Natural recovery in a community-based sample of alcoholics: study design and descriptive data.

The majority of alcoholics who recover do so without the benefit of treatment, yet little is known about these individuals and the factors associated with their success. A better understanding is needed of the self-initiated and maintained change processes ("natural recovery") associated with such recoveries. In the current study, initiated in 1997, we followed up alcoholics identified in four previous community surveys and conducted a brief physical examination and an in-depth interview assessing factors thought to be associated with "natural recovery" or entry into treatment. Here we present the study model, describe our sample of 83 "naturally recovered" and 138 "hazardous problem drinkers," and report factors associated with "natural recovery." During the period when their drinking was at its most problematic, those who naturally recovered had discussed their alcohol-use associated problems with fewer network members and had been advised to stop drinking or to drink less by fewer network members. In addition to older age, "natural recovery" was associated with marriage, lower levels of avoidant coping, higher self-esteem, social networks with members who drank less, and a history of less frequent drug use and lower frequencies of intoxication. Rates of "natural recovery'' may be increased by encouraging the development of these attributes in hazardous problem drinkers who do not already have them.