There were no studies of self-remitters in either the drug or alcohol field prior to the 1960’s and 70’s, for several reasons, chief among them was that by the early 1960’s, the popular “disease model” had become the foundation of alcohol and drug research as well as policy in the United States. According to that model, addiction is irreversible and progressive, and, once addicted, the addict is powerless over his disease and cannot recover without help. It was believed that narcotic drugs (opium and derivatives) had properties that enslaved even casual users, instantly and for life.
Instead of studies, resources went into treatment centers for alcoholics, mostly based upon the 12-step model, and the prevention of any use of narcotic drugs. The suggestion that alcohol dependence, or heroin use might be temporary conditions that the afflicted might address on their own, struck at the heart of widespread and firmly rooted beliefs, and challenged strong and powerful vested interests in the prevention and treatment fields.
Another major reason there were no studies in those years was that the phenomenon of self-remission from alcohol and drugs was largely unknown, because of the population the researchers were seeing. The only addicts the researchers saw were those whose problems were severe enough to come to the attention of society, those who wound up behind bars or in treatment centers. The vast majority of drug and alcohol abusers who were addressing their problems on their own without help were simply invisible.
A researcher named Charles Winick noticed in 1962, that approximately two-thirds of the over sixteen-thousand addicts who were reported as regular users to the Federal Bureau of Narcotics between 1953 and 1954 were not reported again at the end of 1959. Believing that only a slight minority of regular users could be missed during a 2-year period, he concluded that, allowing for a number who probably died, the rest had ceased their drug use. He also found that three-quarters of the over seven-thousand addicts who had quit during the period 1955-60 had stopped their drug use prior to age 38. In addition, more then 80% stopped using prior to the tenth year of their addiction.
The conclusion Winick drew was that there might be some sort of natural life cycle of heroin addiction, and that after learning to cope with the stresses that drove them to drugs in the first place, addicts were able to “mature out” of their addictions.[i]
In 1968, an Australian psychiatrist, Les Drew noticed that a large number of clinical studies showed the number of alcoholics in relation to the population, tended to peak before the age of 50, then markedly decline. Although he felt some of the decline was due to the increased mortality rate among alcoholics, he didn’t believe that factor alone was enough to account for the differences he saw, nor were the effects of treatment programs. He began to believe that some sort of self-change process might account for a significant number of the alcoholics who disappear from alcohol statistics as they get older. He believed that the factors that might accompany aging, and account for the statistics were things like increasing maturity, responsibility, and family and social pressures.
What made his paper (along with Winick’s) something of a ground breaker was that, together, they made a strong and hard-to-ignore case that substance dependence was not always a progressive and irreversible condition, the widely-accepted belief at the time, even though there was little or no evidence for it.[ii] It would be years before researchers and treatment professionals realized that there was a tremendous difference in the appearance of alcohol and drug abuse between the general population and those who ended up in treatment.