid row or under a bridge.

“I grew up in a home with lots of Group of Seven paintings on the wall,” she says — and a mother who was addicted to both alcohol and Valium. It was classic Betty Ford territory.

As an adult, she thought she knew enough about booze and its destructive path to protect herself. But alcohol knew better.

Dowsett Johnston was a high achiever — an award-winning journalist at Maclean’s for much of her career. Then in her 50s, after she had become vice-president of McGill University, she was hit with loneliness and depression.

At the end of a long workday, she’d pour herself a glass of wine. “One or two became three or four,” she said.

“I drank way more than I should have and probably a lot less than you’re thinking,” she told a West Vancouver audience at the Kay Meek Centre recently.

She isn’t alone.

According to figures from B.C.’s Centre for Addiction Research, rates of alcohol consumption among both men and women shot up between 1998 and 2008 — before starting to fall again after the economic recession hit.

In the province as a whole, addiction researchers have seen estimates for the number of drinks consumed annually go from about 480 per adult in 2002 to 492 in 2013.

Those numbers vary considerably by region. In the local health region in 2012, figures ranged from just under 460 drinks per adult per year in North Vancouver to 502 in West Vancouver and Bowen Island.

Those statistics come primarily from data on alcohol sales.

When asked in surveys, most people will “hugely underestimate” the amount they drink, said Dr. Tim Stockwell, director for the Centre for Addiction Research. “It covers less than 40 per cent of the alcohol sold,” he said. “It’s not all being consumed by tourists.”

For a long time, Dowsett Johnston didn’t think she had a problem, because she didn’t resemble the violent alcoholic her mother had been.

“I didn’t crack up a car. I didn’t lose my family. I didn’t do all those things that my mother did.”

But as Dowsett Johnston has since come to realize, “I’m actually the poster girl for the modern alcoholic because she looks like me.”

It’s a message Dowsett Johnston wants more people to hear — especially women and those who make public policy around alcohol.

Women are driving up rates of drinking in most countries at an alarming rate, she said. Many of those women are highly educated, professional people — not what people think of as a “typical” alcoholic.

In fact, wealthy middle-aged people are more likely to be regular drinkers than those with lower incomes, according to the Centre for Addictions Research.

“We tell women they have to be perfect at work and perfect at home and perfectly thin and perfectly behaved,” said Dowsett Johnston.

When the pressure gets too much, a lot of women reach for a drink, something Dowsett Johnston calls “the modern woman’s steroid.”

“For a lot of women it’s becoming a problem,” she said.

“We don’t think of the fact that in these homes all around us there are many alcoholics.”

That’s something Dr. Marie Durnin, a physician who works with addicts, can attest to.

“Behind closed doors there is a lot of abuse of alcohol going on,” she says.

Women in high-powered jobs with family obligations at home drink to cope, she says.

“None of us have the time to deal with things in the old-fashioned way, like taking the dog for a long walk. We go home for the second shift.”

While men more often drink to heighten positive feelings and combine their drinking with social situations, women who are heavier drinkers often do so to deal with negative feelings like stress and depression.

Durnin says many middle-class women who fit that profile will mix alcohol with anti-anxiety drugs like Atavan and Xanax.

In that situation, “It isn’t just one plus one makes two. It’s one plus one makes four,” she says.

Dowsett Johnston has first-hand experience with being a secret drinker. She hid it so well that “My best friend thought I was lying when I went to rehab,” she said. “There’s a massive amount of shame involved.”

That stigma is something Brenda Plant, executive director of the Turning Point Recovery Society, says she’s constantly battling.

“I promise you there are women sitting in the British Properties who are drinking all day and probably popping the odd benzo who are terrified of asking for help because they are so afraid of being stigmatized,” said Plant.

“As the nurturer and the mother and the parent, it’s just that much more shameful.

“It’s a complicated social issue to address,” she said. “What are our attitudes to women in society in general? Then add alcohol to that.”

Turning Point opened the first nine-bed recovery centre for women on the North Shore in August of last year, offering three to five month residential treatment programs.

More than 30 women have gone through the program so far and there are another 31 on the waiting list.

Plant estimates about 60 per cent of the women who attend the recovery centre are from the North Shore. The average age of those seeking help is 40. Over a third of them have university degrees.

In 2011, Dowsett Johnston was awarded the prestigious Atkinson Fellowship to research and write a series of articles on women and alcohol, published in the Toronto Star.

