Do people recover without treatment?

I want to comment on an article I read recently which stated some FACTS 1. about  3/4 of individuals in recovery did not use formal treatment or mutual help groups to achieve full, sustained remission. 2.  About 20% of all people with alcohol use disorders recover naturally, without formal treatment or mutual help. Individuals with less severe substance use problems, fewer psychiatric comorbidities and more recovery capital (e.g. social support) have a greater chance of recovering without formal treatment. 4. Self-efficacy, or one’s level of belief in the chances of success is an important predictor of natural recovery success.

First of all, it is never a good way to start an article by stating you have FACTS, not good practice. Given this article appeared in a website which I think is great and does good work and has good contributors I was surprised by the claims of this article, which I believe are dangerously misleading to those who actually suffer from alcoholism and are being directed to go it alone. Which of the hundreds of alcoholics I have known over many years, including myself, has not once tried that approach!

This article may be confusing abuse with addiction, they are transitory phases in the addiction cycle, one less severe than the other, so it may be easier to get off the train earlier than later with addiction, if you have no underlying conditions.  

Equally the sample population for studies of this kind often contains people are not actually alcoholic but simply drink too much. Alcholism is more than alcohol. Alcoholism is an underlying psychiatric condition maladaptively treated by alcohol. 

Alcoholism is on a spectrum of severity, with various underlying psychiatric complications. 


This article is misleading as it then states in it’s “facts” that “individuals who did not utilize formal help or treatment in their recovery process were more likely to have non-abstinent recoveries compared to individuals who did engage in formal substance use help and/or treatment” These so-called non-abstinent recoveries are not recoveries then!

One study (1) examined the rates and predictors of 3-year remission, and subsequent 16-year relapse, among initially untreated individuals with alcohol use disorders who did not obtain help or who participated in treatment and/or Alcoholics Anonymous in the first year after recognizing their need for help. A sample of individuals (n = 461) who initiated help-seeking was surveyed at baseline and 1 year, 3 years, 8 years and 16 years later.

Compared to individuals who obtained help, those who did not were less likely to achieve 3-year remission and subsequently were more likely to relapse.  Among individuals who were remitted (relapsed) at 3 years, those who consumed more alcohol but were less likely to see their drinking as a significant problem, had less self-efficacy, and relied more on avoidance coping, were more likely to relapse by 16 years.

Conclusion – Natural remission may be followed by a high likelihood of relapse; thus, preventive interventions may be indicated to forestall future alcohol problems among individuals who stop or  cut down on their own.

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Chronic alcoholism is a condition of severely limited self will or cognitive control over addictive behaviours, as a result we, as recovering alcoholics, need the help of others to act as our external prefrontal cortex, our external cognitive control over subcortical addictive behaviour and our evident emotional dysregulation, until we can do it ourselves more effectively.

I do not remember having a choice in getting off my train earlier, it never occurred to me even as my illness kept the truth about what I had from me. Like many alcoholics I was the last to know.
AA came into being to help those who cannot recover by themselves – like me and countless others who tried but failed. Read The Natural History of Alcoholism by George Vaillant who, over many decades, showed clearly the progression of this disease/disorder, many of his extensive sample also thought they could go it alone, only to find they ultimately needed help or died from their alcoholism. Alcoholism is a fatal condition if left untreated. Sometimes I wish academics who write about it, would consider this when they write about it too.



1. Moos, R. H., & Moos, B. S. (2006). Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction101(2), 212-222.


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