Epidemiology of Recovery From Alcohol Use Disorder

Tucker, Jalie A.; Chandler, Susan D.; Witkiewitz, Katie

doi:10.35946/arcr.v40.3.02

Cited by 101 publications

(88 citation statements)

References 35 publications

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“…Most individuals who develop an Alcohol Use Disorder (AUD) or have subclinical problems eventually reduce or resolve their problem, and some achieve stable “recovery” (Tucker, chandler et al, 2020; Witkiewitz, Montes et al, 2020). Over 70% of problem resolutions occur outside the context of treatment or mutual‐help participation, and stable limited drinking without problems (moderation) is a more common outcome in untreated than treated samples (Fan et al, 2019; Sobell et al, 1996), in part because many treatment programs emphasize abstinence, and treatment‐seeking is associated with higher problem severity.…”

Section: Introductionmentioning

confidence: 99%

Shifts in behavioral allocation patterns as a natural recovery mechanism: Postresolution expenditure patterns

Tucker

Cheong

Chandler

2021

Alcoholism Clin & Exp Res

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Background Behavioral economics predicts that recovery from Alcohol Use Disorder involves shifts in resource allocation away from drinking, toward valuable nondrinking rewards that reinforce and stabilize recovery behavior patterns. Further, these shifts should distinguish nonproblem drinking (moderation) outcomes from outcomes involving abstinence or relapse. To evaluate these hypotheses, 5 prospective studies of recent natural recovery attempts were integrated to examine changes in monetary spending during the year following the initial cessation of heavy drinking as a function of 1‐year drinking outcomes. Methods Problem drinkers from Southeastern U.S. communities (N = 493, 67% male, 65% white, mean age = 46.5 years) were enrolled soon after stopping heavy drinking without treatment and followed prospectively for a year. An expanded Timeline Followback interview assessed daily drinking and monetary spending on alcohol and nondrinking commodities during the year before and after recovery initiation. Results Longitudinal associations between postresolution drinking and spending were evaluated using MPlus v.8. Initial models evaluated whether changes in spending at 4‐month intervals predicted drinking outcomes at 1 year and showed significant associations in 6 commodity categories (alcohol, consumable goods, gifts, entertainment, financial/legal affairs, housing/durable goods/insurance; ps < 0.05). Cross‐lagged models showed that the moderation outcome group shifted spending mid‐year to obtain large rewards with enduring benefits (e.g., housing), whereas the abstinent and relapsed groups spent less overall and purchased smaller rewards (e.g., consumable goods, entertainment, and gifts) throughout the year. Conclusions Dynamic changes in monetary allocation occurred during the postresolution year. As hypothesized, compared to the groups who abstained or relapsed, the moderation group shifted spending in ways that, overall, yielded higher value alcohol‐free reinforcement that should reinforce recovery while they enjoyed some limited nonproblem drinking below heavy drinking thresholds. These findings add to evidence that moderation entails different behavioral regulation processes than abstinent and relapse outcomes, which were more similar to one another.

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Section: Introductionmentioning

confidence: 99%

Shifts in behavioral allocation patterns as a natural recovery mechanism: Postresolution expenditure patterns

Tucker

Cheong

Chandler

2021

Alcoholism Clin & Exp Res

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“…In contrast, consumption criteria considered indicative of higher-risk drinking practices are any occasions of more than 14 drinks weekly or more than five drinks daily for men and more than seven drinks weekly or more than four drinks daily for women. 22 As discussed in the rest of this paper and elsewhere, 4 , 23 these criteria have been widely adopted in recovery research, but have been found wanting as an outcome metric on several grounds and have contributed to a lesser focus on measures of well-being and functioning, which are central to most current definitions of recovery.…”

Section: Definitions Of Recoverymentioning

confidence: 99%

“…As summarized by Tucker et al, research using both clinical and non-treatment-seeking samples has shown that the majority of individuals who develop AUD reduce or resolve their problem over time. 4 The pathways to improvement are heterogeneous, may occur with or without participation in treatment or mutual help groups, and involve improved functioning and well-being with or without reductions in drinking. Several lines of quantitative research, ranging from treatment outcome to naturalistic observational studies, have converged to support this expanded characterization of improvement in alcohol-related problems.…”

Section: Empirical Research Examining Recovery Among Individuals Withmentioning

confidence: 99%

“…2 Based on epidemiological survey data in the United States, as many as 14% of individuals meet criteria for current AUD, and nearly one-third (29%) meet lifetime criteria for AUD. 3 Importantly, data from national epidemiological surveys, prospective observational studies, and randomized clinical trials of patients with AUD and individuals who engage in problem use of alcohol indicate that most affected persons will ultimately recover 4 —with “recovery” defined in various ways by different stakeholders including researchers, clinicians, mutual help groups, health care organizations and policymakers, and persons with AUD.…”

Section: Introductionmentioning

confidence: 99%

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What Is Recovery?

Witkiewitz

Montes

Schwebel

et al. 2020

ARCR

122

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Alcohol use disorder (AUD) is among the most prevalent psychiatric disorders and is associated with enormous public health costs. Although AUD and other addictive behaviors have been described as chronic relapsing conditions, most individuals who develop AUD will eventually recover. This narrative review provides an overview of definitions of recovery, with a focus on recovery from AUD. The definitions reviewed include those developed by key stakeholder groups, as well as definitions derived from recent quantitative and qualitative studies of individuals who meet criteria for AUD and attempt to resolve their problems with or without treatment or who self-identify as pursuing or achieving recovery. The literature reviewed supports a definition of recovery as an ongoing dynamic process of behavior change characterized by relatively stable improvements in biopsychosocial functioning and purpose in life. The review concludes that definitions of recovery that rely solely on abstinence from alcohol and the absence of AUD symptoms fail to capture the multidimensional and heterogeneous pathways to recovery that are evident among individuals in general population and clinical samples.

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“…Some of the reasons for these differences are detailed and explained along with the known estimates of recovery prevalence in the United States (Tucker, Chandler, and Witkiewitz, 2020). 7 The positive neurophysiological, somatic, psychological, and behavioral effects of, and the milestones involved in, AUD recovery are of great interest to affected parties, as well as to the public and the clinical and research fields. These effects are covered in detail across domains of brain (Nixon and Lewis, 2020) 8 and other organ systems (Thomes, Rasineni, Saraswathi, et al, 2021).…”

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confidence: 99%

From the Editors

Kelly¹

2021

ARCR

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Epidemiology of Recovery From Alcohol Use Disorder

Cited by 101 publications

References 35 publications

Shifts in behavioral allocation patterns as a natural recovery mechanism: Postresolution expenditure patterns

Shifts in behavioral allocation patterns as a natural recovery mechanism: Postresolution expenditure patterns

What Is Recovery?

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