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Article Excerpt
Natural-history research has encompassed a wide range of topics. The seminal studies explored factors associated with change in untreated samples of recovered drinkers (reviewed in: Blomqvist, 1996; Blomqvist, 1999). Such research has helped identify factors that could be used to modify, and potentially to improve, treatment for alcohol and drug concerns (Sobell et al., 1996b). Other research in this area has explored the prevalence of, and factors associated with, untreated recoveries in representative samples of the general population (e.g., Cunningham et al., 2000). In general, these studies have found that untreated recoveries are more common than treated ones, but that the use of treatment services is more common among those with severe alcohol problems prior to resolution (Cunningham, 1999). In addition, moderate drinking recoveries are more common among those with less severe problems prior to recovery (Cunningham, 1999).
Several studies have attempted to combine these two types of natural-history research. Rumpf et al. (2000) recruited former heavy drinkers from a population survey and found that such respondents had less severe problems as compared with those recruited through a newspaper sample. In a pilot study for the present project (Cunningham et al., 1999), respondents in a random-digit-dialing telephone survey were asked open-ended questions probing their reasons for quitting or reducing their alcohol or drug use. The interviewer summarized these reasons, and the summaries were categorized for analysis. For alcohol, the predominant reasons for change included health concerns, intrapsychic change, and new responsibilities. However, this study was limited because the accuracy of the interviewer summaries was unknown and because the survey lacked other relevant information (e.g., treatment use). The present study attempted to address some of these limitations by conducting a survey focusing on natural-history issues. This report explores factors associated with moderate drinking and abstinent pathways to recovery. In addition, a sample of respondents who have reduced their drinking but who do not meet conventional definitions of controlled drinking is included in order to explore another possible pathway to resolving alcohol problems.
Method
A random-digit-dialing (RDD) telephone survey was conducted of 3,006 respondents in Ontario, Canada. Briefly, the RDD survey employed a two-stage sampling design in which random-digit dialing was used to select eligible households; then individual respondents 19 years old or older were selected, based on the adult member of the family whose last birthday was closest to the date of telephone contact. People living in old-age homes, group homes, educational institutions, and penitentiaries were excluded from the sample, as were the approximately 2% of Ontario households without telephones. Respondents were eligible to participate only if they spoke English. The response rate was 65%. This was calculated as completed interviews over the sum of: completed interviews plus refusals (1,369), callbacks (150), and a proportionate number of the never answered/always busy numbers (114) that could be assumed to be eligible households. Means, standard deviations, percentages and statistical calculations are based on weighted data. Sample sizes are reported as unweighted data. Results based on sample sizes of 15 or fewer are not reported because such estimates may be unstable.
All respondents were asked about their current drinking, employing items taken from the 1996 Ontario Drug Monitor (Adlaf et al., 1997). These variables were, in the last year: frequency of consumption; average drinks per drinking day; frequency of occasions in which five or more drinks were...
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