A 50-year study shows that reformed alcoholics can't become social drinkers.
"Liberal-minded people are very upset by the idea that Alcoholics Anonymous says you've got to remain abstinent," said Dr. George Vaillant, research director at Brigham and Women's Hospital in Boston. But it seems that stopping completely is the only long-term solution.The hospital, connected to Harvard University, has followed the lives of a group of Harvard students and inner-city youths who were alcohol abusers in the 1940s. More than half the men remained problem drinkers in their 60s and 70s, according to results reported today in the American Medical Association's Archives of General Psychiatry.
Those who stayed away from drinking for a full five years reported they became more confident about resisting the craving. This is the point at which they are considered cured, but "if they go back to drinking, disaster is only a matter of time," Vaillant said. He noted that the advantage of such a long-term study is that it shows it remains easy for an alcoholic to fall off the wagon even after 10 years of sobriety.
Nearly 80 percent of the men studied relapsed to alcoholism after attempts to quit, and only 11 percent were able to avoid temptation and remain abstinent the entire time. However, many of those who faltered were able to make repeated, stable recoveries for years at a time by abstaining, Vaillant said. "The bad news is that a lot die young from alcoholism."
A quarter of the inner-city alcoholics and 15 percent of the Harvard students had died before the age of 60, nearly triple the death rate of the general population.
The study followed the lives of 268 former Harvard students and 456 inner-city dwellers who were alcohol abusers in their youth. A full 59 percent were still abusing alcohol after the age of 60.
While 11 percent claimed to have learned to drink moderately, meaning no more than one drink a day, "they could be lying to us," Vaillant said.
A striking finding was that the poor alcoholics living in the inner city recovered at a higher rate than college-educated alcoholics, presumably because they "hit bottom" sooner and had no one to cover up for them, Vaillant noted.
"It's hard work to give up alcohol forever, and it helps if you're really hurting."
Current efforts try to identify potential problem drinkers early - particularly among teen-agers - to prevent development of the habit, commented Dr. Helen Annis of the behavioral-change unit of the Addiction Research Foundation in Toronto.
One new treatment option is a medication to reduce relapses. In another study in the AMA's magazine, only one-third of a group of 80 patients who took the drug naltrexone for 12 weeks had relapsed to alcohol dependence six months later, compared to two-thirds of a control group not receiving the drug.
However, there were also differences among patients who received different types of counseling. Those who received active counseling on coping with drinking situations, the type often given in detoxification clinics, were less likely to be drinking at the six-month follow-up than those who received only supportive encouragement, of the type offered by Alcoholics Anonymous.
(Distributed by Scripps Howard News Service.)