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Controlled Drinking and the Treatment of Alcoholism

William R. Miller, PhD; A. Lane Leckman, MD; Martha Tinkcom, MS
JAMA. 1987;257(23):3228-3229. doi:10.1001/jama.1987.03390230064019.
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To the Editor.—  We wish to correct a misleading inference drawn from our data by Dr Maltzman1 in his recent letter. From a prepublication manuscript, Dr Maltzman drew the figure that only 10% of our clinical sample were engaging in controlled and asymptomatic drinking at long-term follow-up. This figure is correct, but is erroneously contrasted with a recovery rate of 60% to 65% that he describes as "the industry norm for abstinence-oriented programs." This quoted figure, based on a comment made in an interview, is a gross and unsubstantiated estimate of outcomes among "those who finish treatment" and is quite at variance with empirical evidence from properly conducted clinical trials. In a review restricted to outcome studies with at least one year of follow-up data, Costello2 concluded that the average success rate (abstinent plus improved cases) after alcoholism treatment is 26%. A similar picture emerged from Vaillant's3


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