Recovery/remission of Substance Use Disorders: Recent U.S. Data and Reviews

In 2012, I authored a monograph reviewing the results of 415 studies published over more than a century that reported rates of addiction recovery. Major findings of that review included 5.3% to 15.3% (25-40 million adults) of the adult population who reported once having but no longer having an alcohol or other drug (AOD) problem—either through sustained abstinence or reductions in AOD use. Substance use disorder (SUD) remission rates in studies published since 2000 were 53.9% in community samples and 50.3% in clinical samples (follow-up studies of addiction treatment). The wide range of estimates of prevalence and remission rates can be attributed to different problem definitions, different definitions of remission, and duration of follow-up (also see Mellor et al., 2019), but these studies collectively confirm a substantial population of people who reported having resolved an AOD problem in their lifetime.   

Two recently published studies led by McCabe (2018) and Kelly (2017, 2018) offer additional date on recovery prevalence in the United States. Major findings from the McCabe study, based on data from the 2012-2013 Epidemiologic Survey on Alcohol and Related Conditions, include the following:

  • 25.4% of the adult U.S. population reported meeting criteria for a DSM-5 SUD in their lifetime, with one-fourth of these reporting multiple SUDs.
  • Among those with prior SUD, past year status was reported as: abstinence (14.2%), asymptomatic use (36.9%), partial remission (10.9%), and persistent/recurrent SUD (38.1%).
  • Persistent/recurrent SUD status was associated with being 18-24, current tobacco use, higher levels of education and income, never married or divorced/separated, no prior addiction treatment, and stressful life events.

Major findings from the Kelly study, based on a U.S. adult population survey, include the following:

  • 9.1% of U.S. adults reported once having but no longer having an AOD problem (Kelly, Bergman et al., 2017)
  • At the time surveyed, more than 64.5% reported stable remission of more than five years (Kelly, Bergman et al., 2017)
  • 53.9% of those reporting having resolved an AOD problem reported having used either formal addiction treatment, a mutual help group, or recovery support services to aid resolution of their problem. Assisted recovery was associated with greater problem severity and complexity. (Kelly, Bergman et al., 2017)
  • Recovery identity status of those reporting once having but no longer having an AOD problem is as follows: 45.1% identify as being in recovery, 39.5% never identified as being in recovery, and 15.4% once identified but no longer identify as being in recovery (Kelly, Abry, et al., 2018).

The McCabe and Kelly studies add further evidence that tens of millions of American have experienced an AOD problem and have found sustainable and varied solutions to that problem. Two key tenets of the recovery advocacy movement are: 1) Recovery is a reality in the lives of individuals, families, and communities, and 2) There are multiple pathways of recovery and ALL are cause for celebration. The latest scientific studies simply add an empirical “Amen” to those declarations.

References

Kelly, J. F., Abry, A. W., Milligan, C. M., Bergman, B. G., & Hoeppner, B. B. (2018). On being “in recovery”: A national study of prevalence and correlates of adopting or not adopting a recovery identity among individuals resolving drug and alcohol problems. Psychology of Addictive Behaviors, 32(6), 595-604. doi: 10.1037/adb0000386.

Kelly, J. F., Bergman, B., Hoeppner, B., Vilsaint, C., & White, W. L. (2017). Prevalence, pathways, and predictors of recovery from drug and alcohol problems in the United States Population: Implications for practice, research, and policy. Drug and Alcohol Dependence, 181, 162-169.

Kelly, J. F., Bergman, B. G., Hoeppner, B., Eddie, D., Vilsaint, C., & Hoffman, L. (2018). Recovery from alcohol and other drug problems in the U.S. population: Prevalence, pathways, and predictors. Journal of Recovery Science, 1(2), c1. https://doi.org/10.31886/jors.12.2018.11

McCabe, S. E., West, B T., Strobbe, S., & Boyd, C. J. (2018). Persistence/recurrence of and remission from DSM-5 substance use disorders in the United States: Substance-specific and substance-aggregated correlates. Journal of Substance Abuse Treatment, 93, 38-48.

Mellor, R., Lancaster, K. & Ritter., A. (2019). Systematic review of untreated remission from alcohol problems: Estimation lies in the eye of the beholder. Journal of Substance Abuse Treatment, March, DOI: 10.1016/j.jsat.2019.04.004

White, W. L. (2012). Recovery/remission from substance use disorders: An analysis of reported outcomes in 415 scientific studies, 1868-2011. Chicago:  Great Lakes Addiction Technology Transfer Center; Philadelphia Department of Behavioral Health and Developmental disAbilites; Northeast Addiction Technology Transfer Center.