Alcoholics Need Five Years of Sobriety to Be Considered Free of Relapse, Study Says

ALCOHOL April 1996

A study published in the March issue of the American Medical Association's Archives of General Psychiatry suggests that a five-year period of abstinence from alcohol is necessary to place recovering alcoholics out of danger of relapse (George E. Vaillant, MD, "A Long-Term Follow-up of Male Alcohol Abuse," Archives of General Psychiatry, March 1996, p. 243-249; Brenda Coleman, "Five Years Without a Drink," Washington Post, March 13, 1996, p. A12).

The study's author, George E. Vaillant of Harvard Medical School and Brigham and Women's Hospital in Boston, likened recovery from alcoholism to recovery from cancer: an individual needs a set period of freedom from the disease to be considered cured.

The study followed 724 men over a fifty-year period, and selected subjects from both privileged college campuses and low-income inner-city neighborhoods. Individuals in both groups who developed problems with alcohol were tracked from age 40 to age 60 or 70.

Of the college graduates with alcohol problems, 18% had died by age 60, 11.5% were abstinent from alcohol, and 59% were still abusing alcohol. Of the inner city group, 29% had died, 32% were abstinent, 11% were controlled drinkers, and 28% were still abusing alcohol. The discrepancies between the death rates of the two groups was accounted for by the poor nutritional habits of the city group. The differences in rates of continued abuse were attributed to the college groups' higher socioeconomic status, which may have supported or excused their alcoholism. Disadvantaged alcohol abusers were found to be more likely to become sober because their situation required it.

Among both groups of subjects, relapse occurred 40 percent of the time after two years of sobriety, but was rare after five years without a drink.

The issue of Archives of General Psychiatry is devoted to alcohol-related studies. One study found that people with a higher tolerance for alcohol are more likely to become alcoholics, as are those with a family history of alcoholism (Marc A. Schuckit, MD and Tom L. Smith, PhD, "An 8-Year Follow-up of 450 Sons of Alcoholic and Controlled Subjects," Archives of General Psychiatry, March 1996, p. 202-210).

Another study in the same issue found that alcoholics taking naltrexone had a lower rate of relapse than did those who were not taking the drug. As was reported in the February 1995 issue of NewsBriefs, naltrexone was approved by the Food and Drug Administration for treatment of alcoholism. The drug works by blocking the pleasurable effects of alcohol and heroin, thus lessening craving ("FDA Approves Drug to Curb Craving for Alcohol, NewsBriefs, February 1995, p. 6). The study found that naltrexone can be used effectively on a short-term basis, or during high-risk periods, although the effects will not be long-lasting (Stephanie S. O'Malley, PhD, et al, "Six-Month Follow-up of Naltrexone and Psychotherapy for Alcohol Dependence," Archives of General Psychiatry, March 1996, p. 217-224).

In other research on alcoholism, a study in the Journal of the American Medical Association found that depressed alcoholics, if treated with antidepressants, have much improved periods of abstinence (Barbara J. Mason, PhD, et al, "A Double-Blind, Placebo-Controlled Trial of Desipramine for Primary Alcohol Dependence Stratified on the Presence or Absence of Major Depression," Journal of the American Medical Association, March 13, 1996, p. 761-767).