There is little information on the stability of abstinent and nonabstinent remission from alcohol dependence in the US population. To examine this, researchers assessed alcohol use and alcohol use disorder (AUD) symptoms over 3 years among 1772 adults who had participated in a national alcohol survey and who were in remission from alcohol dependence at baseline.

At the baseline interview, 25% of subjects drank risky amounts,* 38% engaged in low-risk drinking,** and 37% abstained. During follow-up, 51% of subjects who drank risky amounts, 27% of those who engaged in low-risk drinking, and 7% of those who abstained reported a recurrence of AUD symptoms at some point during the three years; 10%, 4%, and 3%, respectively, met criteria for recurrence of alcohol dependence at some point over the course of the study.

Although the differences in recurrence rates of AUD symptoms were significant between the 3 groups, the overall rates of recurrence for alcohol dependence did not differ between low-risk drinkers and abstainers. Recurrence of AUD symptoms or alcohol dependence was more likely in younger subjects and less likely among patients with a longer duration of remission at baseline.

Comments by Michael Levy, PhD
This study demonstrates the complexity of AUD. Although an abstinent recovery is more stable and, thus, should be supported, some individuals may be able to achieve a recovery through a nonabstinent remission. Although the risk for relapse always needs to be monitored, individuals in recovery through a nonabstinent remission need even more careful monitoring, as the risk for recurrence of AUD symptoms is greater.