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Wiley InterScience

Addiction

Addiction

Volume 100 Issue 3, Pages 281 - 292

Published Online: 12 Oct 2005

Journal compilation © 2010 Society for the Study of Addiction



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FOR DEBATE
Recovery from DSM-IV alcohol dependence: United States, 2001–2002
Deborah A. Dawson, Bridget F. Grant, Frederick S. Stinson, Patricia S. Chou, Boji Huang & W. June Ruan
Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
Correspondence to  Deborah A. Dawson
NIAAA/LEB Room 3083
5635 Fishers Lane
MSC 9304
Bethesda
MD 20892–9304
USA
Tel: 301 435 2255
Fax: 301 443 1400
E-mail: ddawson@mail.nih.gov
Copyright 2005 Society for the Study of Addiction
KEYWORDS
Dependence • natural recovery • remission • recovery • risk drinking

ABSTRACT

Aims  To investigate the prevalence and correlates of recovery from Diagnostic and Statistical Manual version IV (DSM-IV) alcohol dependence by examining the past-year status of individuals who met the criteria for prior-to-past-year (PPY) dependence.

Design  Cross-sectional, retrospective survey of a nationally representative sample of US adults 18 years of age and over (first wave of a planned longitudinal survey).

Methods  This analysis is based on data from the 2001–02 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), in which data were collected in personal interviews conducted with one randomly selected adult in each sample household. A subset of the NESARC sample (total n = 43 093), consisting of 4422 US adults 18 years of age and over classified with PPY DSM-IV alcohol dependence, were evaluated with respect to their past-year recovery status: past-year dependence, partial remission, full remission, asymptomatic risk drinking, abstinent recovery (AR) and non-abstinent recovery (NR). Correlates of past-year status were examined in bivariate analyses and using multivariate logistic regression models.

Findings  Of people classified with PPY alcohol dependence, 25.0% were still classified as dependent in the past year; 27.3% were classified as being in partial remission; 11.8% were asymptomatic risk drinkers who demonstrated a pattern of drinking that put them at risk of relapse; 17.7% were low-risk drinkers; and 18.2% were abstainers. Only 25.5% of people with PPY dependence ever received treatment. Being married was associated positively with the odds of both AR and NR, and ethanol intake was negatively associated with both. Severity of dependence increased the odds of AR but decreased the odds of NR. The odds of AR (but not NR) increased with age and female gender but were decreased by the presence of a personality disorder. Treatment history modified the effects of college attendance/graduation, age at onset and interval since onset on the odds of recovery.

Conclusions  There is a substantial level of recovery from alcohol dependence. Information on factors associated with recovery may be useful in targeting appropriate treatment modalities.


Submitted 23 April 2004; initial review completed 3 August 2004; final version accepted 28 September 2004

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1360-0443.2004.00964.x About DOI

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