Medicine And Books

Women and Alcohol: Contemporary and Historical Perspectives

BMJ 1997; 315 doi: (Published 19 July 1997) Cite this as: BMJ 1997;315:197
  1. Alex Paton, retired consultant physician
  1. Oxfordshire

    Moira Plant Free Association Books, £15.95, pp 388 ISBN 1 85343 364 0

    The macho Romans meted out severe punishments to women (the traditional producers and retailers of alcohol) if they touched a drop of the stuff; the fun loving Etruscans made sure that women as well as men were provided with wine in the afterlife. Nowadays men drink alcohol in some Islamic countries, but women on the whole do not; we enlightened Europeans boast that we do not discriminate between men and women, yet ambivalence about alcohol is widespread and old prejudices persist. Men are allowed to drink around, but women have to drink in secret if they overindulge, otherwise they are labelled unladylike, loose women, whores even.

    Moira Plant, distinguished member of the well known alcohol group at the university of Edinburgh, produced an account of Women, Drinking and Pregnancy in the 1980s, which was required reading for alcohol workers. It was her research that enabled British women to enjoy an occasional drink during pregnancy, while their American cousins were forbidden to drink at all, on evidence which might charitably be called unsupported. Her new book, with over 2000 references, is an astonishing tour de force for a single author: a comprehensive social, historical, and, indeed, global survey of women's drinking. The merit of this approach is that it exposes past attitudes, often absurd and sometimes cruel, and repeatedly demonstrates that slick solutions for extremely complex problems run the risk of perpetuating previous errors.

    The fact is, of course, that women are different from men. In general they are more likely to abstain from alcohol, to drink less, and to drink in moderation. These well known gender differences in the handling of alcohol, however, increase their sensitivity—when they drink to excess, serious psychological and physical harm may result from smaller amounts over shorter periods than in men. The burning practical issue, though, is how to end the isolation of the woman drinker who needs help. A stunning chapter on treatment issues (largely male oriented) and especially the difficulties experienced by women in counselling, which should be mandatory reading for therapists of both sexes, offers a glimmer of hope. With women's drinking increasingly resembling that of men, the likelihood of damage increases, and the need to tailor treatment to their needs becomes more urgent.

    Rating: ****

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