Conclusions
The diverse research discussed here, ranging from surveys to RCTs to process-oriented naturalistic studies, converged to raise previously overlooked research questions about relations between patterns of help-seeking and drinking problem resolutions. Contrary to conventional views, treatment is neither a necessary nor a sufficient condition for resolution, which can occur through a number of pathways and is influenced by extratherapeutic contextual variables. Further research on the variable course of resolutions, the surrounding contexts, and relations with help-seeking holds promise for informing the development of a range of interventions for drinking problems across the continuum of severity and for increasing their appeal.
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References
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: Author.
Armor, D.J., & Meshkoff, J.E. (1983). Remission among treated and untreated alcoholics. In N.K. Mello (ed.), Advances in Substance Abuse: Behavioral and Biological Research. Greenwich, CT: JAI Press, Vol. 3, pp. 239–269.
Bickel, W.K., & Vuchinich, R.E. (eds.) (2000). Reframing Health Behavior Change with Behavioral Economics. Mahwah, NJ: Erlbaum.
Blomqvist, J. (1996). Paths to recovery from substance misuse: Change of lifestyle and the role of treatment. Substance Use & Misuse 31, 1807–1852.
Chaloupka, F.J., Grossman, M., Bickel, W.R., & Saffer, H. (eds.) (1999). The Economic Analysis of Substance Use and Abuse: An Integration of Econometric and Behavioral Economic Research. (A National Bureau of Economic Research Conference Report.) Chicago, IL: University of Chicago Press.
Crawford, A.L., & Tucker, J.A. (2002). Life events surrounding behavior change efforts and treatment entry among women with bulimia nervosa. Submitted for review.
Cunningham, J.A., Sobell, L.C., Sobell, M.B., Agrawal, S., & Toneatto, T. (1993). Barriers to treatment: Why alcohol and drug abusers delay or never seek treatment. Addictive Behaviors 18, 347–353.
Dawson, D.A. (1996). Correlates of past-year status among treated and untreated persons with former alcohol dependence: United States, 1992. Alcoholism: Clinical and Experimental Research 20, 771–779.
Eysenck, H. (1952). The effects of psychotherapy: An evaluation. Journal of Consulting Psychology 16, 319–324.
Fillmore, K.M. (1988). Alcohol Use Across the Life Course: A Critical Review of 70 Years of International Longitudinal Research. Toronto: Addiction Research Foundation.
Fortney, J.C., Booth, B.M., & Curran, G.M. (1999). Do patients with alcohol dependence use more services? A comparative analysis with other chronic disorders. Alcoholism: Clinical and Experimental Research 23, 127–133.
Grant, B.F. (1996). Toward an alcohol treatmentmodel: A comparison of treated and untreated respondents with DSM-IV alcohol use disorders in the general population. Alcoholism: Clinical and Experimental Research 20, 372–378.
Hilton, M.E. (1987). Drinking patterns and drinking problems in 1984: Results from a general population survey. Alcoholism: Clinical and Experimental Research 11, 167–175.
Hodgins, D.C., El-Quebaly, N. (2000). Natural and treatment-assisted recovery from gambling problems: A comparison of resolved and active gamblers. Addiction 95, 777–789.
Humphreys, K., & Tucker, J.A. (2002). Toward more responsive and effective intervention systems for alcohol-related problems. Addiction 7, 126–132.
Humphreys, K., & Weisner, C. (1999, June). The one-year course of alcohol dependence in a community sample. Presented at the meeting of the Research Society on Alcoholism, Santa Barbara, CA.
Humphreys, K., Moos, R.F., & Finney, J.W. (1995). Two pathways out of drinking problems without professional treatment. Addictive Behaviors 20, 427–441.
Institute of Medicine (1990). Broadening the Base of Treatment for Alcohol Problems. Washington, DC: National Academy Press.
King, M.P., & Tucker, J.A. (1998). Natural resolution of alcohol problems without treatment: Environmental contexts surrounding the initiation and maintenance of stable abstinence or moderation drinking. Addictive Behaviors 23, 537–541.
King, M.P., & Tucker, J.A. (2000). Behavior change patterns and strategies distinguishing moderation drinking and abstinence during the natural resolution of alcohol problems without treatment. Psychology of Addictive Behaviors 14, 48–55.
Klingemann, H.K.-H. (1991). The motivation for change from problem alcohol and heroin use. British Journal of Addiction 86, 727–744.
Klingemann, H., Sobell, L. Barker, J., Blomqvist, J., Cloud, W., Ellinstad, T., Fingfeld, D., Granfield, R., Hodgins, D., Hunt, G., Junker, C., Moggi, F., Peele, S., Smart, R., Sobell, M., & Tucker, J. (2001). Promoting Self-Change from Problem Substance Use: Practical Implications for Prevention, Policy and Treatment. Dordrecht, The Netherlands: Kluwer Academic.
