Recovering alcoholics who abstain from drinking are least likely to relapse

Recovering alcoholics whose chosen strategy is to abstain from drinking are least likely to relapse, according to a new study of a nationally representative sample of adults.

However, although abstinence is the most reliable form of recovery to help middle-age and older adults avoid alcohol abuse and dependence problems, the study found that sustained recovery might be more elusive for young people, regardless of whether they avoid all alcohol or simply restrict their consumption.

“The biggest surprise was how little abstinence did to improve the prospects for younger alcoholics remaining in remission. To my knowledge, no one has looked at this age differential before,” said lead study author Deborah Dawson, Ph.D. She is a substance abuse researcher with the National Institute on Alcohol Abuse and Alcoholism.

The study appears in the December edition of Alcoholism: Clinical and Experimental Research . The article examines results from the National Epidemiologic Survey on Alcohol and Related Conditions.

Dawson's team analyzed the recovery status of more than 1,700 adults who were in some form of recovery at the beginning of the study, but who had been dependent on alcohol in the past.

Researchers grouped the participants into three categories: 1) abstainers, people who said they did not imbibe alcohol; 2) low-risk drinkers, people who drink at levels lower than those thought to increase the risk for relapse; and 3) asymptomatic risk drinkers, people who do not have any symptoms of alcohol abuse or alcohol dependence, but who drink more than the recommended guidelines for low-risk drinking.

The team interviewed study participants in 2001 and 2002, and again in 2004 and 2005.

The alcoholics who were abstainers at the beginning of the study were most likely to still be in recovery — and symptom free — at the second wave of the survey. Fifty-one percent of the asymptomatic risk drinkers had experienced the recurrence of alcohol dependence symptoms, compared with 27.2 percent of low-risk drinkers and 7.3 percent of abstainers.

“The most commonly reported symptoms of dependence in this study were repeatedly trying to stop or cut down on drinking, drinking more or for longer than intended and problems with sleeping, nausea or restlessness when the effects of alcohol were wearing off,” Dawson said. “The most commonly reported abuse symptom was driving after drinking too much.”

Abstaining worked best for alcoholics older than 25, the study found. The benefits of abstinent recovery were not as strong for younger individuals. “Youthful abstainers are still at high risk,” Dawson said.

It is not clear why abstinence does not work as well for young drinkers, but the authors said the high risk for relapse among people age 18 to 24 begs for more study and signals a significant treatment and prevention challenge for the legal system and college campuses.

Health researcher Lee Ann Kaskutas says it is too soon to discount the benefits of abstinence for young alcoholics.

“It may be that these very young drinkers just haven't lived long enough — or had time to experience the cycle of failure and success — to allow abstinence to work,” said Kaskutas, director of training at the Alcohol Research Group in Berkeley, Calif.

Alcoholism: Clinical and Experimental Research : Contact Mary Newcomb at (317) 375-0819 or [email protected] or visit http://www.alcoholism-cer.com

Dawson DA, Goldstein RB, Grant BF. Rates and correlates of relapse among individuals in remission from DSM-IV alcohol dependence: a 3-year follow-up. Alcoholism: Clinical and Experimental Research 31(12), 2007.