Destroying the Powerless Myth, Once and For All!

This is the last of the excerpts from Chapter four of my book. If you are not yet convinced after reading this chapter that you are not powerless over your addiction, the rest of the book will be of little use to you, because it concerns self-managed recovery. Speaking of which, my next post will detail what is in the book, chapter-by-chapter, what I hope to accomplish, and, most importantly, what’s in it for you; how I think you might benefit by reading it, and considering some of my suggestions. for now, though, let’s first finish the demolition of the myth of powerlessness over addiction.

[i]The first large-scale study of natural recovery was carried out by researchers Hasin and Grant in 1995, using data from the National Health Interview Study, which was conducted in 1988, using a sample of almost 44,000 people aged 18 and over in all 50 states and the District of Columbia. They identified former drinkers, who comprised about 19% of the total sample, or 8,324 people. Of these, 21% were alcohol dependent and 42% were alcohol abusers according to DSM-IV criteria. Only 33% of the dependent people, and 17% who were alcohol abusers had attended AA, or sought any other kind of treatment.

Breaking the numbers down, out of 8,324 former drinkers, 3,497 were alcohol abusers, 1,748 met the criteria for alcohol dependence. 83% of the abusers quit on their own, along with 67% of those dependent upon alcohol. Overall, in this important study, 77% of those diagnosed with alcohol abuse or dependence quit on their own, without treatment, AA, or help of any kind![ii]

Several large surveys of recovery without treatment have also been conducted in Canada. Using data from a national survey of nearly 12,000, and an Ontario survey of over 1,000, one study of those who self-remitted found recovery rates about the same as the American study mentioned above: 77.6% of those who quit did so on their own without help of any kind.[iii]

Another large American study was from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), in 2005. The sample size was over 43,000 U.S. adults. Data were collected through personal interviews, and out of the entire sample, 4,422 people were classified with DSM-IV alcohol dependence, with onset prior to the previous 12 months. Only 25.6% of the sample had ever sought help for their dependence. It can be calculated from this study that of those who were fully remitted in the last year, 72.4% did so without formal help.[iv][v]

Another natural recovery study involved several groups of dependent drinkers. One group had significant alcohol problems over many years and resolved them through abstinence or treatment, while another group experienced fewer problems but “matured out” of them as they aged. Yet another group recovered from problems and were able to drink with fewer problems than the abstinent groups. In this study, non-treatment recoveries varied between 53.7% and 87.5% depending upon the number of DSM-IV problems the drinker had experienced. The greater number of symptoms the drinker experienced, the lower the percentage of self-remitters. Even among those who had six or more problems, however, 53.7% recovered without formal treatment. As with all the other studies, recoveries with and without treatment were lower as the number of DSM-IV problems increased.[vi]

A study of older, untreated alcoholics involved 1,884 individuals recruited from a larger community sample. Using data from 4 and 10-year follow-ups, it was found that 73% of these 51-to 65-year-olds remitted without any formal help.[vii]

These are just a very few of the more than eighty studies that have been done on untreated remission of drug and alcohol abuse and dependence over the past forty years. Taken overall, the studies indicate that self-change accounts for just about three-quarters of all successful recoveries from substance abuse and dependency problems. That statistic is amazing enough, given that it’s kept such a deep and dark secret by the treatment industry, but what I’m about to tell you is even more of a blow to the disease model of substance abuse, and the idea of powerlessness. For more information about these studies, please see this link, which is also on my web site.[viii]

Successful Non-abstinent outcomes and natural recovery

Those of you who have been in AA, have heard it repeated hundreds of times: “Once you’re an alcoholic, you can never, ever drink safely again,” or perhaps my personal favorite: “Once you’re a pickle, you can never again be a cucumber.” AA teaches that a “real alcoholic” must remain abstinent for the rest his or her life, because, by its very definition, alcoholism is a “progressive disease” with no known cure. It can only be arrested, and then only if the alcoholic attends meetings for the rest of his or her life, and develops a relationship with a power greater than themselves.

