Book contents
- Dynamic Pathways to Recovery from Alcohol Use Disorder
- Dynamic Pathways to Recovery from Alcohol Use Disorder
- Copyright page
- Dedication
- Contents
- Figures
- Tables
- Contributors
- Foreword
- Preface
- Acknowledgments
- Introduction
- 1 Historical and Contemporary Perspectives on Pathways to Recovery from Alcohol Use Disorder
- Part I Micro Level
- Part II Meso Level
- Part III Macro Level
- Conclusions and Future Directions
- Index
- References
1 - Historical and Contemporary Perspectives on Pathways to Recovery from Alcohol Use Disorder
from Introduction
Published online by Cambridge University Press: 23 December 2021
Book contents
- Dynamic Pathways to Recovery from Alcohol Use Disorder
- Dynamic Pathways to Recovery from Alcohol Use Disorder
- Copyright page
- Dedication
- Contents
- Figures
- Tables
- Contributors
- Foreword
- Preface
- Acknowledgments
- Introduction
- 1 Historical and Contemporary Perspectives on Pathways to Recovery from Alcohol Use Disorder
- Part I Micro Level
- Part II Meso Level
- Part III Macro Level
- Conclusions and Future Directions
- Index
- References
Summary
Alcohol use disorder (AUD) has been described as a chronic relapsing condition, yet most individuals who develop AUD will reduce or resolve their problem, and many will “recover.” This chapter summarizes historical and contemporary definitions of recovery, including those developed by key stakeholder groups and definitions based on research with individuals who meet AUD criteria and resolve their problems with or without treatment. The literature supports an expanded definition of recovery as an ongoing dynamic behavior change process characterized by relatively stable improvements in biopsychosocial functioning and purpose in life. Definitions focused solely on abstinence and absence of AUD symptoms do not capture the multidimensional and heterogeneous pathways to recovery found in general population and clinical samples, and non-abstinent recovery is possible. The chapter discusses a shift away from a pathology-based model of recovery towards a strength-based, resilience-building model that recognizes many possible pathways to stable positive change.
Keywords
- Type
- Chapter
- Information
- Dynamic Pathways to Recovery from Alcohol Use DisorderMeaning and Methods, pp. 3 - 22Publisher: Cambridge University PressPrint publication year: 2022
References
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596Google Scholar
Anonymous (1939), . Alcoholics Anonymous: The story of how many thousands of men and women have recovered from alcoholism. Works Publishing.Google Scholar
Ashford, R. D., Brown, A., & Brown, T. (2019). Defining and operationalizing the phenomena of recovery: A working definition from the recovery science research collaborative. Addiction Research & Theory, 27(3), 179–188. https://doi.org/10.1080/16066359.2018.1515352Google Scholar
Best, D., Beckwith, M., Haslam, C., Haslam, S. A., Jetten, J., Mawson, E., & Lubman, D. I. (2016). Overcoming alcohol and other drug addiction as a process of social identity transition: The social identity model of recovery (SIMOR). Addiction Research & Theory, 24(2), 111–123. https://doi.org/10.3109/16066359.2015.1075980Google Scholar
Betty Ford Institute Consensus Panel (2007). What is recovery? A working definition from the Betty Ford Institute. Journal of Substance Abuse Treatment, 33(3), 221–228. https://doi.org/10.1016/j.jsat.2007.06.001CrossRefGoogle Scholar
Brennan, P. L., Schutte, K. K., Moos, B. S., & Moos, R. H. (2011). Twenty-year alcohol-consumption and drinking-problem trajectories of older men and women. Journal of Studies on Alcohol and Drugs, 72(2), 308–321. https://doi.org/10.15288/jsad.2011.72.308CrossRefGoogle ScholarPubMed
