October 17th, 2014

This is the last in a series of three posts that I’ve written highlighting the groundbreaking, long-term study of alcoholism by George Vaillant. By sharing these key findings from his work, I hope to encourage the clinical community to keep having conversations about treating this devastating disease.

Last week’s post focused on the basic questions that we often ask as we attempt to understand and treat alcoholism. George Vaillant’s study of alcoholism went on to address some basic questions about recovery:

1-    Did alcoholics ever return to non-problem drinking?

Answer: Yes, but very rarely and only those who had barely met the criteria for the diagnosis. Even for those individuals, drinking was “not carefree’ (which I take to mean that energy was expended to keep the drinking from at times slipping out of control).

2-    What characterized successful abstainers?

Answer: They tended to have more severe alcoholism. Their level of education was not a predictor.

3-    What role did AA attendance play in recovery according to the George Vaillant research?

Answer: Sustained abstinence was strongly associated with regular AA attendance. Those who attended AA regularly tended to be more severely alcoholic, were of Irish ethnicity, and had a warm childhood environment with an absence of maternal neglect.

4-    How much time was necessary before recovery could be considered stable?

Answer: Only after five years of abstinence could remission from alcoholism be regarded as stable.

5-    Did recovering alcoholics live a normal life span?

Answer: Usually not — alcoholics died earlier than social drinkers. Even if abstinent from alcohol, alcoholics died earlier because of tobacco use. The only ones who lived longer were those who achieved “a permanent change in self-care” (i.e. stopped use of tobacco as well as alcohol).

One surprising finding from George Vaillant that did not come out until the passage of 74 years was that alcoholism was the single most common cause of divorce. The reason this took so long to come out was that the men, both alcoholic and non-alcoholic, were extremely reluctant to talk about their wives’ alcoholism.

They were quicker to talk about their own alcoholism or own sexual infidelities. The divorce finding emerged after including the alcoholism of both the study subjects and their wives. George Vaillant points out that this finding had not been previously reported in the literature on marriages.

My brief summaries of the findings from George Vaillant in Triumphs of Experience cannot do justice to the richness of the details of the study. I urge you to see for yourself by reading the entire book.

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