Though men are more likely to drink and in larger amounts, differences in body structure and chemistry mean women are more vulnerable to alcohol's long-term effects on their health.
Their risks for liver disease, memory loss and brain shrinkage, and heart damage are greater than for men. Alcohol consumption increases the risk of cancer of the mouth, throat, esophagus, liver, colon and breast among women.
NIAAA recommends women drink no more than seven drinks per week and no more than three drinks on any single day. But many women far exceed those guidelines.
Amy, a 50-something professional from New York City who did not want to use her last name, said she drinks two glasses of white wine for cocktails and two or three more reds with dinner.
"I truly like the taste and it is an addiction and one I try to keep in check," she said. "I'm a depressed person but I truly don't think that plays in to the drinking, but I know that it definitely affects the sadness if I've had too much to drink and then having an emotionally low day."
She acknowledged she inherited an "alcoholic" a gene from her father and paternal grandmother, but is more "self-aware." Still, she said drinking is a "coping mechanism."
In the 2013 book, "Best Kept Secret," author Gabrielle Glaser argues that female drinking starts insidiously in the male-oriented college environment.
"Activities are still really male-dominated with frat parties, dive bars and tailgating oriented around drinking," she said.
"Now, there is serious binge drinking and women take that with them into their first jobs in technology, law and business and carry it with them even though they can't tolerate it," Glaser said.
When they become mothers, the demands of parenthood are triggers. In an article for the Wall Street Journal, Glaser cites the Facebook page, "Moms Who Need Wine," which now has 660,000 followers.
"If you're not sure you could survive motherhood without a stockpile of your favorite Red -- then you've come to the right place!" it proclaims. "Let's face it, we all LOVE being Moms. There's not a better, more rewarding job in the world. But sometimes, enough is enough! And there's nothing better to bring you down than a little sip from a nice piece of stemware (or the closest sippy cup.)"
Before writing her book, Glaser began noticing the bottles women in their late 30s to 50s were bringing to the recycling center when she was living in Oregon.
"When their kids are still at home, they are trying to relax after work and set boundaries of time between their selves and their kids," she said. "Then they kind of keep pouring. It doesn't look like binge drinking -- it's not like they are slapping down shots at the bar, but it kind of borders on that."
Glaser, 49, said she interviewed numerous women who "intended to drink half a bottle, but after the third glass, said, 'What the hell, I'll finish it.' Then it becomes a shameful secret and an embarrassing one."
In most European countries, women drink more than the recommended amounts in the United States, but have fewer abuse problems and higher life expectancies, according to Glaser.
She said Americans lead overwhelmed lives and don't know how to moderate their drinking.
"We are driving our kids more, competition is greater, we are away from our extended families," she said. "We are doing more -- instead of saying stop the drinking for the rest of my life, maybe you can step away from the triggers."
She urges a national conversation on what moderate drinking is.
"Alcohol is not the demon here," she said. "It's a wonderful substance if enjoyed in moderation."
But Johnston said many women need professional help.
She went into rehab in the United States when her son and then-partner, who left her 18 months into sobriety, sounded the alarm in 2008.
"I was a high functioning -- I didn't crack up the car or go to jail as my mother did," she said. "I would open up a bottle of wine and continue drinking and they called me on it."
But today, she said she feels "fabulous."
"I am the most Ann I have ever been," said Johnston. "I have been able to do the book I always dreamt about -- to write about addiction. I lost my love through this, but I have turned it into something fulfilling and spiritually satisfying."
Go to the NIAAA website under "publications' to find a downloadable book, "Rethinking Drinking," to compare your drinking with that of the general population and to assess risk for developing an alcohol use disorder.
For a national directory of treatment programs, go to the Substance Abuse and Mental Health services website.