Time to alcohol dependence after abstinence and first drink

Area of Science:

• Addiction Medicine
• Neuroscience
• Psychiatry

Background:

• Relapse is common in alcohol dependence.
• The speed of relapse to alcohol dependence after abstinence is not well understood.
• Previous dependence may influence future relapse dynamics.

Purpose of the Study:

• To compare the time taken to develop initial alcohol dependence with the time taken to re-establish dependence after a period of abstinence.
• To investigate the acceleration of alcohol dependence upon relapse.

Main Methods:

• A cohort of 31 individuals with a history of alcohol dependence and at least 2 months of abstinence were interviewed.
• Subjects who had relapsed into dependence were assessed for the time taken to re-establish dependence.
• Statistical analysis was performed to compare initial dependence timelines with relapse timelines.

Main Results:

• The median time to initial alcohol dependence was 13 years, while the median time to dependence upon relapse was 7 days, representing a 700-fold acceleration.
• Most relapses occurred rapidly, with many subjects re-establishing dependence within days or weeks of resuming drinking.
• The time to initial dependence and the duration of abstinence did not correlate with the time to relapse.

Conclusions:

• Alcohol dependence can re-establish much more rapidly after abstinence than it initially developed.
• Patients in recovery should be warned about the risk of accelerated dependence upon resumed drinking.
• Recurrent drinking following abstinence should be treated as a medical emergency due to the potential for rapid re-dependence.