Levenson, M.R., Aldwin, C.M., & Spiro, A. (1998). Age, cohort and period effects on alcohol consumption and problem drinking: Findings from the Normative Aging Study. Journal of Studies on Alcohol 59, 712–722.
Luborsky, L., Singer, B., & Luborsky, L. (1975). Comparative studies of psychotherapies: Is it true that “everyone has won and all must have prizes”? Archives of General Psychiatry 32, 995–1008.
Maisto, S.A., Sobell, L.C., Sobell, M.B., Lei, H., & Sykora, K. (1988). Profiles of drinking patterns before and after outpatient treatment for alcohol abuse. In T. Baker & D. Cannon (eds.), Assessment and Treatment of Addictive Behaviors. New York: Praeger, pp. 3–27.
Mariezcurrena, R. (1994). Recovery from addictions without treatment: Literature review. Scandinavian Journal of Behaviour Therapy 23, 131–154.
Marlatt, G.A., Tucker, J.A. Donovan, D.M., & Vuchinich, R.E. (1997). Help-seeking by substance abusers: The role of harm reduction and behavioral-economic approaches to facilitate treatment entry and retention. In L.S. Onken, J.D. Blaine, & J.J. Boren (eds.), Beyond the Therapeutic Alliance: Keeping the Drug-Dependent Individual in Treatment (National Institute on Drug Abuse Monograph No. 165). Rockville, MD: U.S. Dept. of Health and Human Services, National Institutes of Health, pp. 44–84.
Mechanic, D. (1978). Medical Sociology, 2nd ed. New York: The Free Press.
Miller, W.R., & Page, A.C. (1991). Warm turkey: Other routes to abstinence. Journal of Substance Abuse Treatment 8, 227–232.
Narrow, W.E., Regier, D.A., Rae, D.S., Manderscheid, R.W., & Locke, B.A. (1993). Use of services by persons with mental and addictive disorders. Archives of General Psychiatry 50, 95–107.
Peele, S. (1993). The Diseasing of America: Addiction Treatment out of Control. Boston, MA: Houghton Mifflin.
Prochaska, J.O., DiClemente, C.C., & Norcross, J.C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist 47, 1102–1114.
Regier, D.A., Narrow, W.E., Rae, D.S., Manderscheid, R.W., Locke, B.A., & Goodwin, F.K. (1993). The de facto U.S. mental and addictive disorders service system. Archives of General Psychiatry 50, 85–94.
Robins, L.N. (1993). Vietnam veterans’ rapid recovery from heroin addiction: A fluke or normal expectation? Addiction 88, 1041–1054.
Robins, L.N., Helzer, J.E., & Davis, D.H. (1975). Narcotic use in Southeast Asia and afterward. Archives of General Psychiatry 32, 955–961.
Roizen, R., Cahalan, D., & Shanks, P. (1977). “pontaneous remission” among untreated problem drinkers. In D.B. Kandel (ed.), Longitudinal Research on Drug Use. Washington, DC: Hemisphere, pp. 197–221.
Roizen, R., & Fillmore, K.M. (2001). Some notes on the new paradigmatic environment of “natural remission” studies in alcohol research. Substance Use & Misuse 36, 1443–1466.
Room, R. (1977). Measurement and distribution of drinking patterns and problems in general populations. In G. Edwards, M.M. Gross, M. Keller, J. Moser, & R. Room (eds.), Alcohol-Related Disabilities. Geneva, Switzerland: World Health Organization, pp. 61–87.
Rosenberg, H. (1993). Prediction of controlled drinking by alcoholics and problem drinkers. Psychological Bulletin 113, 129–139.
Rumpf, H.-J., Bischof, G., Hapke, U., Meyer, C., & John, U. (2000). Studies on natural recovery from alcohol dependence: Sample selection bias by media solicitation? Addiction 95, 765–775.
Schachter, S. (1982). Recidivism and self-cure of smoking and obesity. American Psychologist 37, 436–444.
Schmidt, L.A., & Weisner, C.M. (1999). Public health perspective on access and need for substance abuse treatment. In J.A. Tucker, D.M. Donovan, & G.A. Marlatt (eds.), Changing Addictive Behavior: Bridging Clinical and Public Health Strategies. New York: Guilford, pp. 67–96.
Smart, R.G. (1975/76). Spontaneous recovery in alcoholics: A review and analysis of the available research. Drug and Alcohol Dependence 1, 277–285.
Sobell, L.C., Cunningham, J.A., & Sobell, M.B. (1996). Recovery from alcohol problems with and without treatment: Prevalence in two population surveys. American Journal of Public Health 86, 966–972.
Sobell, L.C., Ellingstad, T.P., & Sobell, M.B. (2000). Natural recovery from alcohol and drug problems: Methodological review of the research with suggestions for future research. Addiction 95, 749–764.
