OBJECTIVE: This study identified risk factors for 1-year and 8-year nonremission among initially untreated individuals with alcohol use disorders and examined whether a longer duration of professional treatment or Alcoholics Anonymous (AA) increased the likelihood of remission, moderated the influence of risk factors on remission status and reduced modifiable risk factors.

METHOD: A sample of individuals with alcohol use disorders (N = 473) was recruited at alcoholism information and referral centers and detoxification units and was surveyed at baseline and 1 year, 3 years and 8 years later. At each contact, participants completed an inventory that assessed their alcohol-related problems and personal characteristics and their participation in treatment and AA since the last assessment.

RESULTS: An 11-item baseline risk index was associated with 1-year nonremission. Longer duration of treatment and AA in the first year predicted remission and a decline in modifiable risk factors. In addition, longer duration of AA increased the likelihood of remission more among high-risk than among low-risk individuals. The risk factors at 1 year were associated with 8-year nonremission; longer duration of additional treatment or AA was associated with a higher likelihood of 8-year remission and further reductions in modifiable risk factors.

CONCLUSIONS: Referral counselors and treatment providers can identify high-risk individuals early in their help-seeking career and intervene to reduce the likelihood of a chronic course of their alcohol use disorder.