High-risk drinking among women has increased significantly over the past decade, and the coronavirus pandemic seems to have made the problem worse. A recent study in JAMA Network Open compared drinking patterns before and after the pandemic. The results? Women increased how often they drink more than men did, and also reported major increases in binge drinking and problems related to drinking.

These trends have serious health consequences. Because of sex differences such as lower average body weights compared to men, women suffer from more severe alcohol-related problems, including liver damage and heart disease, at lower levels of drinking. What’s more, women of reproductive age who drink also risk prenatal alcohol exposure, the most common preventable cause of intellectual and developmental issues in the United States. 

As one of the largest groups of behavioral health providers, social workers are essential to addressing this growing public health challenge. From hospitals and mental health centers, to schools and private practices, social workers can make a difference by integrating alcohol screening and brief intervention (SBI) into routine care. 

April is Alcohol Awareness Month—a call for social workers to take these three steps to protect women’s health:

1. 

   Start the conversation. Studies of alcohol SBI show providers often feel uncomfortable talking with patients about alcohol use. These conversations are sorely needed, as four in five adults who binge drink have not been advised by a health professional to cut back, according to the Centers for Disease Control and Prevention (CDC). The good news is that talking to clients about their drinking really works: Alcohol screening and brief intervention is supported by 30 years of research, including findings that alcohol SBI can reduce a person’s drinking on one occasion by 25 percent. Research has also shown that pregnant women who receive counseling are twice as likely to avoid drinking as those who don’t have the opportunity. 

2. Use a validated screening instrument. The CDC recommends using a validated set of screening questions to identify clients’ drinking patterns. A wide range of screening practices and instruments have been validated for women, including the AUDIT-C, which takes about one minute to administer and can be used for women of all ages, including pregnant women, as well as adolescent girls.

3. Screen all adult patients, including those who are pregnant. Providing alcohol SBI to everyone may help normalize conversations about alcohol use and lessen the stigma for seeking and getting help. In fact, the U.S. Preventive Services Task Force recommends alcohol screening and brief intervention for all adults ages 18 and older, including pregnant women. Electronic SBI can be used when seeing clients in person is not possible. 

NASW and the NASW Foundation, along with leading medical organizations, have partnered with the Centers for Disease Control and Prevention in the Collaborative for Alcohol-Free Pregnancy, a cross-discipline public health initiative. Together, we are encouraging health professionals to use proven prevention strategies in routine patient care. 

To learn more, visit NASW’s Behavioral Health webpage for professional development resources. Additional clinical resources are available through our Collaborative partners:

• Centers for Disease Control and Prevention, Alcohol Screening and Brief Intervention Efforts 

• American College of Obstetricians and Gynecologists, Fetal Alcohol Spectrum Disorders Prevention Program

By Diana Ling, MA, Outreach Program Coordinator; and Leslie Sirrianni, LCSW, Training Coordinator; Health Behavior Research and Training Institute, Steve Hicks School of Social Work, University of Texas at Austin.