What is the number of serious attempts required to achieve stable resolution of a significant alcohol or other drug (AOD) problem? Previous studies of addiction treatment populations suggest prolonged addiction careers, and a substantial proportion (over half) of people in the United States admitted to addiction treatment indicate one or more prior treatment admissions. These reports stand as justification for the characterization of addiction as a “chronic relapsing” disorder. Such clinical studies, however, may not be representative of the larger pool of people experiencing AOD-related problems.
Convenience studies of community populations of “people in recovery” reveal a different profile. A recent Canadian study found that more than half of those surveyed reported no problem recurrence after the first initial recovery attempt, and that only 15% of those surveyed required six or more attempts prior to achieve stable recovery. But it has been unclear whether such convenience samples accurately represent the experience of all people who have resolved AOD problems, including those who do not embrace a recovery identity.
Having normative information about recovery attempts prior to successful AOD problem resolution is critically important to the individuals and families affected by such problems, to the multiple professionals and institutions seeking to help such individuals and families, and to drug and health care policy makers. A newly published study by Dr. John Kelly and colleagues provides the first available data on recovery attempts based on a national representative sample of people who have resolved a significant AOD problem. Findings and implications of this landmark study include the following.
Data from the Kelly study should spur optimism among people seeking resolution of low to moderate AOD problems, their families, and their service providers. The study also encourages persistence and possibility among those with the most severe and complex problems. Recovery is possible in both circumstances though with varying levels of effort.
Future reports on recovery attempts and reported treatment history should report both the mean and median of such episodes to assure that the prospects of problem resolution are not over or under estimated. AOD problems are not a single clinical entity and representing them as such may do great disservice to both those with the lowest and highest levels of problem severity.
Chaiton, M., Diemert, L., Cohen, J. E., Bondy, S. J., Selby, P., Philipneri, A., & Schwartz, R. (2016). Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers. BMJ Open, 6:e011045.
Kelly, J. F., Greene, M. C., Bergman, B. G., White, W. L., & Hoeppner, R. B. (2019). How many recovery attempts does it take to successfully resolve a drug or alcohol problem? Estimates and correlates from a national representatives study of recovering U.S. adults. Alcoholism: Clinical & Experimental Research. May 15. doi: 10.1111/acer.14067. [Epub ahead of print]