Decades of research have repeatedly shown that most alcoholics don’t get any formal help and yet most recover anyways. The typical response from those who believe that alcoholics are “powerless” and suffer from a “chronic relapsing disease” that will inevitably get worse “if left untreated” goes like this – they claim that the people shown to recover without treatment/support groups are “not real alcoholics.” What is a “real alcoholic”? Well, in the recovery society, they conveniently define a real alcoholic as a person who cannot overcome their addiction without formal help. So of course, the definition inherently disqualifies anyone who succeeds without them. This is of course self-insulating fallacious BS reasoning.
But let’s say you, the reader, are not in the recovery society subculture, and that you’re willing to approach this matter with at least an ounce of intellectual honesty. That being the case, you’d probably agree that at the very least, “real alcoholics” would probably fit under the latest diagnostic criteria for “Severe” Alcohol Use Disorder in the DSM V, and that even though it’s insulting and dismissive, we could classify the “not real alcoholics” (i.e. “heavy drinkers”) under the “Mild” and “Moderate” Alcohol Use Disorder (AUD) diagnoses. Agreed? Good. Let’s see how they fare, according to the latest epidemiological research.
NESARC III, a representative survey of over 36,000 Americans (the latest study of its kind, conducted 2012-2013), presents us with 2 important sets of numbers . It tells us how many people fit the diagnosis for DSM V AUD over the past year, and it tells us how many people have fit the same diagnosis at ANY point in their life. We can use these two numbers to calculate an estimate of how many people are currently recovered from their previous AUD.
AUD is diagnosed with an 11 symptom system. Those with 2 or 3 symptoms are diagnosed with Mild AUD, those with 4 or 5 have Moderate AUD, and those with 6 to 11 symptoms have Severe AUD.
Here are the percentages of how many have fit these diagnoses in their lifetime, versus how many fit the diagnoses in the year prior to data collection:
Mild AUD:
Lifetime – 8.6%
Past year – 7.3%
Moderate AUD:
Lifetime – 6.6%
Past year – 3.2%
Severe AUD:
Lifetime – 13.9%
Past year – 3.4%
A quick glance should be enough to see that those with Severe AUD (the real alcoholics) are far more likely to recover than those with Mild or Moderate AUD (the mere heavy drinkers – our hats are off to them!). But let’s crunch the numbers anyways with some back of the envelope math. We will subtract those who fit the diagnoses over the past year from those who have ever fit the diagnoses in their lifetime, in order to arrive at percentages of who has recovered and who is still struggling – under the assumption that if you no longer fit the diagnosis, then you are “recovered” for all practical intents and purposes (in short, divide past year AUD percentage by lifetime AUD percentage to arrive at percentage of whole who are still dependent, with remainder percentage considered recovered). Here’s how that comes out (rounded to nearest half percentage point):
Mild AUD:
15% Recovered
85% Still dependent
Moderate AUD:
51.5% Recovered
48.5% Still dependent
Severe AUD:
75.5% Recovered
24.5% Still dependent
See that? Those in the Severe category have the highest rate of recovery. Real Alcoholics are more likely to recover than Heavy Drinkers.
It’s not necessarily this straightforward though, because there’s a lot that we haven’t been told by the researchers who have access to and are analyzing the NESARC-III data. Hopefully more papers will be rolling out that provide us with more relevant data in a clearly presented form. For example, one thing that could confound the conclusions I’ve drawn here about recovery rates is that some percentage of those who have ever fit the Severe AUD diagnosis might now be included in the groups who fit the past year Mild or Moderate AUD diagnoses. If we assume that is the case though, it still doesn’t fare well for the “real alcoholic” vs “heavy drinkers” rhetoric and view of such data, because it would mean that “real alcoholics” can and do become “heavy drinkers” (i.e. not-real alcoholics). This, we’re told by the recovery society, is impossible. Clearly though, the data show it is possible and probable.
This is not unlike 2 previous similar datasets, which both surveyed over 40,000 people. First, NLAES gathered data in 1992 and found that of those who ever fit the diagnosis for DSM IV Alcohol Dependence (3 or more of 7 possible symptoms), their current status was:
27.8% were drinking in a way diagnosable as “alcohol abuse” or “alcohol dependence”
22.3% were abstinent
49.9% were “drinking without abuse or dependence” (i.e., drinking moderately)
And so we see, almost 75% who ever fit the diagnosis were currently recovered in 1992. The same goes for the NESARC data from 2001-2002:
25% drinking in a way diagnosable as “alcohol dependence”
18.2% were abstinent
56.8% were drinking without dependence (i.e., drinking moderately)
Again, 75% were currently recovered. Only about 20% ever seek help in their lifetime (including through groups such as Alcoholics Anonymous). It is by now a well established fact that “real alcoholics” can and do get over their drinking problems, and they do it most often without formal help. What’s more, it’s well established that they can and do become moderate drinkers. Let’s forget this ridiculous “real alcoholic” rhetoric. If you wanna believe yourself one, be my guest – but don’t deny the truth to others in the process with your ignorance and fallacious reasoning.
[Note: of course I don’t like the terms real alcoholics, alcoholism, addiction, or even recovery for that matter because I don’t see this problem as something that defines people, or as a disease that can be recovered from, but I’ve used these terms here for brevity and to make the point. I can imagine a million little silly arguments people will make with my analysis and I won’t bother to address them ahead of time. The comparisons between the studies aren’t perfect, but they’re certainly not apples to oranges comparisons. They’re more like Granny Smith Apples to Mcintosh Apples comparisons, due to shifting definitions, criteria, and methods of data presentation.]
