Smart readers

Loran Archer left the following comment on the previous post:

Lifetime DSM-IV alcohol dependence in the NIAAA NESARC survey is not a chronic condition. It a broad spectrum of disorders ranging from mild dependence (3 to 9 lifetime symptoms), moderate dependence (10 to 14 lifetime symptoms)and severe dependence (15+ lifetime symptoms).

The 63% with mild and moderate lifetime symptoms do not self-identify as alcoholics and would not be identified by others as alcoholics. If they attend AA 53% will drop out.

The mild/moderate and the severe dependent populations are categorically different types of drinkers. 

In an earlier study of AA access and continuance, A model of access to and continuance in Alcoholics Anonymous http://knol.google.com/k/a-model-of-access-to-and-continuance-in-alcoholics-anonymous# , I describe the differences.

His link is an AMAZING resource. He has two Knol articles:

• A model of access to and continuance in Alcoholics Anonymous
• Pathways to abstinence: Impact of Alcoholics Anonymous

I've never seen such a clear summary of research on AA attendance and abstinence among AA attendees (and dropouts).

The first paper reports on the people who try AA, who continues, who does not and possible reasons.

The second looks at abstinence rates among people who have attended AA.

It looks at data from only one study and some of the numbers are not huge due to low numbers of subjects with any prior AA attendance, and it won't satisfy critics who will only accept randomized controlled trial, but it seems to me like a pretty strong response to a lot of the twelve-step facilitation criticism.

From the conclusions of the paper on abstinence:

The abstinence recovery rate for Americans with high severity alcohol disorders who continue to attend AA ranges from a low of 45%, age 18-29, to a high of 84%, age 50+ years.

The findings of this study support the findings of Kaskutas et al that "disengagement from AA does not necessarly translate to a return to drinking". The rates of abstinence, over 60%, in the 40+ years high severity AA drop outs are similar to the rate of abstinence, 63%, in the 30-39 year age high severity group who continued in AA.. The findings suggest that a substantial portion of the "AA drop outs" attain sobriety or abstinence after a period of AA membership and maintain their abstinence without AA attendance.