Women in the entertainment industry face special problems in relation to drug and alcohol abuse. You may find you are using substances to curb your performance anxiety or to feel more outgoing. Alcohol may seem to raise your self-esteem, alleviate depression, reduce your social isolation and free you from anxiety. However, it is well documented that the chronic use of alcohol ultimately makes people more withdrawn, less self-confident, more depressed and often more anxious.

Women in our industry may join colleagues for drinks after performances to try and fit in, or to network as part of advancing their careers. They may feel pressure to keep up with the drinkers – but if a woman consumes the same amount of alcohol or drugs as the men she will become more intoxicated, and her body will suffer more damage. This may exacerbate existing emotional problems, such as depression, which afflict women more than men.

There is a substantial body of research indicating that women are more vulnerable than men to both the immediate and long-term consequences of alcohol and drug abuse. It suggests that they are more vulnerable than men to alcohol-related organ damage, trauma, sexually transmitted diseases and legal and interpersonal difficulties. Women account for 60 percent of all drug-related emergency room visits.

And American women are closing the gap with men in terms of their substance use habits. A recent survey showed that 10 percent of women and 22 percent of men consumed two or more drinks per day on average. Women are starting to smoke, drink and use drugs at earlier ages than ever before. Today’s young women are 15 times more likely than their mothers to have begun using illegal drugs by age 15. Among racial groups women’s drinking is more prevalent among whites, although Black women are more likely to drink heavily.

Women become intoxicated faster than men, become addicted more quickly, and develop substance abuse-related diseases sooner. They are twice as likely as men to be addicted to prescription drugs in combination with alcohol – a dangerous and potentially fatal combination. About 70 percent of prescriptions for tranquilizers, sedatives and stimulants are written for women.

The risk of cirrhosis of the liver becomes significant for a woman who consumes less than two drinks a day, while for men this risk becomes significant only after six drinks per day. Alcohol also increases the risk of breast cancer, menstrual and circulatory disorders, and other organ damage, including heart and brain damage.

If you are of childbearing age, drinking puts you at high incidence of gynecological-obstetrical problems such as infertility, miscarriages and hysterectomies. And the use of drugs or alcohol creates the risk of serious mental, physical and behavioral defects in your unborn baby. Fetal Alcohol Syndrome (FAS) and maternal crack addiction have devastating consequences.

Another health concern involves nutrition: drinking strips away many water-soluble vitamins from the body and inhibits its ability to use specific vitamins and calcium, leaving you susceptible to nutritional deficiencies.

A recent survey also showed a significant relationship between the amount of alcohol women reported drinking weekly and increased likelihood of sexual victimization. Genetic influences, early initiation of drinking, and a history of victimization can increase women’s risk for alcohol abuse or dependence.

Women with drug and alcohol problems tend to struggle with identity and dependency issues, and studies suggest that conflicts surrounding traditional feminine roles may be more common among them than for women in the general population.

In our culture women often place an overriding importance on being thin, and see a link between maintaining low weight and smoking or using drugs like cocaine and heroin. Yet the health consequences of smoking are severe; one of every two female smokers will die of a tobacco-related disease.

In the entertainment industry, cocaine use and abuse is often tied to success and achievement. Cocaine can provide a temporary sense of self-confidence, power and control, which counteracts feelings of inferiority as well as discomfort and guilt about acting assertively and aggressively in pursuing career achievement and becoming successful. However cocaine is highly addictive, and creates serious risks of heart failure and cerebral hemorrhages. Initially, cocaine can decrease inhibitions and seems to increase creativity and performance ability. However, over time performance is often impaired and users begin to orient their entire lives around the drug, which consumes the money needed for rent, savings, and all the other necessities of life.

A woman’s symptoms of substance abuse are usually inner-directed – depression, anxiety, low self-esteem – while men more often show external manifestations, such as drunk driving and frequent fighting. Society tends to more readily accept alcoholism and drug abuse in men than in women, even when the addiction results from the use of a legally prescribed drug.

This stronger social stigma attached women’s use of drugs and alcohol often leads women to feel intense shame. They may try harder than men to conceal their use from friends, family and health care providers, making it harder to receive help. In fact, although women now account for almost half of those with addiction problems, only about 20 percent of the clients in most treatment programs are women.

A woman’s problem with substance abuse can be perpetuated when family members do not know how to respond helpfully. They may make excuses, rationalize why the addicted person is high or intoxicated, and deny that there is a problem – because confronting the behavior would create conflict in their relationships. However, unless there are immediate consequences for her behavior, an addicted woman’s problem is minimized and treatment is often further delayed.

If you are concerned about your own or another person’s substance use, the Musicians’ Assistance Program can help by providing confidential counseling and case management. We will work with you to assess the problem, provide referrals, help you access financial assistance for a treatment program and follow-up, and do ongoing case management. Call the Musicians’ Assistance Program at (212) 397-4802 to schedule an appointment to speak to a social worker. These services are free of charge.

(Sources: “Drug and Alcohol Addiction in Women” by Rosalyn Gilbert, CSW; “Substance Abuse and the American Woman,” from the National Center on Addiction and Substance Abuse at Columbia University, June 1996; “Alcohol and Drugs Are Women’s Issues,” from The Woman’s Alcohol & Drug Education Project; “Are Woman More Vulnerable to Alcohol’s Effects?” in Alcohol Alert, No. 46, December 1999.)