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First published December 2007

An Eight-Year Perspective on the Relationship Between the Duration of Abstinence and Other Aspects of Recovery

Abstract

Using data from 1,162 people entering treatment and followed up (> 94%) for 8 years, this article examines the relationship between the duration of abstinence (1 month to 5 or more years) and other aspects of recovery (e.g., health, mental health, coping responses, legal involvement, vocational involvement, housing, peers, social and spiritual support), including the trend and at what point changes occur. It also examines how the duration of abstinence at a given point is related to the odds of sustaining abstinence in the subsequent year. The findings demonstrate the rich patterns of change associated with the course of long-term recovery.

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References

American Psychological Association. 2000. Diagnostic and statistical manual of mental disorders, 4th ed., text revision. Washington, DC: Author.
Anglin, M.D., Y.I. Hser, and C.E. Grella. 1997. Drug addiction and treatment careers among clients in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behaviors 11 (4): 308—23.
Anglin, M.D., Y.I. Hser, C.E. Grella, D. Longshore, and M.L. Prendergast . 2001. Drug treatment careers: Conceptual overview and clinical, research, and policy applications. In Relapse and recovery in addictions, ed. F. Tims, C. Leukefeld, and J. Platt, 18—39. New Haven, CT: Yale University Press.
Betty Ford Consensus Panel. In press. What is recovery: A working definition from the Betty Ford Institute. Journal of Substance Abuse Treatment.
Bray, J., G. Zarkin, M. Dennis, and M. French. 2000. Symptoms of dependence, multiple substance use, and labor market outcomes. American Journal of Drug and Alcohol Abuse 26 (1): 77—95.
Carpenter, K., and D. Hasin. 1999. Drinking to cope with negative affect and DSM-IV alcohol use disorders: A test of three alternative explanations . Journal of Studies on Alcohol 60: 694—704.
Chi, F.W., D.D. Satre, and C. Weisner. 2006. Chemical dependency patients with co-occurring psychiatric diagnoses: Service patterns and 1-year outcomes. Alcoholism: Clinical and Experimental Research 30: 851—59.
Chi, F.W., and C. Weisner. in press. Nine-year psychiatric trajectories and substance use outcomes: An application of the group-based modeling approach. Evaluation Review.
Chung, T., J. Langenbucher, E. Labouvie, R.J. Pandina, and R.H. Moos. 2001. Changes in alcoholic patients' coping responses predict 12-month treatment outcomes. Journal of Consulting and Clinical Psychology 69 (1): 92—100.
Cohen, J. 1988. Statistical power analysis for the behavioral sciences . Hillsdale, NJ: Lawrence Erlbaum .
Corless, I.B., and P.K. Nicholas. 2000. Long-term continuum of care for people living with HIV/AIDS. Journal of Urban Health 77 (2): 176—86.
Cunningham, J.A. 1999a. Resolving alcohol-related problems with and without treatment: The effects of different problem criteria. Journal of Studies on Alcohol 60: 463—66.
———. 1999b. Untreated remissions from drug use: The predominant pathway . Addictive Behaviors 24 (2): 267—70.
Dawson, D. 1996. Gender differences in the risk of alcohol dependence: United States, 1992. Addiction 91(12): 1831—42.
Dennis, M.L. 1999. Global Appraisal of Individual Needs (GAIN): Administration guide for the GAIN and related measures (Version 1299). Bloomington, IL: Chestnut Health Systems.
———, G.T. Karuntzos, G.L. McDougal, M.T. French, and R.L. Hubbard. 1993). Developing training and employment programs to meet the needs of methadone treatment clients. Evaluation and Program Planning 16: 73—86.
