Friday, March 28, 2014

The Natural History of Alcoholism - Revisited

In 1983, Dr. George Vaillant published a book titled “The Natural History of Alcoholism”.  It was the result of a landmark study conducted in the Boston area.  There were a number of things that made the study so powerful and important.  The study involved a large group of men from different backgrounds.  Researchers began to interview the men when they were still teenagers and followed them for about 40 to 50 years.  The researchers were able to interview the subjects every few years to see if they became alcoholic or not.  Then they were able to look back at their data to see if there were any factors that determined if the subjects became alcoholic or not.  If the study subjects did become alcoholic, the researchers were able to see what happened to them.  The results were impressive.  The study powerfully supported the idea that alcoholism is a disease, a disease that commonly affects many people from all walks of life.  In 1995, Dr. Vaillant published a follow up book with the original results and another 10 years of follow up data.

Some of the findings from Dr. Vaillant’s study included:
  • Factors that predict alcoholism included: alcoholism in relatives, a personality that is extroverted or antisocial and the ethnic culture – it was more common in Irish descendants than in Italian descendants.
  • The presence of an alcoholic parent increased the likelihood of alcoholism by three times.  If there was a distant relative the rate of alcoholism was increased two times.
  •  An unhappy childhood did not predict future alcoholism ... unless the family problems were due to alcoholism.
  • Alcoholism was generally the cause of depression, anxiety and sociopathic (delinquent) problems.  The alcoholism was not the result of these problems.
  • The so-called “alcoholic personality” – self-centered, immature, dependent, resentful, and irresponsible – was not evident until after the subjects had started to abuse alcohol.
  •  Even though alcoholism is not solely a medical condition, it is helpful therapeutically to explain it to patients as a disease.  The disease concept helps patients take responsibility for their drinking without debilitating guilt.
  • “In this respect, Alcoholism resembles Coronary Heart Disease, which starts as voluntary, unhealthy behaviors such as poor diet and lack of exercise, but ends in a life threatening condition”.
  • For most alcoholics, attempts at controlled drinking, end in either abstinence or a return to alcoholism.
  • Older (active) alcoholics were relatively rare because they either got sober or they died.
  • As of this time (1995), there is no cure for alcoholism. Medical treatment only provides short-term crisis intervention.
  • Of the Core City samples, 72 alcoholic men were followed until age 70.  By this time 54% had died, 32% were abstinent.  Only 1% were controlled drinkers, and 12% were still abusing alcohol.
  • Of the university student sample, there were 19 alcoholics who were followed to age 70.  Of these 19 subjects: 11 had died, 4 were abstinent, 2 were still abusing alcohol and 2 were controlled drinking.
  • “Subjects who had a stable social environment or who frequently went to AA meetings had the highest rates of abstinence”.
  • Achieving long-term sobriety usually involves new relationships, sources of inspiration and hope, experiencing the negative consequences of heavy drinking, and a less harmful substitute dependency. 
  • AA and other similar groups effectively harness the above 4 factors of healing, and many alcoholics achieve sobriety through AA attendance.

This landmark study has indeed contributed greatly to our understanding of the “natural history” of alcoholism.

What was most fun about hearing and seeing Dr. Vaillant was to feel his presence.  He appeared happy, calm, relaxed and confident and exuded serenity.  I don’t think it is any coincidence that he has spent a lot of his life around AA members, thinking about how people become happy and how to be fully present in this world! 

At The Coleman Institute, we want to help you get clean and stay clean.  If you or someone you love is in need of detox off of alcohol, opiates, benzos, Methadone or Suboxone, please do not hesitate to call Jennifer Pius or Amy Stewart at 1.877.773.3869 today.  We are here for you!  

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