Sobell, L.C., Sobell, M.B., & Toneatto, T. (1992). Recovery from alcohol problems without treatment. In N. Heather, W.R. Miller, & J. Greeley (eds.), Self-Control and Addictive Behaviors. New York: Maxwell Macmillan, pp. 192–242.
Sobell, M.B., & Sobell, L.C. (1999). Stepped care for alcohol problems: An efficient method for planning and delivering clinical services. In J.A. Tucker, D.M. Donovan, & G.A. Marlatt (eds.), Changing Addictive Behavior: Bridging Clinical and Public Health Strategies. New York: Guilford, pp. 331–343.
Stall, R., & Biernacki, P. (1986). Spontaneous remission from the problematic use of substances: An inductive model derived from a comparative analysis of the alcohol, opiate, tobacco, and food/obesity literatures. International Journal of the Addictions 21, 1–23.
Tinker, J.E., & Tucker, J.A. (1997). Environmental events surrounding natural recovery from obesity. Addictive Behaviors 22, 571–575.
Tuchfeld, B.S. (1980). Spontaneous remission in alcoholics: Empirical observations and theoretical implications. Journal of Studies on Alcohol 56, 597–610.
Tucker, J.A. (1995). Predictors of help-seeking and the temporal relationship of help to recovery among treated and untreated recovered problem drinkers. Addiction 90, 805–809.
Tucker, J.A. (1999). Changing addictive behavior: Historical and contemporary perspectives. In J.A. Tucker, D.M. Donovan, & G.A. Marlatt (eds.), Changing Addictive Behavior: Bridging Clinical and Public Health Strategies. New York: Guilford, pp. 3–44.
Tucker, J.A. (2001). Resolving alcohol and drug problems with and without interventions: Understanding relations between addictive behavior change and the use of services. Substance Use & Misuse 36, 1501–1518.
Tucker, J.A., & King, M.P. (1999). Resolving alcohol and drug problems: Influences on addictive behavior change and help-seeking processes. In J.A. Tucker, D.M. Donovan, & G.A. Marlatt (eds.), Changing Addictive Behavior: Bridging Clinical and Public Health Strategies. New York: Guilford, pp. 97–126.
Tucker, J.A., Vuchinich, R.E., & Gladsjo, J.A. (1990/91). Environmental influences on relapse in substance use disorders. International Journal of the Addictions 25, 1017–1050.
Tucker, J.A., Vuchinich, R.E., & Gladsjo, J.A. (1994). Environmental events surrounding natural recovery from alcohol-related problems. Journal of Studies on Alcohol 55, 401–411.
Tucker, J.A., Vuchinich, R.E., & Pukish, M. (1995). Molar environment contexts surrounding recovery from alcohol problems by treated and untreated problem drinkers. Experimental and Clinical Psychopharmacology 3, 195–204.
Tucker, J.A., Donovan, D.M., & Marlatt, G.A. (eds.) (1999). Changing Addictive Behavior: Bridging Clinical and Public Health Strategies. New York: Guilford.
Tucker, J.A., Vuchinich, R.E., & Rippens, P.D. (2002a). Predicting natural resolution of alcohol-related problems: A prospective behavioral economic analysis. Experimental and Clinical Psychopharmacology 10, 248–257.
Tucker, J.A., Vuchinich, R.E., & Rippens, P.D. (2002b). Environmental contexts surrounding resolution of drinking problems among problem drinkers with different help-seeking histories. Journal of Studies on Alcohol 63, 334–341.
Vuchinich, R.E., & Tucker, J.A. (1996). The molar context of alcohol abuse. In L. Green & J.H. Kagel (eds.), Advances in Behavioral Economics, Vol. 3: Substance Use and Abuse. Norwood, NJ: Ablex, pp. 133–162.
Walters, G.D. (2000). Spontaneous remission from alcohol, tobacco, and other drug abuse: Seeking quantitative answers to qualitative questions. American Journal of Drug and Alcohol Abuse 26, 443–464.
Watson, A.L., & Sher, K.J. (1998). Resolution of alcohol problems without treatment: Methodological issues and future directions of natural recovery research. Clinical Psychology: Science and Practice 5, 1–18.
Wille, R. (1983). Processes of recovery from heroin dependence: Relationship to treatment, social changes and drug use. Journal of Drug Issues 13, 333–342.
Williams, G.D., & DeBakey, S.F. (1992). Change in level of alcohol consumption in the United States, 1983–1988. British Journal of Addiction 87, 333–342.
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Tucker, J.A. (2002). Natural Resolution of Alcohol-Related Problems. In: Galanter, M., et al. Recent Developments in Alcoholism. Recent Developments in Alcoholism, vol 16. Springer, Boston, MA. https://doi.org/10.1007/0-306-47939-7_7
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