——— and C.K. Scott. In press. Managing substance use disorders (SUD) as a chronic condition. NIDA Science and Practice Perspectives.
——— C.K. Scott, and R. Funk. 2003. An experimental evaluation of recovery management checkups (RMC) for people with chronic substance use disorders . Evaluation and Program Planning 26 (3): 339—52.
———, C.K. Scott, R. Funk, and M.A. Foss. 2005. The duration and correlates of addiction and treatment careers. Journal of Substance Abuse Treatment 28 (Suppl. 1): S51—S62.
———, J.C. Titus, M. White, J. Unsicker, and D. Hodgkins. 2003. Global Appraisal of Individual Needs (GAIN): Administration guide for the GAIN and related measures, Version 5 . Bloomington, IL: Chestnut Health Systems.
Di Sclafani, V., P. Finn, and G. Fein. 2007. Psychiatric comorbidity in long-term abstinent alcoholic individuals. Alcoholism: Clinical and Experimental Research 31: 795—803.
Dismuke, C.E., M.T. French, H.J. Salome, M.A. Foss, C.K. Scott, and M.L. Dennis. 2004. Out of touch or on the money: Do the clinical objectives of addiction treatment coincide with economic evaluation results? Journal of Substance Abuse Treatment 27 (3): 253—63.
Elder, G.H. Jr. 1985. Perspectives on the life course. In Life course dynamics: Trajectories and transitions 1968-1980, ed. G. H. Elder, 23—49. Ithaca, NY: Cornell University Press.
Finney, J.W., and R.H. Moos. 1995. Entering treatment for alcohol abuse: A stress and coping model. Addiction 90: 1223—40.
French, M.T., H.J. Salome, and M. Carney. 2002. Using the DATCAP and ASI to estimate the costs and benefits of residential addiction treatment in the state of Washington. Social Science and Medicine 55 (12): 2267—82.
Grella, C.E., C.K. Scott, and M.A. Foss. 2005. Gender differences in long-term drug treatment outcomes in Chicago PETS. Journal of Substance Abuse Treatment 28 (2S): S3—S12.
Grella, C.E., C.K. Scott, M.A. Foss, and M.L. Dennis. In press. Gender similarities and differences in the treatment, relapse and recovery cycle. Evaluation Review.
Grella, C.E., C.K. Scott, M.A. Foss, V. Joshi, and Y.I. Hser. 2003. Gender differences in drug treatment outcomes among participants in the Chicago Target Cities Study. Evaluation and Program Planning 26 (3): 297—310.
Holahan, C.J., R. Moos, C.K. Holahan, R. Cronkite, and P.K. Randall. 2003. Drinking to cope and alcohol use and abuse in unipolar depression: A 10-year model. Journal of Abnormal Psychology 112: 159—65.
Hser, Y.I., M.D. Anglin, C. Grella, D. Longshore, and M.L. Prendergast . 1997. Drug treatment careers: A conceptual framework and existing research findings. Journal of Substance Abuse Treatment 14 (6): 543—58.
Hser, Y.I., V. Hoffman, C.E. Grella, and M.D. Anglin. 2001. A 33-year follow-up of narcotics addicts. Archives of General Psychiatry 58: 503—8.
Hser, Y.I., D. Longshore, and M.D. Anglin. 2007. The life course perspective on drug use: A conceptual framework for understanding drug use trajectory and its management. Evaluation Review 31(6), 515-547.
Hser, Y.I., D. Longshore, M.L. Brecht, and M.D. Anglin. 2005. Studying the natural history of drug use. In Epidemiology of drug abuse, ed. Z. Sloboda, 29—43. New York: Springer .
Humphreys, K., R.J. Moos, and C. Cohen. 1997. Social and community resources and long-term recovery from treated and untreated alcoholism. Journal of Studies on Alcohol 58: 1—8.
Jessor, R., M.S. Turbin, and F.M. Costa. 1998. Protective factors in adolescent health behavior. Journal of Personality and Social Psychology 75 (3): 788—800.
Kessler, R.C. 1994. The National Comorbidity Survey of the United States. International Review of Psychiatry 6: 365—76.
