There are a number of different types of reports on the benefits of alcoholism treatment programs.  The least scientific are short studies which report abstinence and drinking rates one month or three months after beginning treatment.  The accepted standard in the field is one year of abstinence. Some recent medication studies are more oriented to avoiding heavy drinking rather than drinking avoidance per se.  One year of abstinence may sound like a lot, but one study of alcoholism found that until patients had achieved two years of abstinence, they were still more likely to relapse into alcoholism than to avoid alcoholic consumption for the rest of their lives.

Even longer-term studies that report one-year abstinence rates of patients too often report only on those who finish their programs and only on those they can contact.  It is very possible that patients who cannot be contacted or who drop out will do worse than patients who can be contacted or who don't drop out.  However, even if these patients are all included, it is still very difficult to judge the quality of a program because patients may vary tremendously in their motivation and ability to achieve abstinence.  Programs that require private insurance coverage will cater to individuals who usually have good jobs and families and who come in because their job is on the line. 

The only type of truly scientific study requires random assignment of patients to one program or another or or no treatment or to a waiting list of some type.  Also, the larger the study, the more likely it is to detect a useful difference and the more likely that its findings will be real.  Unfortunately, most studies of alcoholism therapy are not controlled studies.  The entire world probably averages only a few controlled studies per year and most of these are of cognitive-behavior therapy. 

I am gathering Recent Control Studies and useful observations from Recent Uncontrolled Studies to add to my fairly complete report on Controlled Studies to 1992.  This may take a little time, so please be patient.

Thomas E. Radecki, M.D., J.D.