Natural History of Alcoholism

I just heard the most incredible presentation by Dr. O’Connor and Dr. George Vaillant.  Dr. Vaillant wrote the "Natural History of Alcoholism".  They are both great writers and teachers.  They both presented on the spirituality of recovery. Dr. Vaillant called spirituality the 'vital force'.
Dr. O Connor focused on the need for trauma and disruption with major loss to cause an alcoholic to forsake the slow path death ward and turn about to embrace life.  He spoke of the negative emotions of addiction: fear, resentment and shame as opposed to the positive emotions of recovery: trust, compassion, empathy,  forgiveness, joy.  To embrace spirituality one needed to connect but alcoholism lead to disconnection and it took years sometimes before a person's capacity for genuine love returned.  Alcoholism in one or more partners was more a cause of divorce than financial problems or issues of child care yet was rarely addressed.
Dr. Vaillant’s research is that of 60 years of individuals suffering from alcoholism.  He states that it is the longest running ‘prospective  study" of alcoholics.  He states very positively that the greatest density of abstinent alcoholics is in the rooms of AA.  His studies show that those abstinent for 5 years enter a steady state of mostly life long recovery.  His studies showed that those with abstinence versus those with chronic alcoholism within the rooms of AA could be differentiated simply by the number of meetings attended. Those with long term abstinence, 20 years etc, attended 40 x the meetings of the chronic relapsers, those whose alcoholism was expressed by chronicity rather than abstinence.
Alcoholism caused nearly twice the deaths of tobacco smoking.  Yet it received very little funding relatively. As a chronic disease it was comparable to cancer, heart disease and chronic respiratory diseases.  In contrast to the general thought that chronic alcoholism lead to death predominantly by liver disease his research showed that death in chronic alcoholism while by liver disease was more commonly as a result of heart disease or death by accident.
Alcoholism and depression often appear together but where the alcoholism preceded the depression there is little genetic weighting and the most successful treatment is treating the alcoholism. When alcoholism follows depression there is greater incidence of family history of alcoholism and treatment of depression must be accompanied by treatment of alcoholism.
The research findings overwhelmingly support the success of AA.  However the problem to date has been that people have been doing studies on treatment for alcoholism with assessment of result at one or 2 years.  This would never be accepted in the treatment of other diseases, such as diabetes or cancer where 5 years success is the standard. The benefit of AA is seen at five years and especially at 20 years.  Abstinence works.  AA works.
He said AA was a specific program of recovery. It was not a cult. To suggest such is just simply misinformation.
Both Dr. O'Connor and Dr. Vaillant felt it was more important than ever that doctors learn early about the evidence based research benefits of Alcoholics Anonymous and be taught to send their patients who have alcoholism to AA.