Is Recovery from Alcoholism without Treatment Possible? a Review of the Evidence

Background and Purpose:  Alcohol use disorders (AUD), a category consisting of individuals diagnosed with alcoholism, alcohol abuse, and alcohol dependence are prevalent in the United States with an estimated 17 million meeting criteria for this classification (National Institute for Alcohol Abuse and Alcoholism [NIAAA], 2014). It is increasingly common for individuals diagnosed with an AUD to be told by practitioners and family members their only chance at recovery is through formal treatment, such as outpatient substance abuse programs, inpatient detoxification and recovery programs, or self-help groups such as Alcoholics Anonymous (AA). While research supports these methods of recovery as optimal paths to successful remittance of alcohol use disorders, most individuals diagnosed with alcohol abuse or dependence do not receive formal treatment (NIAAA, n.d.; Timko, Moos, Finney, & Lesar, 2000). According to the NIAAA (2014), in 2012, 17 million adults living in the United States were diagnosed with an alcohol use disorder yet only 8.4% received AUD treatment at a specialized facility. The purpose of this review is to collect and report the findings of published studies that report the incidence of diagnosed alcoholics who, without formal treatment, achieved a state of abstinence.

Methods: Potential studies were identified through searches of electronic bibliographic databases. Studies were selected for review if they met the following criteria: 1) were published in a scholarly journal, 2) were published prior to March 2014, 3) were written in the English language, 4) contained study participants were over the age of 18, 5) study participants had an initial diagnosis of alcoholism, alcohol abuse, or alcohol dependence, 6) study participants had never been known to receive formal group or individual substance abuse treatment, and 7) recovery was defined as maintained sobriety for a minimum six consecutive month period.

Results: Sixteen studies meeting inclusionary criteria and published between 1976 – 2013 were located and reviewed. A growing body of evidence confirms successful remittance of alcoholism can be achieved and maintained over time, without formal treatment. Based on the review of the available empirical studies, achieving abstinence from alcoholism is not solely dependent upon whether or not an individual receives formal treatment. Successful remittance from alcoholism absent treatment is not only possible; it is plausible.

Conclusion: Contrary to common lay and professional perceptions, a significant percentage of alcoholics appear to achieve sobriety without receiving formal treatment.  However it is not yet possible to predict who these individuals might be.  Thus entering into formal treatment remains the safest recommendation. Recommendations for future research include: additional studies comparing untreated vs. treated samples, studies evaluating gender and socioeconomic differences among remitters, and increasing the number of, and length of time between follow-up assessments.