Differences between abstinent and non-abstinent individuals in recovery from alcohol use disorders

• Length of time in recovery and the probability of abstinence are positively related.
• Quality of life in abstinent recovery is better than in non-abstinent recovery.
• Time in recovery should be accounted for when examining correlates of recovery.

ObjectiveNon-abstinent goals can improve quality of life (QOL) among individuals with alcohol use disorders (AUDs). However, prior studies have defined “recovery” based on DSM criteria, and thus may have excluded individuals using non-abstinent techniques that do not involve reduced drinking. Furthermore, no prior study has considered length of time in recovery when comparing QOL between abstinent and non-abstinent individuals. The current aims are to identify correlates of non-abstinent recovery and examine differences in QOL between abstainers and non-abstainers accounting for length of time in recovery.SampleA large (N = 5380) national sample of individuals who self-describe as “in recovery” from alcohol problems recruited in the context of the What Is Recovery? (WIR) study.MethodMultivariate stepwise regressions estimating the probability of non-abstinent recovery and average quality of life.ResultsYounger age (OR = 0.72), no prior treatment (OR = 0.63) or AA (OR = 0.32), fewer dependence symptoms (OR = 0.17) and less time in recovery all significantly (P < 0.05) related to non-abstinent recovery. Abstainers reported significantly (P < 0.05) higher QOL than non-abstainers (B = 0.39 for abstinence vs. non-abstinence), and abstinence was one of the strongest correlates of QOL, even beyond sociodemographic variables like education.ConclusionsNon-abstainers are younger with less time in recovery and less problem severity but worse QOL than abstainers. Clinically, individuals considering non-abstinent goals should be aware that abstinence may be best for optimal QOL in the long run. Furthermore, time in recovery should be accounted for when examining correlates of recovery.