By Sarah Carstens, LCSW, LCADC
Do you ever find yourself reaching for a drink to cope with stress? Do you secretly worry that you are drinking more than you should?
If so, you may be a “gray-area drinker.”
Gray-area drinking falls between casual, social drinking and full-blown alcohol dependency. It’s increasingly common in the United States, especially among women.
Getting to the Gray-Area
From greeting cards with pithy messages about aging like a fine wine to joking memes that equate cocktails to self-care, drinking references are woven into popular culture and often targeted to women.
This normalization of alcohol use may be contributing to a rise in alcohol dependence, particularly among U.S. women.
According to the 2023 National Survey on Drug Use and Health, 67% of adults ages 18 and older drank alcohol in the past year, and more than 20% of women reported binge drinking.
If you are experiencing minor problems in your life that can be linked to alcohol, like difficulty sleeping or mood swings, you may have entered the gray-area.
Signs and Symptoms
Gray-area drinking is not always easy to spot. As a general rule, women who are gray-area drinkers consume more than one drink per day or more than seven drinks in a week, according to the National Institutes of Health.
Other signs and symptoms of gray-area drinking include:
- Drinking more than planned. Finding it hard to stop once you start.
- Using alcohol as a coping tool. Drinking alcohol to relieve stress, ease anxiety or to avoid certain responsibilities.
- Interruptions to sleep, waking up tired, hangovers and mood swings, and other physical effects.
- Feeling guilty after drinking. Regretting how much you consumed or feeling badly about yourself after drinking.
- Drinking more often. Consuming more alcohol than usual or skipping regular activities in order to drink.
- Ignoring limits. Exceeding the recommended guideline of one drink per day for women. One drink is a 12-ounce beer or 5-ounce glass of wine, according to the National Institute on Alcohol Abuse and Alcoholism.
- Struggling to say no. Finding it hard to stay alcohol-free for extended periods.
- Silent worry. Wondering if you’re drinking too much or worrying you may have a problem, but feeling unsure what to do.
- Memory loss. Blacking out after drinking or forgetting things that happened while you were drinking.
Alcohol Impacts Women Differently
Even moderate drinking can have short- and long-term impacts on the body. These effects can vary depending on the person, and are generally more pronounced in women than men.
Women have less water in their bodies than men, so even if a woman and a man of equal weight drink the same amount of alcohol, the woman’s blood alcohol level will be higher. As a result, alcohol-related health issues can appear earlier in women.
The National Institutes of Health reports that over the past 20 years, rates of alcohol-related hospital visits and deaths have increased at a faster rate among women than men.
Effects of Drinking on Mental and Physical Health
Gray-area drinking can take a toll on mental health. You may rely on alcohol to help you cope with stress or sadness, yet alcohol can actually worsen anxiety and depression over time. Excessive drinking can also disrupt sleep, and cause mood changes.
The physical effects of alcohol consumption include:
- Brain damage. Alcohol interferes with the brain’s communication pathways by temporarily blocking the transfer of memories from short-term to long-term storage. This is why there are sometimes gaps in a person’s memory after a long night of drinking.
- Heart disease. Alcohol use is linked to heart disease, which is the leading cause of death in the U.S.
- Cancer. Alcohol consumption is a leading cause of cancer, according to the U.S. Surgeon General, and breast cancer in women is the most common alcohol-related cancer.
- Liver Damage. Excessive drinking can trigger an inflammatory response in the liver causing tissue damage, scarring and serious complications such as cirrhosis of the liver, fatty liver disease and liver cancer.
Getting Out of the Gray-Area
It’s important to recognize that drinking impacts people differently. What is a safe level of alcohol for one person may be problematic for another.
If alcohol is negatively impacting your life, or if you’re relying on alcohol to help you manage emotions, it may be time to make a change. There are several steps you can take to cut back.
- Pace yourself. Alternate between alcoholic and non-alcoholic drinks. For example, drink one glass of water for every glass of wine.
- Set limits. Stop after one glass.
- Ask for support. Tell close friends or family that you’re trying to cut back so that you feel less social pressure to drink, and so they can support you.
- Seek professional help. If you find that you are unable to make these or other adjustments, talk with a therapist. A therapist can help you to address your concerns and make a plan to get your drinking in check.
At Penn Medicine Princeton House Behavioral Health, patients have access to evidence-based care for a range of mental health conditions, including anxiety, depression, and substance use disorders.
For more information about Penn Medicine Princeton House Behavioral Health visit www.princetonhouse.org. Princeton House admissions clinicians can be reached at (888) 437=1610.
Sarah Carstens, LCSW, LCADC, is a licensed clinical social worker and licensed clinical alcohol and drug counselor. She is the Clinical Director of Addiction Services at Penn Medicine Princeton House Behavioral Health.