Karuntzos, G.T. 2002. Vocational status as a moderator of substance abusers' employability. Raleigh: North Carolina State University. Retrieved December 20, 2002, from http://www.lib.ncsu.edu/theses/available/etd-08262002-111957/unrestricted/etd.pdf
Kranzler, H.R., R.M. Kadden, R.F. Babor, and B.J. Rounsaville . 1994. Longitudinal, expert all data procedure for psychiatric diagnosis in patients with psychoactive substance use disorders. Journal of Nervous and Mental Disease 182 (5): 277—83.
Kranzler, H.R., H. Tennen, T.F. Babor, R.M. Kadden, and B.J. Rounsaville . 1997. Validity of the longitudinal, expert, all data procedure for psychiatric diagnosis in patients with psychoactive substance use disorders. Drug and Alcohol Dependence 45: 93—104.
Kushner, M.G., K. Abrams, P. Thuras, K.L. Hanson, M. Brekke, and S. Sletten. 2005. Follow-up study of anxiety disorder and alcohol dependence in comorbid alcoholism treatment patients. Alcoholism: Clinical and Experimental Research 29: 1432—43.
Laub, J.H., and R.J. Sampson. 2001. Understanding desistance from crime . In Crime and justice: A review of research, ed. M. Tonry, 2—69. Chicago: University of Chicago Press.
Laudet, A., S. Magura, H. Vogel, and E.L. Knight. 2004. Perceived reasons for substance misuse among persons with a psychiatric disorder. American Journal of Orthopsychiatry 74 (3): 365—75.
Laudet, A., K. Morgen, and W. White. 2006. The role of social supports, spirituality, religiousness, life meaning and affiliation with 12-step fellowships in quality of life satisfaction among individuals in recovery from alcohol and drug use . Alcoholism Treatment Quarterly 24 (1/2): 33—73.
Laudet, A.B., W.L. White, and G. Storey. In press. Recovery capital as prospective predictor of sustained recovery, life satisfaction, and stress among former poly-substance users. Substance Use and Misuse.
Loeber, R., and M. LeBlanc. 1990. Toward a developmental criminology. In Crime and justice, vol. 12, ed. M. Tonry and N. Morris, 375—473. Chicago: University of Chicago Press.
McAweeney, M.J., R. Zucker, H. Fitzgerald, L. Puttler, and M. Wong. 2005. Individual and partner predictors of recovery from alcohol-use disorder over a nine-year interval: Findings from a community sample of alcoholic married men. Journal of Studies on Alcohol 66 (2): 220—28.
McCollister, K.E., and M.T. French. 2003. The relative contribution of outcome domains in the total economic benefit of addiction interventions: A review of first findings. Addiction 98: 1647—59.
McLellan, A.T., H. Kushner, D. Metzger, R. Peters, I. Smith, G. Grissom, H. Pettinati, and M. Argeriou. 1992. The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment 9: 199—213.
McLellan, A.T., D.C. Lewis, C.P. O'Brien, and H.D. Kleber. 2000. Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. Journal of the American Medical Association 284 (13): 1689—95.
Mertens, J.R., Y.W. Lu, S. Parthasarathy, C. Moore, and C.M. Weisner. 2003. Medical and psychiatric conditions of alcohol and drug treatment patients in an HMO. Archives of Internal Medicine 163: 2511—17.
Miller, W.R. 1998. Researching the spiritual dimensions of alcohol and other drug problems. Addiction 93 (7): 979—90.
———, V.S. Westerberg, R.J. Harris, and J.S. Tonigan. 1996. What predicts relapse? Prospective testing of antecedent models. Addiction 91: S155—S172.
Moggi, F., P.C. Ouimette, R.H. Moos, and J.W. Finney. 1999. Dual diagnosis patients in substance abuse treatment: Relationship of general coping and substance-specific coping to 1-year outcomes. Addiction 94 (12): 1805—16.
Mokdad, A.H., J.S. Marks, D.F. Stroup, and J.L. Gerberding . 2004. Actual causes of death in the United States, 2000. Journal of the American Medical Association 291 (10): 1238—45.