But she didn’t tell her own story until she published a book on the topic, Drink: The Intimate Relationship Between Women and Alcohol in 2013.

There were those who warned her not to go public.

But Dowsett Johnston — who spoke earlier this month at a talk hosted by Bowen Island’s Orchard Recovery Centre and West Vancouver MP John Weston — thinks the increasing rates of women’s drinking is an issue that needs to be publicly discussed.

Women are playing catch up to men in rates of alcohol consumption worldwide. But women’s bodies don’t process alcohol in the same way as men. Not only are women smaller, with a greater percentage of body fat but we also have much less of a key enzyme in our stomachs that helps metabolize alcohol, she said — meaning for women, more alcohol enters the bloodstream than it does for men.

“We become addicted faster and we suffer the consequences faster.”

Women’s drinking can take a variety of forms — from steady, daily drinking more common among women in their 40s and 50s to the “weekend warrior” pattern of binge drinking in younger women.

Both are exacerbated by deliberate marketing of alcohol to women — what Dowsett Johnston calls “the pinking of the market” — that’s been going on since Carrie Bradshaw downed her first Cosmopolitan in Sex and the City. It’s continued as the Real Housewives staggered their way from their West Vancouver mansions to their Whistler condos with their champagne and vodka. It’s progressed to the likes of Skinnygirl cocktails and Happy Bitch wines.

Women go to book clubs, which have become “wine clubs.” Some young women think of booze like a food group when it comes to counting calories, said Dowsett Johnston.

But most women don’t know more sinister facts about alcohol consumption, like the one linking 15 per cent of breast cancer cases to alcohol consumption, along with several digestive system and liver cancers.

In the United Kingdom — which Dowsett Johnston calls the Lindsay Lohan of the international community because of the country’s rates of alcohol consumption — some young women are even dying of end-stage liver disease — usually an old man’s disease. It’s no coincidence alcohol is cheap there, she said.

“Whether you put alcohol in corner stores and make it cheap is going to have a really big impact on how you and your neighbours drink.”

Binge drinking among teenage girls is another worrying trend, says Durnin. “They drink a lot very fast,” she says. Girls who pound vodka coolers — sometimes mixed with caffeine-laced stimulants like Red Bull — shoot their blood alcohol levels up dangerously quickly, she says.

According to the most recent adolescent health study conducted by the McCreary Society, binge drinking among teens — both boys and girls — is still a problem on the North Shore. Among those who said they’d tried booze, 50 per cent of local teens said they’d had five or more drinks within a couple of hours on at least one occasion in the month before the survey.

Dowsett Johnston says there’s still no real public health dialogue about our drinking habits.

“We know all about trans fats. We know all about gluten-free diets. We know all about tanning beds but we tend to look at a glass of red wine like dark chocolate or vitamin D — good for us,” she said.

Dowsett Johnston knows it’s not a popular topic.

“We don’t want to hear that there’s something wrong with the one thing we look forward to at the end of the day or the end of the week. Nobody wants to hear that.”

But she thinks more people — especially women — need to know about the dangers of risky drinking.

Risky drinking for women is defined as four or more drinks on any one occasion. Doctors recommend women have no more than two or three drinks per day and no more than 10 drinks per week.

“I’m not a kill joy,” said Dowsett Johnston. “If you can drink within the low-risk drinking guidelines it’s a fabulous substance, for relaxing, for rewarding, for celebrating.”

But many women find that hard.

To those who approach her after she speaks on the topic, wondering if they have a problem, she says, “If you started a drinking diary tomorrow and said ‘I’ll only have one drink tonight’, could you keep your promise? Or would you have three?”

In Dowsett Johnston’s case, clarity came when her cousin was killed by a drunk driver. That’s when she vowed to give up drinking — and couldn’t. That’s when she took herself to rehab.

Today, Dowsett Johnston has been sober for seven years and is a founding director of Faces and Voices of Recovery Canada.

She encourages everyone — but especially women — to take an honest look at their relationship to alcohol.

Drinking “cost me my self-respect,” she said. “It cost me enormous peace of mind, and a goodly number of years in my 50s” — things she has fortunately been able to rebuild.

That’s one of the reasons she’s willing to be public about her struggles — to help those who are still hidden.

“Long before you’ll tell your best friend, you’re lying in bed at night worried,” she said.