AA, and the treatment industry as a whole treat substance abuse as though it were an on-or-off condition. People who can drink safely under any conditions, cannot, therefore qualify as an “alcoholic,” according to the AA definition. The American Psychiatric Association in the DSM-IV, on the other hand, and all of the relevant studies view substance abuse and dependence as a continuum, with symptoms and criteria that apply in different ways to different effected individuals

Substance disorders are difficult and complicated, and we are all individuals, with different backgrounds, genetics, biology, and circumstances. I would be the last person to tell anyone who is having a substance abuse problem that they could someday safely use again. Frankly, I don’t believe that I, myself, could ever drink alcohol and predict the outcome, nor can I think of single reason why I would ever want to. Alcohol is simply not a part of my life any longer.

If naturally-recovering substance abusers and dependent individuals, by DSM-IV criteria,  can be shown to have returned to low-risk non-problem drinking, by the same standards, it constitutes a dual threat to the disease model and, of course the attendant idea of powerlessness. The fact that such dependent people can not only recover on their own, but also reverse the disorder has been met over the years with emotional reactions ranging from deep-seated disbelief to serious attacks.

Many of the studies and reviews undertaken in the last several years have shown low-risk alcohol use among former abusers and dependents is a widespread and frequent occurrence. In a review of 28 natural recovery studies undertaken in 2000, 22 of the 28 studies (78%) showed significant low-risk drinking on the part of the participants. As many as one-third, in some studies were able to return to moderate drinking, to the point where they no longer met DSM-IV abuse or dependence criteria.[ix] In the same major review of 15 additional studies, 13 of the 15 (86.6%) showed the same results. A similar pattern emerged among drug users, where nearly half the studies reported limited drug use recoveries.

These results are about the same as those from several alcohol treatment outcome studies, which capture degree of abstinence over time, and together these data suggest that viewing abstinence as the only possible outcome for all drug and alcohol abusers is neither practical nor realistic.[x],[xi]

Conclusion – natural recovery and what it means for you

As I said earlier, it does not matter whether you believe addiction is a disease or not a disease, it only matters that you realize that even if the professionals decide that it is, you are not powerless over it. The problem I have with the disease model that has dominated the treatment field for decades is that it implies that you are powerless over it, and cannot, therefore find any meaningful recovery on your own. I hope that the examples and studies I have presented so far on this website have at least begun to convince you otherwise. If nothing else, you are now aware that it has been a well-known fact among researchers in the field for many years that most people with drug an alcohol disorders recover absolutely on their own, and you can too.

What I have not discussed in detail up to now on this blog are the motivations for change, and the rest of the causative factors that influenced these men and women to stop, or at least moderate what you and I know is an extremely self-destructive behavior, one that uses our primary survival instincts to motivate us to continue using. We will take a detailed look at these factors shortly, and we will also compare them with various recovery paths so you will hopefully have enough information to map out a path that will be the most effective for your own situation. Before we leave this subject, however, let’s revisit a few major points:

• Most population surveys show the large majority (75%) of people with alcohol and drug problems can and do resolve them without formal treatment or 12-step groups
• Alcohol and drug dependence is not an on-or-off disorder, but a continuum, with many different degrees of severity.
• Many people simply “mature out” of drug and alcohol problems when they reach a certain age.
• It is possible for some who were once substance dependent to use safely in moderation, proving that addiction is not always progressive and irreversible.
• There is some evidence that higher percentages of people with less severe problems (fewer DSM-IV criteria) self-recover than those with more severe problems, but many with very severe problems still recover naturally

The next chapter of my book is titled: “Harnessing the Power of Self-Change, Making a Difference in Your Own Life.” In the excerpts from that chapter, we will introduce “stages of change,” and discuss the steps necessary for you to first of all, decide if you have a problem, and if you do, find a path to your own personal recovery “program.”