Moos, R.H. 1993. Coping Responses Inventory: Adult form. Odessa, FL: Psychological Assessment Resources.
——— and B.S. Moos. 2005. Sixteen-year changes and stable remission among treated and untreated individuals with alcohol use disorders. Drug and Alcohol Dependence 80 (3): 337—47.
——— and B.S. Moos. 2006. Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction 101 (2): 212—22.
——— and B.S. Moos. 2007. Protective resources and long-term recovery from alcohol use disorders. Drug and Alcohol Dependence 86: 46—54.
National Institute on Alcohol Abuse and Alcoholism. 2006. Five-year strategic plan (FY07-11). Alcohol across the lifespan. U.S. Department of Health and Human Services . Retrieved March 3, 2007, from http://pubs.niaaa.nih.gov/publications/StrategicPlan/NIAAASTRATEGICPLAN.htm
National Institute on Drug Abuse. 2006. Principles of drug abuse treatment for criminal justice populations: A research-based guide. Rockville, MD: National Institute on Drug Abuse.
Pescosolido, B.A., and C.A. Boyer. 1999. How do people come to use mental health services? Current knowledge and changing perspectives. In A handbook for the study of mental health: Social contexts, theories and systems, ed. A. V. Horwitz and T. L. Scheid, 392—411. New York: Cambridge University Press.
Piquero, A.R., D.P. Farrington, and A. Blumstein. 2003. The criminal career paradigm: Background and recent developments. In Crime and justice: A review of research, ed. M. Tonry, 359—506. Chicago: University of Chicago Press.
Prendergast, M.L., D. Podus, E. Chang, and D. Urada. 2002. The effectiveness of drug abuse treatment: A meta-analysis of comparison group studies. Drug and Alcohol Dependence 67 (1): 53—72.
Procidano, M.E., and K. Heller. 1983. Measures of perceived social support from friends and from family: Three validation studies. American Journal of Community Psychology 11 (1): 1—24.
Rajkumar, A., and M. French. 1997. Drug abuse, crime costs, and the economic benefits of treatment. Journal of Quantitative Criminology 13 (3): 293—323.
Robins, L.N., and D.A. Regier. 1991. Psychiatric disorders in America. New York: MacMillan.
Rounsaville, B.J., T.R. Kosten, M.M. Weissman, and J.D. Kleber. 1986. Prognostic significance of psychiatric disorders in treated opiate addicts. Archives of General Psychiatry 43: 739—45.
Rounsaville, B.J., M.M. Weissman, K. Crits-Christoph, C. Wilber, and H.D. Kleber. 1982. Diagnosis and symptoms of depression in opiate addicts. Archives of General Psychiatry 39: 151—56.
Rush, B.R., M.L. Dennis, C.K. Scott, S. Castel, and R.R. Funk. In press. The interaction of co-occurring mental disorders and recovery management checkups on substance abuse treatment participation and recovery. Evaluation Review.
Substance Abuse and Mental Health Services Administration. 2002. Report to Congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders, November ed. Rockville, MD: U.S. Department of Health and Human Services.
Sampson, R.J., and J.H. Laub. 2005. A life-course view of the development of crime. The Annals of the American Academy of Political and Social Science 602 (1): 12—45.
Schutte, K., F. Byrne, P. Brennan, and R. Moos. 2001. Successful remission of late-life drinking problems: A 10-year follow-up. Journal of Studies on Alcohol 62: 322—34.
Scott, C.K., M.L. Dennis, M.D. Godley, and M.A. Foss. 1995. Intake Augmented—Addiction Severity Index (instrument developed under CSAT Grant No. 5—U95—TI00664) . Chicago: Chestnut Health Systems .
Scott, C.K., M.A. Foss, and M.L. Dennis. 2003. Factors influencing initial and longer-term responses to substance abuse treatment: A path analysis. Evaluation and Program Planning 26 (3): 287—95.
