White Coat, Black Art·DR. BRIAN'S BLOG

Emergency departments see spike in young women binge drinking

Young women are the fastest rising group of patients brought into hospitals with alcohol intoxication, according to a new study. Dr. Brian Goldman gives his front-line perspective.

Study in CMAJ uncovers disturbing trends about young women and booze

According to a CMAJ study, alcohol-related visits by women went up 86.5 per cent during the study period, compared to 53.2 per cent for men. (Justin Tang/Canadian Press)

Rising alcohol use in Canada is putting a strain on emergency departments that are already bursting at the seams. The Canadian Institute for Health Information says more people are admitted to hospital for alcohol-related problems than for heart disease. A study published Monday in the Canadian Medical Association Journal uncovered some disturbing trends. 

Alcohol has a large and growing impact on emergency department volumes, according to the study led by Dr. Daniel Myran at the School of Epidemiology and Public Health at the University of Ottawa and researchers at The Ottawa Hospital, the Ottawa Hospital Research Institute, ICES uOttawa and the Bruyère Research Institute.

Myran and his colleagues analyzed 765,346 visits to emergency departments in Ontario involving 480,611 patients. To be included in the study, the visit had to be attributed to alcohol use.

Overall, between 2003 and 2016, emergency department visits were up in general. However, visits attributed to alcohol use were up a lot more. In fact, the rate of increase of visits due to alcohol was 4.4 times greater than the overall increase in visits for all causes.

Not only that, but patients who visited emergency departments for alcohol intoxication were disproportionately more likely to result in hospital admissions.

It's not just the number of patients but the demographics that got researchers' attention. From 2003 to 2016, people aged 25 to 29 had a 175 per cent increase in hospital visits triggered by drinking. In addition, people who lived in low-income neighbourhoods were more than twice as likely as those who live in wealthier places to require emergency care for alcohol.

But the most striking finding was a disproportionate increase in alcohol-related visits by women. They went up 86.5 per cent during the study period, compared to 53.2 per cent for men. And women who visited the ER due to alcohol were nearly twice as likely as men to be under the legal drinking age of 19. 

These are percentage increases only. To put things in perspective, men continue to visit the ER due to alcohol much more than women. Still, should these trends continue, women may one day catch up to men.

Evidence from emergency rooms

For some time now, I've been seeing more women who get intoxicated and are brought to the ER by paramedics. Typically, these are young women 17 to 30 years of age. The men who present to the ER with alcohol intoxication tend to be older, so the trends spotted in the study track pretty closely to what we see anecdotally in the ER.

Patients who visited emergency departments for alcohol intoxication were disproportionately more likely to result in hospital admissions, according to the study published in the Canadian Medical Association Journal. (Shutterstock/SpeedKingz)

The young women arrive unconscious or semiconscious, and hospital personnel depend on friends who were with them to tell us what happened. The companions often give a strikingly similar story. The patient and friends went to a club or a restaurant where they consumed several mixed drinks in short order. The friends say the patient reported feeling nauseated before retiring to a bathroom where they vomit before passing out. They're discovered by friends or bystanders who summon the paramedics.

If someone isn't rousable and isn't protecting the airway, call 911. 

The study results coincided with increases in average weekly alcohol consumption patterns in Ontario as well as higher rates of binge drinking across Canada. These trends are particularly striking among younger women. A 2017 study in the U.S. showed excess binge drinking in women ages 12 to 17. This is a recent observation that some experts believe is due to a growing social acceptance of women who drink enough to get intoxicated.

The study's authors noted that the increased numbers of patients seeking treatment in the emergency department for alcohol intoxication cannot be explained by the general increase in the total number of emergency patients. They said there's a disproportionate increase in patients whom come to the hospital repeatedly for treatment of alcohol-related symptoms.

Doctor says women disproportionately at risk

A commentary also published earlier Monday in CMAJ by Dr. Sheryl Spithoff noted a 26 per cent increase in alcohol-related deaths among women. In 2017, hospital admissions for girls aged 10–19 years outnumbered hospital admissions for boys of the same age.

Spithoff,  a family physician and addiction medicine doctor at Women's College Hospital in Toronto, argued public policies can help reduce alcohol-related harms. For instance, she noted that increasing the price of alcohol through taxation or price minimums helps curb use by younger drinkers and those who tend to binge. She said banning the promotion of alcohol has also been shown to be effective.

These public health initiatives appear to be at odds with policies from the government of Ontario that are aimed at lowering the minimum cost of beer, increasing the hours during which alcohol can be sold and allowing the sale of alcohol in corner stores.

Spithoff calls on governments to recognize that women are disproportionately at risk of alcohol-related harms and to enact policies aimed at reversing this disturbing trend.

About the Author

Dr. Brian Goldman is a veteran ER physician and an award-winning medical reporter. As host of CBC Radio’s White Coat, Black Art, he uses his proven knack for making sense of medical bafflegab to show listeners what really goes on at hospitals and clinics. He is the author of The Night Shift and The Power of Kindness: Why Empathy is Essential in Everyday Life.


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