Social and community resources and long-term recovery from treated and untreated alcoholism.
OBJECTIVE
Long-term studies of the course of alcoholism suggest that a variety of factors other than professional treatment influence the process of recovery. This study evaluated the role of demographic factors, baseline alcohol-related problems and depression, professional treatment, Alcoholics Anonymous (AA) and other social and community resources in predicting remission and psychosocial outcome over 8 years.


METHODS
A sample of 628 previously untreated alcoholic individuals was recruited at detoxification units and alcoholism information and referral services. Of these participants, 395 (68.2%) were followed 3 and 8 years later. Most (83.3%) were white (n = 329) and 50.1% (n = 198) were men. At each contact point, participants completed a self-administered inventory that assessed their current problems, treatment utilization, AA participation and quality of relationships.


RESULTS
Number of inpatient treatment days received in the 3 years after baseline were not independently related to 8-year remission or psychosocial outcomes. More outpatient treatment in the first 3 years increased the likelihood of 8-year remission, but was not related to psychosocial outcomes. The number of AA meetings attended in the first 3 years predicted remission, lower depression, and higher quality relationships with friends and spouse/partner at 8 years. Extended family quality at baseline also predicted remission and higher quality friendships and family relationships at 8 years.


CONCLUSIONS
Given that alcoholism is a chronic, context-dependent disorder, it is not surprising that short-term interventions have little long-term impact. Social and community resources that are readily available for long periods are more likely to have a lasting influence on the course of alcoholism.
Humphreys
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Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA 34025, USA.
Moos
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Cohen
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D000328:Adult; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D003156:Community Mental Health Services; D005260:Female; D005500:Follow-Up Studies; D006295:Health Resources; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012008:Recurrence; D012944:Social Support