It has been a very eventful year, but no part of it has surpassed the effects of Gabrielle Glaser’s work and her book. We asked her to write about her side of the experience and she has graciously provided us with the following…
My name is Gabrielle Glaser, and I’m an author and journalist who has written about women’s health for decades. I found Your Empowering Solutions in May 2010, not long after I had signed a book contract to explore the reasons why women in the US seemed to be drinking more than in any other time in recent history. ( “Her Best-Kept Secret: Why Women Drink — And How They Can Regain Control,” was published last summer.)
The worrisome trends were easy to document: between 1998 and 2007, drunken driving arrests among women jumped nearly 30%, while they stayed flat among men.
Hospitalizations for dangerous levels of intoxication had skyrocketed among women, but increased only slightly for men. Federal drinking surveys found an increase in the number of women of all ages who said they regularly binge-drank — including women over 65. (While fewer older women binge drink, what’s remarkable is that they do it with nearly the same frequency as women in their twenties.)
Finding reasons why women drank was also easy: we are twice as likely to suffer from depression and anxiety as men, and far more likely to medicate unpleasant feelings with alcohol. Other risk factors include a history of sexual abuse and eating disorders, which affect far more women than men. Add in the modern grind of driving kids to multiple activities, trying to care for aging parents from afar, and the digital tether to work we have even when we’re in bed.
But when it came to explaining how women resolved their drinking problems, I hit a wall. Although I have self-medicated with wine during times of high stress, I don’t have a long history of struggling with alcohol abuse, so initially I began exploring what I thought worked “for everybody” – Alcoholics Anonymous. I’d read about it in books and seen it in films. I knew people who swore by it. It worked, right?
So I went to several open meetings, but left scratching my head. How could this “program,” with its focus on ancient drunken tales, bringing newcomers “down a peg” and denouncing all traces of “ego,” work for anybody — especially women, most of whom weren’t drinking out of excess hubris in the first place? But where was the evidence that it actually worked?
As I quickly learned, there wasn’t any. Our medical and legal institutions had embraced a narrative, not science. And that, I realized, was reinforced by the predominantly Protestant national mores: the sinner who is blind, finds God, and then can see. There are no randomly controlled, double-blind trials in A.A., the faith-based abstinence-only program thought up by the womanizing, chain-smoking, séance-seeking Bill Wilson in 1935.
Like the slogan says, “It works if you work it.” Who needs science with that kind of proof?
I did keep trying to find something that worked for women – or at least promised to, and early in my research I visited a lush female-only treatment center in Tennessee. I walked the “wisdom circle” and met the elderly horses to which the inpatients were supposed to “tell their secrets.” When I asked about the “success rate” of the center’s mandatory three-month, $100,000-stay, my interview quickly ended. Fertility and cancer centers are required to publish their success rates, but rehab is a black box.
A Google search for science based alcohol treatment led me to Ed and Mary Ellen, and I flew to meet them one sunny day in May. In contrast to my previous interviews, our conversation was completely transparent, from their histories to their methodology. Ed, a formerly heavy drinker, and Mary Ellen, the relative of someone with substance dependency, had studied meta-analyses and effective alcohol treatment studies from around the globe. Using their own considerable social skills and psychological backgrounds, they fashioned an approach that appealed to thinking men and women who don’t believe they have a “disease” but instead a habit they’d like to control.
They didn’t offer magic, and they didn’t promise some sort of fairytale setting: their approach was to focus on each client for an intensive week in their office – with a dog but no “wisdom circles” in sight. They don’t judge, and they don’t babysit: clients stay in a hotel nearby. During the client’s sessions, they help to identify her triggers, her resentments, her disappointments – and how she could change them by confronting them instead of swallowing them. They relied on copious evidence that most problem drinkers might also be able, in time, to learn to moderate. They didn’t use the words “sober” or “in recovery” and they didn’t label clients as “alcoholics,” all phrases lodged in the national 12-step culture.
Ed and Mary Ellen talked about the Loevinger Sentence Completion Test (disclosure: they offered me an evaluation, which I gratefully accepted), and how it helps guide them with each client for an individualized plan. We don’t have one-size-fits all treatment for depression, for cancer, or sinus disease: why should we expect it to work for an unhealthy habit that has spiraled out of control?
Their approach often incorporates a romantic partner, since alcohol abuse rarely occurs in a vacuum, and uses a variety of other science-based tools. They offer what global study after global study has proven to be most effective in treating alcohol use disorder, and tweaking it for each client: cognitive behavioral therapy to battle depression and anxiety; motivational interviewing, to help clients determine their own incentives to change; and assertiveness training for unbalanced personal relationships.
They also work with a family medicine doctor who prescribes the anti-craving medication naltrexone, which the U.S. government spent $30 million to discover was by far the most effective treatment in reducing or eliminating heavy drinking days. Until I met Mary Ellen and Ed, I had never heard of naltrexone – and here’s why: the drug first debuted in clinical trials for addiction in the 1970s. It’s available in generic form, has few side effects, and, taken for several months, helps women adjust to a life without an automatic reach for the wine when something goes wrong – but there isn’t any profit in it and the Steppers hate that it isn’t punitive and can be used in achieving moderation.
Yes, female over-drinking is a 21st-century problem. But thanks to people like Mary Ellen and Ed, there are 21st-century answers.
We are pleased to have been of assistance to Gabrielle during the course of researching her book – just as we are glad to be available to you, women and men alike, who are seeking real solutions to your alcohol abuse.
Will you be one of the four dozen individuals or couples that we assist in 2014? That, after all, is up to you.