Alcohol use disorders (AUDs) significantly impact on the life of the person and those who provide care.
Unfortunately, however, people with AUDs, who often also have comorbidities, fall between the cracks as service provision increasingly becomes more specialised, criteria for engagement ever tighter and care becomes more compartmentalised.
The National Health and Medical Research Council suggests that 25% of Australians consume alcohol at risky levels.
Consumption above risky levels of two or more standard drinks per day is considered harmful and increases the lifetime risk of injury and disease.
Given that alcohol is an intrinsic part of the Australian culture, and with the increasing number of women drinking in harmful ways, there is an increased demand for services and an increased need to research reasons why.
Research into alcohol use from a quantitative perspective is well recognised but the views of people who live with AUDs is much more silent, with that of women, almost completely inaudible.
Women are particularly susceptible to alcohol related brain injuries placing them in a very vulnerable position, which according to the World Health Organization (2014, p8), ‘is a major public health concern because alcohol use amongst women has been steadily increasing in line with economic development and changing gender roles’.
Women who consume harmful levels of alcohol are more likely to experience familial conflict and be victims of intimate partner violence and more than twice as likely to experience physical abuse. Women encounter more societal admonition and censure and experience considerably more guilt and shame about their alcohol consumption than men with AUDs.
Clear and consistent gender differences regarding the consequences of alcohol consumption appear in the literature but despite this evidence, only modest consideration has been afforded to women as a separate study population from men and there is an absolute lack of women centred services for AUD treatment.
As nurses, we can make sure we regularly screen women for AUDs even when they present with other issues. AUDs are not screened for as thoroughly as they could be with women at even higher risk than men of not being screened. This is despite medical evidence showing that they experience significantly more alcohol-related harm than men.
The care journey of women with AUDs is often unnecessarily convoluted because some health professionals feel that AUDs are ‘self inflicted’ and the individual does not ‘deserve’ treatment or therapy. The vast majority of nurses are caring and want to help people recover. Most importantly then, treat the woman with respect and dignity, be non-judgmental.
We do not know what is happening in their life now or what has happened. Being empathic and demonstrating unconditional positive regard may assist in help seeking behaviours and quite simply – it is integral to good nursing practice to deliver care that is free of judgement.
World Health Organization. 2014. Global status report on alcohol and health 2014. ISBN 978 92 4 069276 3. Geneva.
Dr Renee Brighton is a Lecturer in the School of Nursing
Professor Lorna Moxham is Professor of Mental Health Nursing, Global Challenges Program & School of Nursing
Both are at the University of Wollongong in NSW