It’s no surprise to Kath to learn emotions may drive heavy drinking

Kath Elliott recognises her former self in some of her clients seeking support to change the way they drink. Many are high-performing, aged in their 40s and 50s, with big jobs, families and numerous stress factors.

Elliott describes herself as a former “social binge drinker”, able to spend days off alcohol but then going hard.

“If I look back at it, a lot of it was around relieving stress and the pressure of juggling motherhood, working a corporate job and trying to keep that perfect veneer,” she says.

Elliott quit alcohol in 2019, aged 46, following a fall in front of her family after drinking. She left corporate PR, trained as an alcohol mindset coach and has since worked with people to understand and adjust their relationship with Australia’s favourite drug .

She helps her clients examine what underlies their alcohol use – shifting from “automatically responding to ‘I need a drink’ to … ‘What am I actually feeling?’” – and has noticed women often identify stress and the sense of reward as factors.

Alcohol use has traditionally been researched on males, in part because men have historically been far bigger drinkers and partly because women’s variable hormones were viewed as a complexity, says Dr Leigh Walker, a Florey Institute of Neuroscience and Mental Health researcher.

But in recent decades, men’s drinking has declined in Australia and women’s has increased, especially in mid-life , and Walker and others have begun researching what is driving the change.

Walker’s team has just published a paper on sex differences in brain circuitry showing emotions are a stronger driver of binge-drinking for females than males. The researchers believe this shows stress or distress may be a cause of craving among female binge drinkers.

“There is building evidence to understand the female brain acts differently in response to alcohol and what causes us to drink excessively. You go out to have one drink, but instead you have five – that stop signal is what we’re interested in,” said Walker, who leads the Florey’s hormones and behaviour group.

The brain’s emotional regulation centre was far more strongly activated in females than males while binge-drinking, and when this mechanism was blocked, females consumed less alcohol, the group found.

Though for ethical reasons this research needs to be conducted on mice – which like many mammals enjoy alcohol when freely given access to it – the brain mechanisms are relevant across species.

Closing the gender gap in understanding drivers of alcohol consumption is especially important because alcohol causes more severe physical harm to women at lower consumption levels, and women have a higher risk of certain alcohol-related problems than men.

“Women will drink at levels that many don’t realise are affecting their body in much worse ways [than men face] because of our physiology,” Walker said.

“We have much more fat, and alcohol can ‘live’ in that fat in a sense; we drink less and get more drunk, and the amount coursing around in our bodies is also different from men because of their lean mass, and how it’s metabolised.”