Dawson, D. A., Goldstein, R. B., & Grant, B. F. (2007). Rates and correlates of relapse among individuals in remission from DSM-IV alcohol dependence: A 3-year follow-up. Alcoholism: Clinical and Experimental Research, 31(12), 2036–2045. https://doi.org/10.1111/j.1530-0277.2007.00536.xGoogle Scholar
Dawson, D.A., Grant, B. F., Stinson, F. S., Chou, S. P., Huang, B., & Ruan, W. J. (2005). Recovery from DSM-IV alcohol dependence: United States, 2001–2002. Addiction, 100(3), 281–292. https://doi.org/10.1111/j.1360-0443.2004.00964.xCrossRefGoogle ScholarPubMed
Edwards, G., & Gross, M. M. (1976). Alcohol dependence: Provisional description of a clinical syndrome. Alcohol Health and Research World, 19 (1), 44–45.Google Scholar
Fan, A. Z., Chou, S. P., Zhang, H., Jung, J., & Grant, B. F. (2019). Prevalence and correlates of past-year recovery from DSM-5 alcohol use disorder: Results from National Epidemiologic Survey on Alcohol and Related Conditions – III. Alcoholism: Clinical and Experimental Research, 43(11), 2406–2420. https://doi.org/10.1111/acer.14192Google Scholar
Furtwængler, N. A. F., & De Visser, D. O. (2013). Lack of international consensus in low-risk drinking guidelines. Drug and Alcohol Review, 32 , 11–18. https://doi.org/10.1111/j.1465-3362.2012.00475.xGoogle Scholar
Gilbert, P. A., Pro, G., Zemore, S. E., Mulia, N., & Brown, G. (2019). Gender differences in use of alcohol treatment services and reasons for nonuse in a national sample. Alcoholism: Clinical and Experimental Research, 43(4), 722–731. https://doi.org/10.1111/acer.13965Google Scholar
GBD 2016 Alcohol and Drug Use Collaborators (2018). The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry, 5, 987–1012. http://dx.doi.org/10.1016/S2215–0366(18)30337-7Google Scholar
Granfield, R., & Smith, W. (1999). Coming clean: Overcoming addiction without treatment. New York University Press.Google Scholar
Grant, B. F., Goldstein, R. B., Saha, T. D., Chou, S. P., Jung, J., Zhang, H., Pickering, R. P., Ruan, W. J., Smith, S. M., Huang, B., & Hasin, D. S. (2015). Epidemiology of DSM-5 Alcohol Use Disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry, 72(8):757–766. https://doi.org/10.1001/jamapsychiatry.2015.0584Google Scholar
Grønbaek, M. (2009). The positive and negative health effects of alcohol – and the public health implications. Journal of Internal Medicine, 265(4), 407–420. https://doi.org/10.1111/j.1365-2796.2009.02082.xGoogle Scholar
Grucza, R. A., Sher, K. J., Kerr, W. C., Krauss, M. J., Lui, C. K., McDowell, Y. E., Hartz, S., Virdi, G., & Bierut, L. J. (2018). Trends in adult alcohol use and binge drinking in the early 21st-century United States: A meta-analysis of 6 national survey series. Alcoholism: Clinical and Experimental Research, 42(10), 1939–1950. https://doi.org/10.1111/acer.13859CrossRefGoogle ScholarPubMed
Hingson, R. W., Hereen, T., & Winter, M. R. (2006). Age at drinking onset and alcohol dependence: Age at onset, duration, and severity. Archives of Pediatric and Adolescent Medicine, 160(7), 739–746. https://doi.org/10.1001/archpedi.160.7.739.40Google Scholar
Holahan, C. J., Brennan, P. L., Schutte, K. K., Holahan, C. K., Hixon, J. G., & Moos, R. H. (2017). Late-life drinking problems: The predictive roles of drinking level vs. drinking pattern. Journal of Studies on Alcohol and Drugs, 78(3), 435–441. https://doi.org/10.15288/jsad.2017.78.435CrossRefGoogle ScholarPubMed
Humphreys, K. N., Mankowski, E. S., Moos, R. H., & Finney, W. H. (1999). Do enhanced friendship networks and active coping mediate the effect of self-help groups on substance abuse? Annals of Behavioral Medicine, 21(1), 24–60. https://doi.org/10.1007/BF02895034Google Scholar
