Abstract：
BACKGROUND: Most people with alcohol use disorder (AUD) do not use treatment services, yet the majority ultimately resolve their AUD. As the phenomenon of untreated recovery remains poorly understood, we investigated the strategies used for recovery without treatment.
METHODS: We conducted semi-structured interviews with 65 adults (27 women, 37 White) with resolved AUD and no history of using specialty services (e.g., inpatient or outpatient rehabilitation, medication-assisted treatment). Using both inductive and deductive coding, we identified and elaborated themes and meanings. We verified our findings through nine member-check sessions with interviewers and interview participants.
RESULTS: Majorities of interview participants met criteria for severe lifetime AUD (84.6%), were in long-term recovery (>5 years; 81.5%), and indicated abstinence was their recovery goal (56.9%). Close to half (41.5%) had attended mutual-help groups (e.g., Alcoholics Anonymous). We identified five active strategies (Changing Contexts, Social Connections. Activities, Substitution, and Other Strategies) and four additional factors (Mutual-help Groups, Self-Reliance, Spirituality, and Aging/Maturing) that contributed to their recovery. Most participants employed multiple strategies and were intentional in adopting the ones that best suited them. By far, the two most common strategies were Changing Contexts (reported by 69.2% of participants) whereby people reduced their alcohol exposure by modifying social networks or physical settings and relying on Social Connections (reported by 67.7%), especially connections to people with similar lived experiences and struggles. Notably, Social Connections and Mutual-Help groups were the themes most often discussed jointly. Among other contributing factors mentioned, Spirituality appeared to play an important, but not universal, role as it was invoked by approximately half (49.2%) of participants.
CONCLUSIONS: Our study confirms that recovery without specialty treatment is possible, and that multiple strategies and contributing factors help to achieve it. These findings may inform novel interventions to support recovery among people unwilling or unable to obtain treatment for AUD.
METHODS: We conducted semi-structured interviews with 65 adults (27 women, 37 White) with resolved AUD and no history of using specialty services (e.g., inpatient or outpatient rehabilitation, medication-assisted treatment). Using both inductive and deductive coding, we identified and elaborated themes and meanings. We verified our findings through nine member-check sessions with interviewers and interview participants.
RESULTS: Majorities of interview participants met criteria for severe lifetime AUD (84.6%), were in long-term recovery (>5 years; 81.5%), and indicated abstinence was their recovery goal (56.9%). Close to half (41.5%) had attended mutual-help groups (e.g., Alcoholics Anonymous). We identified five active strategies (Changing Contexts, Social Connections. Activities, Substitution, and Other Strategies) and four additional factors (Mutual-help Groups, Self-Reliance, Spirituality, and Aging/Maturing) that contributed to their recovery. Most participants employed multiple strategies and were intentional in adopting the ones that best suited them. By far, the two most common strategies were Changing Contexts (reported by 69.2% of participants) whereby people reduced their alcohol exposure by modifying social networks or physical settings and relying on Social Connections (reported by 67.7%), especially connections to people with similar lived experiences and struggles. Notably, Social Connections and Mutual-Help groups were the themes most often discussed jointly. Among other contributing factors mentioned, Spirituality appeared to play an important, but not universal, role as it was invoked by approximately half (49.2%) of participants.
CONCLUSIONS: Our study confirms that recovery without specialty treatment is possible, and that multiple strategies and contributing factors help to achieve it. These findings may inform novel interventions to support recovery among people unwilling or unable to obtain treatment for AUD.
摘要：
背景：大多数酒精使用障碍（AUD）患者不使用治疗服务，然而，大多数人最终解决了他们的AUD。由于人们对未经处理的恢复现象知之甚少，我们调查了用于无治疗恢复的策略.
方法：我们对65名成年人（27名女性，37白色)，具有已解决的AUD，并且没有使用专业服务的历史(例如，住院或门诊康复，药物辅助治疗)。使用归纳和演绎编码，我们确定并阐述了主题和含义。我们通过与面试官和访谈参与者的九次成员检查会议验证了我们的发现。
结果：大多数访谈参与者符合严重终生AUD的标准（84.6％），长期恢复(>5年；81.5%)，并表示禁欲是他们的康复目标(56.9%)。近一半(41.5%)曾参加互助小组(例如，酗酒者匿名）。我们确定了五种积极的策略(改变上下文，社会关系。活动,替代,和其他策略)和四个额外的因素(互助小组，自力更生,灵性,和老化/成熟)有助于他们的复苏。大多数参与者采用多种策略，并有意采用最适合他们的策略。到目前为止,两种最常见的策略是改变环境（69.2%的参与者报告），即人们通过改变社交网络或物理环境以及依靠社交联系来减少酒精暴露（67.7%的参与者报告）。尤其是与有相似生活经历和挣扎的人的联系。值得注意的是,社会联系和互助小组是最经常共同讨论的主题。在提到的其他促成因素中，灵性似乎发挥了重要作用，但不是普遍的，角色，因为它被大约一半(49.2%)的参与者调用。
结论：我们的研究证实，无需特殊治疗即可康复。多种策略和促成因素有助于实现这一目标。这些发现可能会提供新的干预措施，以支持不愿或无法获得AUD治疗的人的康复。
方法：我们对65名成年人（27名女性，37白色)，具有已解决的AUD，并且没有使用专业服务的历史(例如，住院或门诊康复，药物辅助治疗)。使用归纳和演绎编码，我们确定并阐述了主题和含义。我们通过与面试官和访谈参与者的九次成员检查会议验证了我们的发现。
结果：大多数访谈参与者符合严重终生AUD的标准（84.6％），长期恢复(>5年；81.5%)，并表示禁欲是他们的康复目标(56.9%)。近一半(41.5%)曾参加互助小组(例如，酗酒者匿名）。我们确定了五种积极的策略(改变上下文，社会关系。活动,替代,和其他策略)和四个额外的因素(互助小组，自力更生,灵性,和老化/成熟)有助于他们的复苏。大多数参与者采用多种策略，并有意采用最适合他们的策略。到目前为止,两种最常见的策略是改变环境（69.2%的参与者报告），即人们通过改变社交网络或物理环境以及依靠社交联系来减少酒精暴露（67.7%的参与者报告）。尤其是与有相似生活经历和挣扎的人的联系。值得注意的是,社会联系和互助小组是最经常共同讨论的主题。在提到的其他促成因素中，灵性似乎发挥了重要作用，但不是普遍的，角色，因为它被大约一半(49.2%)的参与者调用。
结论：我们的研究证实，无需特殊治疗即可康复。多种策略和促成因素有助于实现这一目标。这些发现可能会提供新的干预措施，以支持不愿或无法获得AUD治疗的人的康复。
