Long-term Recovery and Relapse Management

By Terence T. Gorski, Author, April 25, 2014


The Long Road Home

Recovery can be a long road home, but many people make the journey and arrive safely. This is demonstrated by a 1997 study by Keith Humphreys, Rudolf H. Moos, Caryn Cohen entitled Social and Community Resources and Long-Term Recovery from Treated and Untreated Alcoholism the published in The Journal for the Study of Alcohol in 1997 (J. Stud. Alcohol 58: 231-238, 1997) clearly showed the need to focus upon life-long disease management in the treatment of alcoholism. This means moving rom an acute care treatment model to a chronic care model is important to improving long-term recovery rates. Acute Care Treatment Models focus upon intensive up-front treatment at high levels of care, often medically supervised detoxification and residential rehabilitation while neglecting ongoing coordinated long-term continuing care. In contract, Chronic Disease Management Models for the treatment of alcoholism focus upon improving long-term recovery rates by providing effective stabilization services matched to patient needs, managing relapse by stopping it quickly should it occur, and supporting ongoing recovery that changes as the needs of patients change over the course of a lifetime. It is important that addiction professionals become familiar with the effectiveness of Long-term Chronic Disease Management Approaches to the treatment of addiction. This approach involves:

  • Early identification and intervention;
  • Effective stabilization programs that break the immediate addiction cycle
  • Teaching patients primary recovery skills;
  • Involving families in the recovery process;
  • Building community support services around the needs of recovering people and their families;
  • Preventing relapse when possible by teaching people how to identify and manage early warning signs of relapse and high risk situations;
  • Effectively managing relapse by stopping it quickly should relapse occur and getting the patient back into an ongoing recovery process.

The following outline can be used for presentation summarizing the Humphreys et al 1997 study. Feel free to use it in your public presentations. 1. Long-term studies of the course of alcoholism suggest that a variety of factors other than professional treatment influence the process of recovery. These factors include:

  • Demographic factors;
  • Baseline alcohol-related problems;
  • Depression;
  • Professional treatment;
  • Alcoholics Anonymous (AA);
  • Other social and community resources

2. This study evaluated the role of these factors in predicting remission and psychosocial outcome over 8 years. 3. In this study a sample of 628 previously untreated alcoholic individuals was recruited at detoxification units and alcoholism information and referral services.

  • Of these participants, 395 (68.2%) were followed 3 and 8 years later.
  • Most (83.3%) were white (n = 329) and 50.1% (n = 198) were men.

4. At each contact point, participants completed A self-administered inventory that assessed their:

  •  Current problems,
  • Treatment utilization,
  • AA participation and
  • Quality of relationships.

4. The results showed that:

  • The number of inpatient treatment days received in the 3 years after baseline were not independently related to 8-year remission or psychosocial outcomes.
  • More outpatient treatment in the first 3 years increased the likelihood of 8-year remission, but was not related to psychosocial outcomes.
  • The number of AA meetings attended in the first 3 years predicted remission, lower depression, and higher quality relationships with friends and spouse/partner at 8 years.
  • Extended family quality at baseline also predicted remission and higher quality friendships and family relationships at 8 years.

5. The Conclusions drawn were:

  • Alcoholism is a chronic, context-dependent, and lifestyle related disorder.
  • Short-term up-front interventions have little long-term impact upon recovery rates or quality of life improvements.
  • Social and community resources that are readily available for long periods are more likely to have a lasting influence on the course of alcoholism.

2 Responses to Long-term Recovery and Relapse Management

  1. Thank you for sharing all this Terry!

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