Kaskutas, L. A., Borkman, T. J., Laudet, A., Ritter, L. A., Witbrodt, J. Subbaraman, M. S., Stunz, A., & Bond, J. (2014). Elements that define recovery: The experiential perspective. Journal of Studies on Alcohol and Drugs, 75(6), 999–1010. https://doi.org/10.15288/jsad.2014.75.999CrossRefGoogle ScholarPubMed
Kelly, J. F., Bergman, B., Hoeppner, B. B., Vilsaint, C., & White, W. L. (2017). Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy. Drug and Alcohol Dependence, 81, 162–169. https://doi.org/10.1016/j.drugalcdep.2017.09.028Google Scholar
Kelly, J. F., Greene, M. C., Bergman, B. G., White, W. L., & Hoeppner, B. B. (2019). How many recovery attempts does it take to successfully resolve an alcohol or drug problem? Estimates and correlates from a national study of recovering US adults. Alcoholism: Clinical and Experimental Research, 43(7), 1533–1544. https://doi.org/10.1111/acer.14067Google Scholar
Lancaster, K. (2017). Rethinking recovery. Addiction, 112(5), 758–759. https://doi.org/10.1111/add.13552Google Scholar
Lee, M. R., Boness, C. L., McDowell, Y. E., Vergés, A., Steinley, D. L., & Sher, K. J. (2018). Desistance and severity of alcohol use disorder: A lifespan-developmental investigation. Clinical Psychological Science, 6(1):90–105. https://doi.org/10.1177/2167702617736852Google Scholar
Lee, M. R., & Sher, K. J. (2018). “Maturing out” of binge and problem drinking. Alcohol Research: Current Reviews, 39(1), 31–42. PMID 30557146.Google ScholarPubMed
Linden-Carmichael, A. N., Russell, M. A., & Lanza, S. T. (2019). Flexibly modeling alcohol use disorder risk: How many drinks should we count? Psychology of Addictive Behaviors, 33(1), 50–57. https://doi.org/10.1037/adb0000431CrossRefGoogle ScholarPubMed
Moos, R. H., & Moos, B. S. (2007). Protective resources and long-term recovery from alcohol use disorders. Drug and Alcohol Dependence, 86(1), 46–54. https://doi.org/10.1016/j.drugalcdep.2006.04.015Google Scholar
Morris, J., Albery, I. P., Heather, N., & Moss, A. C. (2020). Continuum beliefs are associated with higher problem recognition than binary beliefs among harmful drinkers without addiction experience. Addictive Behaviors, 105, 106292. https://doi.org/10.1016/j.addbeh.2020.106292Google Scholar
National Institute on Alcohol Abuse and Alcoholism (2020). NIAAA recovery research definitions. www.niaaa.nih.gov/research/niaaa-recovery-from-alcohol-use-disorder/definitionsGoogle Scholar
National Institute on Alcohol Abuse and Alcoholism (2005). Helping patients who drink too much: A clinician’s guide. https://pubs.niaaa.nih.gov/publications/practitioner/cliniciansguide2005/guide.pdfGoogle Scholar
National Institute on Alcohol Abuse and Alcoholism (2020). Alcohol facts and statistics. www.niaaa.nih.gov/alcohol-facts-and-statisticsGoogle Scholar
Neale, J., Vitoratou, S., Finch, E., Lennon, P., Mitcheson, L., Panebianco, D., Rose, D., Strang, J., Wykes, T., & Marsden, J. (2016). Development and validation of SURE: A patient reported outcome measure for recovery from drug and alcohol dependence. Drug and Alcohol Dependence, 165, 159–167. https://doi.org/10.1016/j.drugalcdep.2016.06.006CrossRefGoogle Scholar
Patrick, M. E., Terry-McElrath, Y. M., Lanza, S. T., Jager, J., Schulenberg, J. E., O’Malley, P. M. (2019). Shifting age of peak binge drinking prevalence: Historical changes in normative trajectories among young adults aged 18 to 30. Alcoholism: Clinical and Experimental Research, 43(2), 287–298. https://doi.org/10.1111/acer.13933Google Scholar
Pattison, E. M., Sobell, M. B., & Sobell, L. C. (Eds.) (1977). Emerging concepts of alcohol dependence. Springer.Google Scholar
