PERIODS OF ABSTINENCE FOLLOWING THE ONSET OF ALCOHOL DEPENDENCE IN 1,853 MEN AND WOMEN

Objective: Data from both laboratory experiments and retrospective his tories of alcoholics indicate that alternations between periods of abs tinence and heavy drinking are common in the course of alcoholism. Thi s article examines the prevalence, chronological characteristics and c linical features associated with periods of abstinence in a large samp le of alcohol dependent men and women. Method: As part of the Collabor ative Study on the Genetics of Alcoholism (COGA), semistructured perso nal interviews were used to gather data on the course of alcoholism in 1,853 alcohol dependent men and women. Data were evaluated regarding the characteristics of alcoholics with and without peri ods of abstine nce lasting 3 or more months, and the course of these periods over tim e were evaluated separately for subjects with one, two, three or four episodes of abstention. Results: Despite a relatively high threshold o f 3 months for defining an abstinence period, 62.3% of the subjects ha d at least one such episode, including 55.6% of the 1,853 alcoholics f or whom complete data were available. Those alcohol dependent subjects with periods of abstention had an average (+/-SD) of 1.7 +/- 0.99 suc h periods, and 43% of abstainers had two or more. Logistic regression analyses revealed that the predictors of history of abstention were fe male gender (odds ratio [OR] = 1.78), older age at interview (OR = 1.0 4 per year), younger age of onset of alcoholism (OR 0.93 per year), ev er having been married (OR = 1.45), the number of DSM-LU-R dependence items endorsed (OR = 1.09 per item) and attendance in AA (OR = 2.82). Among abstainers, a period lasting 5 or more years was predicted by ol der age (OR = 1.03 per year) and AA participation (OR = 3.23), but als o by more years of alcoholism (OR = 1.06 per year), white racial backg round (OR = 1.79) and the absence of history of having been a proband (OR = 3.39). Conclusions: Periods of abstinence of 3 or more months we re commonly observed in the course of alcohol dependence. This informa tion is important for clinicians who need to avoid inappropriate stere otypes of alcoholism and who wish to educate their alcohol dependent p atients about the course of this disorder.