Publications

Comments On A Commentary

An editorial by John T. O’Neill

As a science writer, research has always seemed to me a rather sporting endeavor. One group arrives at new, perhaps exciting, findings and then their peers take swings at it. Someone once said, “Science is the antidote for the poison of enthusiasm”.  In other fields such antagonism would be thought as competiveness. But researchers seem to view others tweaking their work as brotherly/sisterly collaborators on the pathway to truth.  A current example of this kind of synergistic interaction is a commentary by Moos and Finney on the findings presented in the above report titled Encouraging Report about Remission from Dependence.

These two scientists, while acknowledging the contribution described in the report, provide insights about how epidemiologist’s and clinicians’ ” illusions” about the prevalence and stability of remission from alcohol and/or drug dependence could alter findings. They suggest that these “illusions” can be countered by identifying the psycho-social mechanisms that underlie remission and relapse. 

They point out that clinicians are likely to deal with severe cases with a tendency to relapse and are unlikely to continue seeing individuals in sustained remission. They term this “clinicians illusion”. On the other hand, epidemiologist’s surveys are likely to include data from individuals with less severe disorders, a higher likelihood of remission, and not include those who refuse to participate due to homelessness, institutionalization or death. They term this “epidemiologists’ illusion”. They suggest that integration of epidemiologists’ and clinicians’ perspectives would promote a better understanding of the processes of remission and relapse.

Moo and Finney point to their own work that found that 43% of those who obtained help and achieved remission were relapsed at a 15 year follow-up while 61% of those who achieved remission without obtaining help were relapsed at the 16 year follow-up…a less optimistic picture than that in the study.  Their commentary suggests a need for longitudinal studies over a specified time period if stable remission is to be identified. The good news is that both the study and the commentary reveal that significant numbers of individuals experiencing alcohol dependence do achieve and maintain long term recovery. So I say, “Keep on swingin’”  

Related posts:

1. Do Medical Illness and Medical Services Encourage Recovery?
2. It Helps to Get Help
3. Encouraging Report about Remission from Dependence
4. Outpatient Treatment in Germany
5. Best Recovery Team: AA and Treatment Together