The gap between men and women’s alcohol use has narrowed over the past three decades, with recent studies even suggesting that the gap no longer exists. Experts say that the increase in women using alcohol coincides with the start of the feminist movement in the 1970s, continuing to grow as more women become educated and enter the workforce.

But this isn’t just about a couple of martinis during happy hour. According to the Centers for Disease Control and Prevention, women are abusing alcohol more than ever, with alcohol-related death rates of white women rising 130 percent and Hispanic women rising 27 percent. A recent Washington Post series about women and addiction states that the combination of opioids, anti-anxiety medication and alcohol is also contributing to the higher death rate of white women. It goes on to present the case that women are binge-drinking more because of an increase in women-focused alcohol products and women-targeted alcohol marketing.

To be clear, the fact that women are drinking more is not a problematic side effect of gender equality. What is actually problematic is that some experts and studies imply or outright state that it is. This demonstrates the gender inequality that still exists in the way in which women are judged—while men are accepted—for drinking.

A Shift in the Current

Laura A. Schmidt, Ph.D., a professor of health policy in University of California, San Francisco’s School of Medicine, attributes the increase of drinking in women to the fact that they now have more “freedom” to drink—at times, drinking to intoxication. In her 2014 paper “The Equal Right to Drink,” published in Drug and Alcohol Review, she states that this gender convergence in drinking “is a manifestation of changing norms as women begin to shed their traditional status as subordinates to men.”

The same sentiments are also reflected in recently published memoirs of “privileged” and famous women, many of which detail stories of intense alcohol and substance abuse. In her critically lauded 2015 memoir Blackout: Remembering the Things I Drank to Forget, Sarah Hepola recounts her years as a high-functioning alcoholic. She considered intoxication her right and found drinking to be empowering for her as an individual as well as a woman in a male-dominated world.

The Unequal Yoke

Despite the change in drinking habits to equal that of men’s, women are unchangeably prone to suffer greater physical consequences, strictly by the way they’re built. Smaller size and physiological differences make female blood-alcohol levels climb faster and stay elevated longer. Women also have lower levels of stomach enzymes necessary to process toxins in alcoholic beverages. The CDC states that women drinkers are more apt to suffer brain atrophy, heart disease and liver damage. Research shows that women who drink have an increased risk of breast cancer. Women also progress toward alcoholism faster, a phenomenon called “telescoping.”

On top of that, women also suffer greater social consequences as well as the physical. Jowita Bydlowska, author of 2014’s memoir Drunk Mom, emphasized the shame and disdain she experienced as a mom who drank too much. In a 2014 interview with the The Fix, Bydlowska said there’s more shame for women alcoholics because it’s not “lady-like.” “We’re supposed to be more composed, socialized, and so on,” she said. “This is the reason why a lot of women drink secretly, after everyone goes to bed, the same way I used to. A man who is drunk is often perceived as funny, social—he drinks in pubs with buddies and he pukes in alleys and laughs about it the next day.”

The social consequences of alcohol abuse can be even higher for minorities and those of lower economic status. While privileged women are not experiencing as high of a stigma, Dr. Schmidt goes on to say that there is a “war” on minority and low-income female addicts through a more punitive court system, negative impact on child custody, drug testing that violates civil rights, and more.

College Women and Alcohol Use

With more women in college more than ever and binge drinking on the rise among those in the 18 to 34 age range, it’s relevant that we also take a look at the changing relationship between alcohol and college-age women. The National Institute for Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08. This typically occurs after four drinks for women and five drinks for men in about two hours.

While the stigma of alcohol use and abuse is lowering, campuses across the country are experiencing higher incidents of alcohol abuse among female students—abuse that has had tragic results. According to a study published in the Journal of Studies on Alcohol, female college students are more likely to suffer alcohol poisoning because they experience more effects from alcohol consumption, and they are at a higher risk of sexual assault and physical harm. Shockingly, one out of every 20 college women is sexually assaulted in America, and if both the attacker and victim have alcohol, the risk of rape runs higher.

Let’s be clear again, this absolutely does not make room in any way to blame the woman for being a victim of sexual assault or physical harm. Women are not responsible for other people’s actions no matter what they wear drink or how they live their lives. However, it does bring up the blurring of distinctions between rape (notably by predator males), unwanted sex (where one party agrees to have sex not out of desire but to please or appease the partner), and the kind of consensual sex where both parties are intoxicated and can’t fully remember what happened the next day (and one of them later regrets it).

Sexism in Addiction Treatment

Even though addiction is now developing more rapidly in women, specialized treatment centers are still admitting more men than women by a significant margin (67 percent to 33 percent), according to the Substance Abuse and Mental Health Services Administration’s 2014 TEDS Report.

According to Harvard Medical School, it wasn’t even until the early 1990s that research on substance abuse and dependence started including women. At that time, federal governmental agencies began requiring federally funded studies to enroll more women. As a result, the number of women-only treatment facilities tripled between 1982 and 1992 because of an increased emphasis on the special needs of women in getting treatment.

Dr. Schmidt says that the lower number of women admissions is in part because there aren’t enough treatment facilities to meet demand. Other reasons include the fear of loss of child custody, lower income among women, childcare needs, the stigma of being a substance abuser and existing pregnancy. Keeping this in mind, treatment programs should better address the shame that female substance abusers feel and the fear of losing jobs and children, all of which contribute to a reluctance to enter and stay in treatment.