Long-term treatment careers and outcomes of previously untreated alcoholics

The aim of this project was to describe treatment selection and outcomes over an 8-year follow-up period for 466 individuals who had drinking problems and had not yet received formal treatment at baseline.

By the 8-year follow-up, individuals had self-selected into one of four groups: no-treatment (n = 78); completed treatment (help was received only in Years 1-3 of follow-up; n = 230); additional treatment (help was received in Years 1-3, with more help in Years 4-8; n = 134); and delayed treatment (no help was received until Years 4-8 of follow-up; n = 24).

Compared with individuals who remained untreated, the completed treatment group had more severe drinking problems and depression at baseline, but better drinking outcomes at both the 3- and 8-year follow-ups. At 3 years, the additional treatment group perceived their drinking problem as being more serious than did the untreated group and was more likely to have drinking-related problems; by 8 years, individuals who had obtained additional treatment were more likely to be abstinent, but still perceived their drinking problems as being more serious. Compared to individuals who completed treatment in Years 1-3, additional treatment group members had more severe drinking and functioning problems at 3 and 8 years. More involvement with formal outpatient treatment or AA was associated with more improvement on drinking indices.

Persons with alcohol use disorders who elect to enter formal treatment or AA relatively soon after acknowledging their drinking problems experience better drinking-related outcomes than do those who receive no help or who delay receiving help. Accordingly, referral processes should ensure that problem drinkers enter self-help or formal treatment quickly.