AA attendance was best predictor of abstinence in a 60-year follow-up of alcoholic men

A classic study of alcohol abuse and alcoholism

This prospective follow-up study examined two community cohorts of adolescent males from 1940 until 2001. Two hundred and sixty-eight undergraduates and 456 non-delinquent, socially disadvantaged adolescents participated. Since adolescence, these cohorts have been followed by repeated interview, questionnaires, and physical examination. The college cohort has been followed until age 80 and the younger core city cohort until age 70. DSM-III criteria were used to ascertain alcohol abuse and alcohol dependence.

  • At some point during their lives, 54 (20%) of the college men and
  • 140 (31%) of the core city men met criteria for alcohol abuse.

Outcome categories were mortality, continued alcohol abuse and stable remission.

These socially divergent cohorts resembled each other in four respects.

  • First, by age 70 chronic alcohol dependence was rare; this was due both to death and to stable abstinence. By age 70, 54% of the 72 successfully followed alcohol-dependent core city men had died, 32% were abstinent, 1% were controlled drinkers and only 12% were known to be still abusing alcohol. By age 70, 58% of the 19 successfully followed college alcohol-dependent men had died, 21% were abstinent, 10.5% were controlled drinkers and only 10.5% were known to be still abusing alcohol.
  • Secondly, in both samples alcohol abuse could persist for decades without remission, death or progression to dependence.
    • Thirdly, among both samples prior alcohol dependence and AA attendance were the two best predictors of sustained abstinence.
  • Fourthly, fewer lifetime symptoms of alcohol abuse was the best predictor of sustained return to controlled-drinking.

Research; Vaillant, G.E. 60-year follow-up of alcoholic men. Addiction, 98(8):1043-1051, 2003.

The Natural History of Alcoholism Revisited

The Natural History of Alcoholism Revisited

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