By Tom Horvath, PhD
This study examined relapses in individuals who had at least one year of sustained remission from an alcohol use disorder. The average recovery time for these 50 individuals was 3.6 years, 25 were white, 22 were female, and most were early middle age. All were back in remission for at least three months at the time of the study.
As many people know, solving an addictive problem often (but not always!) seems easy enough at the beginning but the solution may not be sustained. One analogy is starting to run a marathon. After 100 yards you might start thinking “I’ve got this,” but the impact of the run changes as time goes by. What was easy at first will likely change.
Even with a small number of subjects, this is a complex study. It examines the impact of 26 factors, which include biological, psychological, social, and recovery support services factors. Nevertheless, one factor emerged as both the most frequently reported change in the prior year, and the most powerful change was reduction in the individual’s “focus on recovery.”
Participants consistently described the deprioritization of recovery-related activities and attitudes as a central precursor, often accompanied by disengagement from mutual-help organizations and other recovery supports (John Kelly, PhD, the principal investigator, as quoted in the press release below).
Other powerful factors, when present, were physical pain and engaging in recreational drug use. It also appeared that multiple factors typically came together for a relapse, not just one or two, and not all at once.
Although this blog often reports on aspects of “traditional recovery” that seem inaccurate, this study’s evidence suggests that the traditional focus on long-term monitoring and recovery focus is justified. As Kelly states:
For clinicians, this means routinely assessing patients for changes in recovery vigilance, emerging mental health symptoms, social isolation and disengagement from recovery supports, as these factors appear to be more potent predictors of long-term relapse.
One instrument for conducting this routine assessment is here:
The hope is that routine assessment could identify a slide into relapse well before the relapse itself occurs. One of the ways we address this issue at Practical Recovery is to encourage clients to taper off their individual sessions over a long period of time. If you have been attending weekly, you could attend bi-weekly for a few months, then monthly for a few months, and then quarterly even for a year or two (and come back immediately if there are sudden changes or stressors).
One of the primary reasons we offer the free continuing care psychoeducation group by Zoom every Wednesday morning is to provide an option for recovery maintenance that is free. This group is open to anyone who is currently or has ever been a client of Practical Recovery. Some clients attend one individual session to become eligible to attend this group thereafter.
Original Paper:
https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1706192/full