The stability of recoveries from alcohol problems is an important, but little studied issue. Scant information exists on the long-term stability of recoveries among treated individuals, and the stability of recoveries among individuals who recover without treatment is unexplored, despite a high ratio of untreated to treated alcohol abusers in the general population. Thus a major controlled investigation of the stability of natural recoveries (i.e., without formal help/treatment) from alcohol problems is proposed. The study will involve reinterviewing 182 individuals identified in an earlier study as either having resolved an alcohol problem without formal help or treatment (n=120) or as having an active and untreated problem at the time of the project (n=62). Of the 182 subjects, 91.8% smoked cigarettes at one time, and of those subjects who had resolved a drinking problem when initially interviewed, 55.5% had also stopped smoking cigarettes when initially interviewed. The main objective of the proposed longitudinal study would be to evaluate the stability of recoveries among the subjects who were recovered when initially interviewed, and to determine the incidence of recovery among those who had an active problem at that time. The original study, and the proposed study, involve several methodological advances over the few previous studies of natural recoveries. These advances include: inclusion of a control group of nonresolved, nontreated subjects; collateral confirmation of the subjects' problems and recoveries; long-term recoveries; and a large subject cohort. The project has five other major objectives: (1) to suggest ways in which utilization of existing alcohol services can be enhanced or changed to attract individuals who are presently reluctant to use existing services; (2) to impact on alcohol treatment practices by providing directions for developing and testing (a) new interventions, and (b) self-change strategies for alcohol abusers unwilling or unlikely to use available services; (3) to provide information on the incidence of the family history of alcohol problems in naturally recovered subjects: (4) to assess the effects of stopping drinking on the use of other substances and on other health-related behaviors; (5) to identify factors related to the successful cessation of both problem drinking and smoking which may help to empirically guide future interventions for both behaviors; this is particularly important given the synergistic health risks associated with smoking and alcohol use, coupled with the high incidence of smoking among alcohol abusers. This study will constitute an important documentation of the existence of very longterm, problem-free recoveries, and will provide insights into the nature of such recoveries that could stimulate new lines of research and ways of thinking about treatment accessibility and utilization, and about public policy in the alcohol field.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA008593-02
Application #
3112712
Study Section
Clinical and Treatment Subcommittee (ALCP)
Project Start
1991-07-01
Project End
1994-06-30
Budget Start
1992-07-01
Budget End
1993-06-30
Support Year
2
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Centre for Addiction and Mental Health
Department
Type
DUNS #
City
Toronto
State
ON
Country
Canada
Zip Code
Gioia, Christopher J; Sobell, Linda Carter; Sobell, Mark B et al. (2012) Shorter and proximal Timeline Followback windows are representative of longer posttreatment functioning. Psychol Addict Behav 26:880-7
Vakili, Shervin; Sobell, Linda Carter; Sobell, Mark B et al. (2008) Using the Timeline Followback to determine time windows representative of annual alcohol consumption with problem drinkers. Addict Behav 33:1123-30
Gutmann, Lori B; Sobell, Linda Carter; Prevo, Melissa H et al. (2004) Outcome research methodology of smoking cessation trials (1994-1998). Addict Behav 29:441-63
Sobell, Linda Carter; Sobell, Mark B; Connors, Gerard J et al. (2003) Assessing drinking outcomes in alcohol treatment efficacy studies: selecting a yardstick of success. Alcohol Clin Exp Res 27:1661-6
Sobell, Linda Carter; Agrawal, Sangeeta; Sobell, Mark B et al. (2003) Comparison of a quick drinking screen with the timeline followback for individuals with alcohol problems. J Stud Alcohol 64:858-61
Sobell, Linda Carter; Sobell, Mark B; Agrawal, Sangeeta (2002) Self-change and dual recoveries among individuals with alcohol and tobacco problems: current knowledge and future directions. Alcohol Clin Exp Res 26:1936-8
Sobell, Linda Carter; Sobell, Mark B; Leo, Gloria I et al. (2002) Promoting self-change with alcohol abusers: a community-level mail intervention based on natural recovery studies. Alcohol Clin Exp Res 26:936-48
Sobell, L C; Klingemann, H K; Toneatto, T et al. (2001) Alcohol and drug abusers' perceived reasons for self-change in Canada and Switzerland: computer-assisted content analysis. Subst Use Misuse 36:1467-500
Sobell, L C; Ellingstad, T P; Sobell, M B (2000) Natural recovery from alcohol and drug problems: methodological review of the research with suggestions for future directions. Addiction 95:749-64
Cunningham, J A; Lin, E; Ross, H E et al. (2000) Factors associated with untreated remissions from alcohol abuse or dependence. Addict Behav 25:317-21

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