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. 2017 Dec 1:181:162-169.
doi: 10.1016/j.drugalcdep.2017.09.028. Epub 2017 Oct 18.

Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy

John F Kelly  1 , Brandon Bergman  2 , Bettina B Hoeppner  2 , Corrie Vilsaint  2 , William L White  3
Affiliations

Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy

John F Kelly et al. Drug Alcohol Depend. .

Abstract

Background: Alcohol and other drug (AOD) problems confer a global, prodigious burden of disease, disability, and premature mortality. Even so, little is known regarding how, and by what means, individuals successfully resolve AOD problems. Greater knowledge would inform policy and guide service provision.

Method: Probability-based survey of US adult population estimating: 1) AOD problem resolution prevalence; 2) lifetime use of "assisted" (i.e., treatment/medication, recovery services/mutual help) vs. "unassisted" resolution pathways; 3) correlates of assisted pathway use. Participants (response=63.4% of 39,809) responding "yes" to, "Did you use to have a problem with alcohol or drugs but no longer do?" assessed on substance use, clinical histories, problem resolution.

Results: Weighted prevalence of problem resolution was 9.1%, with 46% self-identifying as "in recovery"; 53.9% reported "assisted" pathway use. Most utilized support was mutual-help (45.1%,SE=1.6), followed by treatment (27.6%,SE=1.4), and emerging recovery support services (21.8%,SE=1.4), including recovery community centers (6.2%,SE=0.9). Strongest correlates of "assisted" pathway use were lifetime AOD diagnosis (AOR=10.8[7.42-15.74], model R2=0.13), drug court involvement (AOR=8.1[5.2-12.6], model R2=0.10), and, inversely, absence of lifetime psychiatric diagnosis (AOR=0.3[0.2-0.3], model R2=0.10). Compared to those with primary alcohol problems, those with primary cannabis problems were less likely (AOR=0.7[0.5-0.9]) and those with opioid problems were more likely (AOR=2.2[1.4-3.4]) to use assisted pathways. Indices related to severity were related to assisted pathways (R2<0.03).

Conclusions: Tens of millions of Americans have successfully resolved an AOD problem using a variety of traditional and non-traditional means. Findings suggest a need for a broadening of the menu of self-change and community-based options that can facilitate and support long-term AOD problem resolution.

Keywords: Adults; Assisted; Mutual-help; Population; Prevalence; Problem resolution; Recovery; Treatment; Unassisted.

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Conflict of interest statement

Conflict of interest

The authors have no conflict of interest, including specific financial interests and relationships and affiliations relevant to the subject of this manuscript.

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