She's the boss ? and she's hitting the sauce

Female execs outstrip men when it comes to alcoholism. Looking at the glass ceiling through the bottom of a bottle

By Wendy Banks

Head throbbing, Linda Gorman wearily surveys the mountain of work piling up on her desk. She's the first woman ever to have worked her way to the top spot in her local municipality's transport department, and the strain is starting to tell. She loves her job but lately the stress of running a department and raising a family has been getting her down, and she finds herself using booze more and more to take the edge off. It started with a few scotch and soda lunches with her colleagues, and a glass of wine in the evening to help her unwind. But in the last year, she's fallen into the habit of putting the kids to bed and then drinking herself to oblivion. She's starting to think she might have a problem.

Are female executives more prone to drinking problems than women with less demanding jobs? Possibly, according to a prospective study in the March issue of Occupational and Environmental Medicine examining rates of alcohol dependence in a population of London-based civil servants. One of the study's more startling discoveries is that, whereas men report alcohol dependence at a fairly consistent rate of 10-12% regardless of job status, women climb from 4% on the lower rungs of the civil service to 14% at the top. "It may be the stress for women of working against a glass ceiling that is to blame... They are also turning to alcohol because they feel they are not being adequately rewarded for their efforts," the study states.

YES, MINISTER
The study, led by Jenny Head, Senior Lecturer in Epidemiology and Public Health at London University College, is based on a statistical analysis of the Whitehall II study on the impact of work-related stress on health. Conducted in 1985-88, the Whitehall study screened a population of British civil servants for a broad range of stress factors, including low job status and high workload, and health problems like heart disease. Alcohol dependence in the same population was measured in 1991-93.

Dr Peter Selby, acting clinical director of the Addictions Medicine Program at the Centre for Addiction and Mental Health (CAMH) in Toronto, agrees with the explanations offered by the study authors, but thinks the problems go beyond these. Some of the causes could be cultural, he says: women who have the same responsibilities as men also have the same problems as men. "It may be that women in high-reaching positions have to become like 'one of the guys,'" he observes. "So they may take up some of these things and wind up in trouble because of it." Another explanation is physiological. "In women, we're noticing what's known as 'telescoping of effects,' which means they get all the bad effects of using drugs faster than men do. Their body weight is smaller, they have less body water, and they often have less enzymes to combat the effects of alcohol, so they may have more toxic effects."

However, Dr Selby cautions that some of the causes for the increase in alcoholism rates might have to do with study methods. "This portion of the study is based on the CAGE questionnaire." The CAGE (acronym for Cut down, Annoyed by criticism, Guilty about drinking, Eye-opener drinks) questionnaire focuses on the effects of drinking, including feelings of guilt, rather than on more empirical factors, like the number of drinks required to get drunk. According to Dr Selby, this could lead to false positives, especially in women, who might be socially conditioned to feel guiltier about drinking than men do.

But the study does have its uses. "It's not a bad idea to look at who has these problems," says Dr Selby. "This is a beginning."