Scott, C.K., M.A. Foss, and M.L. Dennis. 2005a. Pathways in the relapse, treatment, and recovery cycle over three years. Journal of Substance Abuse Treatment 28 (2S): S63—S72.
Scott, C.K., M.A. Foss, and M.L. Dennis. 2005b. Utilizing Recovery Management Checkups to shorten the cycle of relapse, treatment reentry, and recovery. Drug and Alcohol Dependence 78: 325—38.
Scott, C.K., M.A. Foss, A.J. Lurigio, and M.L. Dennis. 2003. Pathways to recovery after substance abuse treatment: Leaving a life of crime behind. Evaluation and Program Planning 26 (4): 403—12.
Scott, C.K., M.A. Foss, and R.E. Sherman. 2003a. Effects of centralized intake on participant satisfaction with treatment and ancillary services. In Clinical assessment and substance abuse treatment: The target cities experience, ed. R. C. Stephens, C. K. Scott, and R. D. Muck, 149—64. Albany: State University of New York Press.
Scott, C.K., M.A. Foss, and R.E. Sherman. 2003b. Outcomes before and after implementing centralized intake services. In Clinical assessment and substance abuse treatment: The target cities experience, ed. R. C. Stephens, C. K. Scott, and R. D. Muck, 7—15. Albany: State University of New York Press.
Scott, C.K., R.D. Muck, and M.A. Foss. 2000. The impact of centralized intake on access to treatment and satisfaction with intake procedures. In Advances in medical sociology: Vol. 7, Emergent issues in the field of drug abuse, ed. J. A. Levy, R. C. Stephens, and D. C. McBride, 131—50. Stamford, CT: JAI Press.
Shah, N.G., N. Galai, D.D. Celentano, D. Vlahov, and S.A. Strathdee. 2005. Longitudinal predictors of injection cessation and subsequent relapse among a cohort of injection drug users in Baltimore, MD, 1988-2000. Drug and Alcohol Dependence 83: 147—56.
Simpson, D.D., G.W. Joe, and K.M. Broome. 2002. A national 5-year follow-up of treatment outcomes for cocaine dependence. Archives of General Psychiatry 59 (6): 538—44.
Single, E., L. Robson, X. Xie, and J. Rehm. 1998. The economic costs of alcohol, tobacco, and illicit drugs in Canada, 1992. Addiction 93 (7): 991—1006.
Somer, E. 2003. Prediction of abstinence from heroin addiction by childhood trauma, dissociation, and extent of psychosocial treatment. Addiction Research and Theory 1: 339—48.
Vaillant, G.E. 1988. What can long-term follow-up teach us about relapse and prevention of relapse in addiction? British Journal of Addiction 83: 1147—57.
Weisner, C., H. Matzger, and L.A. Kaskutas. 2003. How important is treatment? One-year outcomes of treated and untreated alcohol-dependent individuals. Addiction 98: 901—11.
White, W.L. 1996. Pathways from the culture of addiction to the culture of recovery: A travel guide for addiction professionals, 2nd Ed. Center City, MN: Hazelden .
———. 2005. Recovery management: What if we really believed that addiction was a chronic disorder? GLATTC BULLETIN. Retrieved December 31, 2005, from http://www.glattc.org
Xie, H., R. Drake, and G. McHugo. 2006. Are there distinctive trajectory groups in substance abuse remission over 10 years? An application of the group-based modeling approach. Administration and Policy in Mental Health 33: 423—32.

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Article first published: December 2007
Issue published: December 2007

Keywords

  1. alcohol
  2. drug
  3. addiction
  4. recovery
  5. life course

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PubMed: 17986709

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Michael L. Dennis
Chestnut Health Systems, Chicago and Bloomington, Illinois, [email protected].
Mark A. Foss
Chestnut Health Systems, Chicago and Bloomington, Illinois
Christy K. Scott
Chestnut Health Systems, Chicago and Bloomington, Illinois

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