Take two (attempts): Hope for overcoming substance use disorders


Newswise — Alcohol and drug problems are often described as ‘chronically relapsing’ conditions, implying that multiple recovery attempts are needed before an addiction can be overcome for good. However, a new study by researchers at Harvard Medical School indicates that most people with an alcohol or drug problem achieve resolution after a surprisingly small number of serious quit attempts.  

The study used survey data from a nationally representative sample of almost forty thousand US adults, of whom two thousand reported having overcome a significant drug or alcohol problem. Researchers analyzed information provided by the participants on the number of serious recovery attempts made and on their medical history and demographics. 

The number of recovery attempts needed to resolve an alcohol or drug problem ranged very widely, from zero to one hundred attempts. Moreover, the averagenumber of attempts needed was found to differ depending on the type of average calculated. The mean number of attempts – derived by adding up all quit attempts and dividing by the number of individuals – was 5.35. However, the median  – the ‘middle’ value when the number of quit attempts for all two thousand individuals were ordered from the least to most attempts ─was just two attempts. This difference shows that the mean is ‘skewed upwards’ by a small group of individuals who need many more quit attempts than most. The researchers argue that the median figure of two attempts is the more appropriate measure to report, and will offer hope to those struggling with an alcohol or drug use problem.

Factors associated with needing a higher number of attempts to quit included a history of depressive and anxiety disorders, prior use of treatment or recovery support services ─probably reflective of more serious substance use problems requiring greater external support ─and being single (rather than married/partnered) when the survey was completed. Being of black, rather than white, race was also associated with a higher number of recovery attempts; the reasons for such racial differences are unclear, and require further research.

The huge variation in the number of recovery attempts required for successful resolution highlights the need for individualized management of substance use problems.  While some groups of people ─such as those with more serious or complex alcohol/drug use problems and little available family or community support ─will require a significant level of care and treatment and recovery support services, many others will need much less intensive support. Efforts to develop treatment models for less severely affected individuals, and to extend acute care approaches towards sustained recovery management for those with more severe and complex problems, hold promise for the future.

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