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.
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