Spontaneous Recovery In Alcoholics: A Review And Analysis Of The Available Research

Abstract

Clear statements about spontaneous recovery of alcoholics are difficult. The problem has not been directly approached in many treatment studies or in special surveys. Most of our information comes from studies of alcoholics not applying for treatment and perhaps they do not apply because their symptoms are controllable or because they realize (correctly?) that their prognosis is good. Tentatively, it is possible to support the following statements: (i) Many studies have found spontaneous recovery among alcoholics to occur. The overall rates vary from 10% (Newman, 1965) to 42% (Goodwin et al., 1971) for alcoholics not seeking treatment. Yearly rates vary from 1 to 33% considering all types of studies. (ii) Only one study provides corroborated evidence on spontaneous recovery among alcoholics seeking treatment (Kendall and Staton, 1965) and it shows that about half recover without treatment, over varying follow-up intervals. It suggests yearly recovery rates of 3.7 to 7.4%, depending upon the criterion of recovery. (iii) We cannot be sure whether spontaneous recovery equals or exceeds that of any type of treatment. There is strong suggestive evidence from Kendall and Staton’s study that recovery rates via treatment and without treatment may be very close. (iv) The reasons for spontaneous recovery are not well understood but probably include changes in health, jobs, marriages and residence. The highest rates (33%) have been found in alcoholics being treated for physical illnesses as a consequence of drinking. (v) More studies of the extent and reasons for spontaneous recovery are required. The best studies for this purpose would involve random assignment of alcoholics seeking treatment to treated and waiting list studies. (vi) Investigations of spontaneous recovery should focus on concomitant changes in social stability but also informal “treatment” by friends, relatives and Alcoholics Anonymous.