Desistance from problematic alcohol use without treatment among active heroin and cocaine users

Abstract

Previous literature has examined natural remission rates from problematic drinking in the general population, but not in heroin and cocaine users. This study is a cross-sectional, retrospective study of the baseline data from the Baltimore site of the NEURO-HIV Epidemiologic Study focusing on self-reported substance use. It is one of the first efforts to identify levels of drinking severity and natural recovery in this population and explores possible rationales for the differences between conditions from non-clinical samples. The sample consisted of 338 participants who reported active heroin and/or cocaine use and having had a period in their lives when they engaged in problematic drinking behavior. Active heroin and cocaine users were divided into three groups based on current levels of alcohol use: abstainers, moderate, and problematic alcohol users. In this study, 69.2% of current heroin and/or cocaine users reported that at one time in their lives they engaged in problematic drinking behavior, but currently were no longer doing so. That is, 59.5% of the current heroin and/or cocaine users reported natural recovery from problematic alcohol misuse. Further, as drinking severity increased, prevalence of injection drug use decreased, while prevalence of snorting/sniffing cocaine increased. The recovery process from problematic alcohol use may provide strengths which could translate into recovery from other more hazardous substances. The authors call for research to explore which cognitive or environmental factors allow active heroin and cocaine users to achieve natural remission from problematic alcohol use beyond that seen in a non-clinical sample.