Course of Alcoholism: Four Years After Treatment

摘要

Alcoholism has traditionally been viewed as a persistent and chronic disorder. Recent years, however, have seen a growing belief that the disorder can be completely transformed into stable, long-term improvement after intervention. Yet we know relatively little about the course of alcoholism over the long run. Although research has documented substantial rates of remission after treatment, the stability of such remission is very much an unanswered question. The purpose of this study is to extend knowledge about the remission process by examining the history of a sample of treated alcoholics over a period of 4 years. We find it is common for alcoholics to reach a state of remission, but that state is generally intermittent rather than stable. The study is based on a random sample of 922 males who made contact in 1973 with any one of eight Alcoholism Treatment Centers (ATCs) funded by the National Institute on Alcohol Abuse and Alcoholism The same cohort was interviewed in previous follow ups at 6 months and 18 months, and has been the subject of other research, including an earlier Rand study. At 4 years, information was obtained from 85 percent of the target sample. In addition to extensive interviews, the 4-year follow up data base included psychological tests, self reported psychiatric and medical information, measures of blood alcohol concentration, validation interviews with subject collaterals, and officially recorded causes of death for deceased subjects. Although all subjects had some contact with a treatment facility, the study was not an experimental evaluation of competing treatment methods. Rather, the principal objective was to trace the natural sequence of events, including treatment, in the course of alcoholism.