Pearson, M. R., Kirouac, M., & Witkiewitz, K. (2016). Questioning the validity of the 4+/5+ binge or heavy drinking criterion in college and clinical populations. Addiction, 111(10), 1720–1726. https://doi.org/10.1111/add.13210CrossRefGoogle ScholarPubMed
Project MATCH Research Group (1997). Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol, 58 (1), 7–29. https://doi.org/10.15288/jsa.1997.58.7Google Scholar
Room, R. (1977). Measurement and distribution of drinking patterns and problems in general populations. In Edwards, G., Gross, M. S., Keller, M., Moser, J., & Room, R. (Eds.), Alcohol-related disabilities (pp. 61–87). World Health Organization.Google Scholar
Rose, G. (2001). Sick individuals and sick populations. International Journal of Epidemiology, 30(3), 427–432. https://doi.org/10.1093/ije/30.3.427CrossRefGoogle ScholarPubMed
Rush, B. (1785). An inquiry into the effects of ardent spirits upon the human body and mind. Tract Association of Friends.Google Scholar
Seligman, M. E., & Csikszentmihalyi, M. (2000). Positive psychology. An introduction. American Psychologist, 55(1), 5–14. https://doi.org/10.1037/0003-066X.55.1.5Google Scholar
Sobell, L. C., Cunningham, J. A., & Sobell, M. B. (1996). Recovery from alcohol problems with and without treatment: Prevalence in two population studies. American Journal of Public Health, 86 (7), 966–972. https://doi.org/10.2105/ajph.86.7.966Google Scholar
Sobell, M. B., & Sobell, L. C. (1995). Controlled drinking after 25 years: How important was the great debate? Addiction, 90(9), 1149–1153; discussion 1157–1177. www.ncbi.nlm.nih.gov/pubmed/7580815Google Scholar
Substance Abuse and Mental Health Services Administration (2011). SAMHSA working definition of recovery: 10 guiding principles of recovery. https://store.samhsa.gov/shin/content//PEP12-RECDEF/PEP12-RECDEF.pdf.Google Scholar
Substance Abuse and Mental Health Services Administration (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.htmGoogle Scholar
Substance Abuse and Mental Health Services Administration (2017). National Survey of Substance Abuse Treatment Services (N-SSATSA): 2016. Data on substance abuse treatment facilities (BHSIS Series S-93, HHS Publication No. (SMA) 17-5039). www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHMethodSummDefs2017/NSDUHMethodSummDefs2017.htmGoogle Scholar
Substance Abuse and Mental Health Services Administration (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdfGoogle Scholar
Tucker, J. A., Chandler, S. D., & Witkiewitz, K. (2020a). Epidemiology of recovery from Alcohol Use Disorder. Alcohol Research: Current Reviews, 40 (30). E-pub 2020 November 12 https://doi.org/10.35946/arcr.v40.3.02Google Scholar
Tucker, J. A., Cheong, J., & Chandler, S. D. (2021). Shifts in behavioral allocation patterns as a natural recovery mechanism: Post-resolution expenditure patterns. Alcoholism: Clinical and Experimental Research. https://doi.org/10.1111/acer.14620Google Scholar
Tucker, J. A., Cheong, J., James, T. G., Jung, S., & Chandler, S. D. (2020b). Differentiating pre-resolution drinking problem severity indicators associated with maintaining stable moderation or abstinence using latent profile analysis. Alcoholism: Clinical and Experimental Research, 44(3), 738–745. https://doi.org/10.1111/acer.14287Google Scholar
Tucker, J. A., & Simpson, C. A. (2011). The recovery spectrum: From self-change to seeking treatment. Alcohol Research & Health, 33, 371–379. PMID 23580021Google Scholar
