Determining actual recovery rates for alcoholics / addicts
 

I hear a lot of statistics bandied about regarding success rates for alcoholics and addicts in recovery. Some are gloomy, some are more optimistic. Often the numbers vary wildly. My take is it's pretty much utterly impossible to determine what percentage of addicts who attend X, Y, or Z program ultimately get sober. Here's why:

It's utterly impossible to get a precisely accurate number as to "relapse rates" for alcoholics and addicts.

The problem is multifold:

First, identifying who is actually and alcoholic and who is an addict. We know them when we see them, sure, and we absolutely know when we are one, but ultimately there isn't a blood test or gold standard way of telling if someone is an alcoholic or addict. Research geeks call this issue a problem of "criterion validity."

Second, defining what is a "relapse." Is being utterly clean and sober for 10 years and then impulsively drinking a half a glass of champagne at your son's wedding and then getting back on the sobriety wagon immediately and sinning no more, is that a "relapse" in the same way that someone who has stayed sober for two days and then goes back to drinking daily for the next 10 years has "relapsed"? Maybe in a sense they are the same, but I would say the first example is someone who has successfully recovered (maybe with a slight bump in the road) while the other is not a success - while both may have technically relapsed. Research geeks might regard this as an issue with "construct validity," perhaps.

Finally, there's something the research geeks called "ascertainment bias" or "sampling bias." That is to say, let's say you look at an AA group (or even *all* AA groups) and you decide that you want to decide what percentage of people successfully recover from addiction based on who continues to attend AA. You follow a sample of AA attendees for 50 years and count those who report relapses and those who drop out as unsuccessful remitters, and those who attend and report sober time as being successful remitters. Problem there is, is it fair to count those who drop out of AA as being failures? How do we know those who drop out of AA don't continue to stay sober? What about people who never attend formal recovery programs who get sober on their own (does happen - see this reference for a great read).

So when it comes to trying to figure out how many addicts or alcoholics eventually get clean and sober (much less trying to figure out how the best way to do it), I think the task is impossible for medical science to come up with a conclusive answer.

I would second that conclusion. Too many variables involved. I can spot a numbers and analysis person a mile away due to the fact that so am I.

I've had spreadsheetitis way too many times and have played with too many pie charts/graphs/pivot tables to count.

I would liken this to trying to determine success of all the diets that are out there.

I'm thankful that there's such an array of sobriety programs for people to chose from and am happy for those who have found success.

The way I see it, success and failure are not always dependent on staying sober. Most people I see in recovery set short term goals when they first start out. Such as;

Getting their license back
Getting their job back
Getting their spouse back
Pleasing some authority figure...

In my estimate, at least half of them meet their short term goal. Then go back to their old ways of living, drinking and drugging. Should we count them as a success or failure?

I just finished a book I borrowed from the library called "Sober for Good: New Solutions for Drinking Problems -- Advice from Those Who Have Succeeded" by Anne M. Fletcher M.S. R.D.
It was very interesting to read the different success stories and how people defined recovery and achieved it.

I think the important question to ask oneself is: why does knowing the odds matter?

This is a situation where "recovery" depends 100% on the person who wants to rcover. We aren't waiting for a cure out there.

WE are our OWN cure.

So if you really want a sober changed life and you are willing to do ANYTHING to get it and you are willing to put it BEFORE absolutely everything, then you have a 100% chance of achieving longterm sobriety.

THOSE are the odds.

Is being utterly clean and sober for 10 years and then impulsively drinking a half a glass of champagne at your son's wedding and then getting back on the sobriety wagon immediately and sinning no more, is that a "relapse" in the same way that someone who has stayed sober for two days and then goes back to drinking daily for the next 10 years has "relapsed"? Maybe in a sense they are the same, but I would say the first example is someone who has successfully recovered (maybe with a slight bump in the road) while the other is not a success -

hm...i see them the opposite way: the person who impulsively picks up a glass after ten years is anything but "recovered". that, to me, is a relapse. it's not about the amount.

your second example...no, he hasn't succeeded at quitting, but he hasn't relapsed, either. he simply never quit.

I have 6 years. I truly believe that if I have a half glass of champagne, it wouldn't end there...

I *know* that. Viscerally.

There's an element to this whole thing that can't be expressed in stark facts and figures IMO - figures can't show the whole picture, no matter how much folks want them to.

D

I agree. I don't call myself "recovered" because I have x number of days not-drinking. I considered myself "recovered" because I have recovered the same attitude towards alcohol as I had as a child (before my first drink.

If I took even one sip of alcohol (deliberately), I would reset my sobriety date due to my relapsed attitude. Now if someone were to hand me a glass with alcohol in it, after I requested a non-alcoholic beverage, I would not change my sobriety date because my attitude had not changed.

I'm grateful that I haven't had a drink or a desire for one in over 30 years but don't consider myself recoverED. In my thinking process that word means it's not a problem for me to drink again. That's all my shite fairy would need to carry me away to LA LA land.
BE WELL

Great post DrSober!

The only recovery statistic I can rely on these days is what happens with the people I work with in my group, and that seems remarkably close to those stated in the foreword to the second edition. It has nothing to do with the percentage of those who attend AA. Nowhere in the big book does it even remotely suggest that attendance at meetings will bring about recovery.

Before I will sponsor someone, I qualify them as an alcoholic as suggested in the book. You may be surprised to know that many that turn up in AA are not alcoholic, and I really have nothing to offer them.

Then, if they are willing, we begin work on the steps. In my personal experience, "of those who really try (take all the steps) at least 50% recover at once. It's amazing to watch. The lights come on, they lose their self centredness and pretty soon they are out there helping others, they are free.

Of those who don't take the steps, some stay dry, but seem to become dependent on meetings. They don't seem to get any freedom from self, or much real freedom at all really. And of course some return to their old existence.

My point is that any alcoholic that comes to AA today and really tries, still has as good a chance at recovery as they did in the early days.

I agree. The success rate of those who actually use all 12 steps appear to be over 50%

It's kind of like watching patients who leave the waiting room before actually seeing the Doctor. What do expect their chances are?

Another problem is that the money spent on chemical dependency research is mostly spent on prevention/ finding out how a person becomes a alcoholic/addict. Very little is spent studying recovery. As far as the scientific/medical community goes, people with more than a few years of recovery do not exist.

Great post I would of typed this out myself if I did not know the OP originally did so. If you look at my thread of where I am at you will see that I struggle with these same conclusions. My brain will not allow me to accept the proquo because my mind knows that the emperical data and a lack of control group standards are flawed. If a study was to be performed on addiction, there would have to be a much more entailed version that I don't even think is possible.