- About 3/4 of individuals in recovery did not use formal treatment or mutual help groups to achieve full, sustained remission.
- About 20% of all people with alcohol use disorders recover naturally, without formal treatment or mutual help.
- Individuals with less severe substance use problems, fewer psychiatric comorbidities and more recovery capital (e.g. social support) have a greater chance of recovering without formal treatment.
- Natural remitters often utilize the same mechanisms as those mobilized by formal treatment and mutual help groups to achieve recovery (e.g. coping, utilizing social networks, avoidance of high-risk situations).
- Self-efficacy, or one’s level of belief in the chances of success is an important predictor of natural recovery success.
Who recovers without formal treatment?
There is evidence to suggest that many people recover without formal treatment. For alcohol specifically, it is estimated that between 50-90% of people with prior alcohol problems recover without treatment, however more severe alcohol problems are more likely to require treatment to facilitate remission and recovery (Cunningham, 1999). Similarly, 80-90% of people dependent on tobacco quit smoking without professional assistance or guidance. Retrospective data suggest that a majority of illicit substance users, irrespective of remission status, had not sought treatment services (Cunningham, 1999). When examining the pathways of recovery between AA members and those who had not attended treatment or mutual help, it was found that there are several similar factors that contribute to abstinence for both groups. These include the utilization of social support, accepting help from God or a Higher Power, a strong desire to achieve abstinence, a desire to be honest with him/herself, a desire to improve self-confidence and remembering the negative consequences of alcohol use (Kubicek, Morgan, & Morrison, 2002).
These findings reinforce the idea that there are multiple pathways to recovery that largely depend on the individual. There are, however, systematic differences in the type of recovery and remission achieved by individuals who recover without mutual help or formal treatment and those who do utilize these services. In a study examining data on approximately 13,000 adults, among individuals who had substance use problems and achieved recovery, 75% didn’t utilize formal help or treatment, however approximately 33-66% of these people continued to drink moderately. In summary, individuals who did not utilize formal help or treatment in their recovery process were more likely to have non-abstinent recoveries compared to individuals who did engage in formal substance use help and/or treatment (Sobell et al., 1996).