The long-term course of treated alcoholism: I. Mortality, relapse and remission rates and comparisons with community...

This study examines the course of alcoholism for a sample of patients who were followed 2 years and 10 years later after an index residential treatment episode. The alcoholic patients were 9.5 times as likely to die as matched community controls over the 8-year interval between the two follow-ups, a ratio considerably higher than that found in previous studies. Of the 83 surviving and successfully followed patients, 57% were classified as remitted at the 10-year follow-up. Of the patients classified as remitted at the 2-year follow-up and recontacted 8 years later, 77% had the same outcome status at the long-term follow-up, 67% of the initially relapsed patients retained that status at the 10-year follow-up. The 10-year remitted patients generally were functioning as well as matched, nonproblem-drinking community controls, whereas the relapsed patients exhibited dysfunction in a number of areas. Retrospective data on drinking patterns during each of the 6 years prior to the 10-year follow-up indicated a slight increase over time in the proportion of patients reporting abstinence or nonproblem drinking, with a concomitant decrease in the proportion indicating heavy or binge drinking. Overall, our data show a substantially elevated mortality risk among these alcoholic patients. For those patients who survive, however, the average course is one of modest improvement.