Communications of Hossein and Bill (Reply to Hossein - Feb 6, 2019)
 
Calander
3/2/2019 12:00:00 AM
     

Communications of Hossein and Bill (Reply to Hossein - Feb 6, 2019)

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Topic : Communications of Hossein and Bill
   
As to your question about the percentage of people who achieve sustained recovery after addiction treatment, I reviewed more than 400 published studies on this question and published the results in a monograph that I have attached. Below is a brief summary of the key findings on this question that is excerpted from the monograph.
  

Feb 4,2019

Dear Hossein,

It is always a pleasure to receive your emails. 

It seems like only yesterday rather than a year ago that you were preparing for the annual examinations. Do the examinations change in content from year to year? I am pleased to know that the William White token has taken on such important within Congress 60.  One of those tokens reside above my writing desk as I write these words. It and other symbols from Congress 60 remind me of our mutual recovery ministry and my enduring respect for all that is being achieved within Congress 60. I so wish political conditions and personal health would allow ease of travel between us.

As to your question about the percentage of people who achieve sustained recovery after addiction treatment, I reviewed more than 400 published studies on this question and published the results in a monograph that I have attached.  Below is a brief summary of the key findings on this question that is excerpted from the monograph.

What is the rate of remission/recovery for persons whose problems are severe enough to

warrant professional treatment? 

In an analysis of 276 addiction treatment follow-up studies of adult clinical samples, the average remission/recovery rate across all studies was 47.6% (50.3% in studies published since

2000). Within studies with sample sizes of 300 or more and studies with follow-up periods of five or more years—two factors used as proxy for greater methodological sophistication—

average remission/recovery rates were 46.4% and 46.3%, respectively. In the 50 adult clinical studies reporting both remission and abstinence rates, the average remission rate was 52.1%,

and the average abstinence rate was 30.3%. Based on available information, this 21.8% difference appears to reflect the proportion of persons in post-treatment follow-up studies who

are using alcohol and/or other drugs asymptomatically or are experiencing only subclinical problems (problems not severe enough to meet diagnostic criteria for substance use disorders).

The monograph includes an appendix listing all of the studies and their period of follow-up. You could review these if you wanted to compare those with one-year follow-up rates with the results from the Congress 60 study that is underway.

You will note that studies differed in their outcome measures. Most measured either remission (the percentage of people who no longer met diagnostic criteria for a substance use disorder) or abstinence (either sustained abstinence or abstinence at the period of time before follow-up). Recovery and relapse rates vary considerably across clinical populations as you well know from both of our experiences.

The 505 sample size in the Congress 60 study is excellent and much larger than many published studies. 

For years I have been asked when recovery from alcohol or drug dependence reaches a point of durability, or put another way, “When does recovery today predict recovery for life?”  After investigating all of the scientific evidence I could locate on this question, I have regularly responded that this point of durability seems to be reached at 4-5 years of continuous recovery, meaning that less than 15% of those who reach that point will re-experience active addiction within their lifetime (with opioid addiction potentially being closer to the 25% mark).  This means that if you reach the 5-year recovery benchmark, your risk of again meeting diagnostic criteria for a substance use disorder is similar to the risk for such a diagnosis within the general population.  (Ironically, this 5-year benchmark is strikingly similar to the durability point for cancer remission.) Reaching this benchmark is not assurance of invulnerability, but it does mark a point at which a much greater force is needed to destabilize recovery.  I have used this finding to argue that all persons treated for addiction should be afforded five years of post-treatment recovery checkups (e.g., monitoring and support) on par with that afforded most cancer patients. I can send you a list of these 5-year benchmark studies if that would be of help to your research team.

On a personal note, Rita is continuing to experience back pain so we are staying busy with Doctor appointments and physical therapy. We appreciate your best wishes on her recovery from these recent health challenges. 

Friends and Brothers Forever,

Bill

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