Tuithof, M., ten Have, M., van den Brink, W., Vollebergh, W., & DeGraff, R. (2016). Treatment seeking for alcohol use disorders: Treatment gap or adequate self-selection? European Addiction Research, 22(5), 277–285. https://doi.org/10.1159/000446822Google Scholar
Vaillant, G. E., & Hiller-Sturmhöfel, S. (1996). The natural history of alcoholism. Alcohol Health & Research World, 20(3), 152–161.Google Scholar
Vasilenko, S. A., Evans-Polce, R. J., & Lanza, S. T. (2017). Age trends in rates of substance use disorders across ages 18-90: Differences by gender and race/ethnicity. Drug and Alcohol Dependence, 180, 260–64. https://doi.org/10.1016/j.drugalcdep.2017.08.027Google Scholar
Vergés, A., Haeny, A. M., Jackson, K. M., Bucholz, K. K., Grant, J. D., Trull, T. J., Wood, P. K., & Sher, K. J. (2013). Refining the notion of maturing out: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. American Journal of Public Health, 103(12): e67–73. https://doi.org/10.2105/AJPH.2013.301358Google Scholar
Vilsaint, C. L., Hoffman, L. A., & Kelly, J. F. (2019). Perceived discrimination in addiction recovery: Assessing the prevalence, nature, and correlates using a novel measure in a US national sample. Drug and Alcohol Dependence, 206 , 107667. https://doi.org/10.1016/j.drugalcdep.2019.107667Google Scholar
Witbrodt, J., Kaskutas, L. A., & Grella, C. E. (2015). How do recovery definitions distinguish recovering individuals? Five typologies. Drug and Alcohol Dependence, 148, 109–117. https://doi.org/10.1016/j.drugalcdep.2014.12.036Google Scholar
Witkiewitz, K., Hallgren, K. A., Kranzler, H. R., Mann, K. F., Hasin, D. S., Falk, D. E., Litten, R. A., O’Malley, S. S., & Anton, R. F. (2017). Clinical validation of reduced alcohol consumption after treatment for alcohol dependence using the World Health Organization risk drinking levels. Alcoholism: Clinical and Experimental Research, 41(1), 179–186. https://doi.org/10.1111/ACER.13272Google Scholar
Witkiewitz, K., Montes, K., Schwebel, F., & Tucker, J. A. (2020). What is recovery? Alcohol Research: Current Reviews, 40 (3). E-pub 2020 September 30 www.arcr.niaaa.nih.gov/arcr403/article01.htmGoogle Scholar
Witkiewitz, K., & Tucker, J. A. (2020). Abstinence not required: Expanding the definition of recovery from alcohol use disorder. Alcoholism: Clinical and Experimental Research, 44(1), 36–40. https://doi.org/10.1111/acer.14235CrossRefGoogle ScholarPubMed
Witkiewitz, K., Wilson, A. D., Pearson, M. R., Montes, K. S., Kirouac, M., Roos, C., Hallgren, K. A., & Maisto, S. A. (2019). Profiles of recovery from alcohol use disorder at three years following treatment: Can the definition of recovery be extended to include high functioning heavy drinkers? Addiction, 114(1), 69–80. https://doi.org/10.1111/add.14403Google Scholar
World Health Organization (1992). The ICD-10 classification of mental and behavioral disorders: Clinical descriptions and diagnostic guidelines. www.who.int/classifications/icd/en/bluebook.pdfGoogle Scholar
World Health Organization (2018). Global status report on alcohol and health 2018. https://apps.who.int/iris/handle/10665/274603Google Scholar
Zemore, S. E., Mulia, N., Ye, Y., Borges, G., & Greenfield, T. K. (2009). Gender, acculturation, and other barriers to alcohol treatment utilization among Latinos in three national alcohol surveys. Journal of Substance Abuse Treatment, 36(4), 446–456. https://doi.org/10.1016/j.jsat.2008.09.005Google Scholar
Zemore, S. E., Murphy, R. D., Mulia, N., Gilbert, P. A., Martinez, P., Bond, J., & Polcin, D. L. (2014). A moderating role for gender in racial/ethnic disparities in alcohol services utilization: Results from the 2000–2010 National Alcohol Surveys. Alcoholism: Clinical and Experimental Research, 38(8), 2286–2296. https://doi.org/10.1111/acer.12500Google Scholar