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The long-term course of alcoholism, 5, 10 and 16 years after treatment


Karl Mann, Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, J 5, D-68159 Mannheim, Germany, Tel: + 49 621 1703 3501, Fax: + 49 621 1703 3505, E-mail:


Aims  To discover the long-term stability of drinking behaviour following an in-patient treatment episode.

Design  Three follow-up periods were used at 5, 10 and 16 years. The patients were classified as being abstinent, improved or unimproved on the basis of self-reported drinking behaviour. Patients who could not be interviewed at follow-up were classified as unimproved.

Setting  An alcohol dependence treatment programme at the University Hospital Tuebingen, Germany.

Participants  We were able to locate all 96 patients at the 16-year follow-up. Seventy were alive and 26 had died. We collected information from 59 of the 70 surviving patients. The remaining 11 patients could be located and were definitely alive.

Findings  Thirty-eight of the 70 patients were abstinent, 10 were improved and 22 (including the 11 living patients without further information) were classified as unimproved. Our main finding indicates that the so-called ‘improved drinking’ is very inconsistent over time. In contrast, the abstinent and unimproved patients were much more stable in their drinking behaviour.

Conclusions  This study extends our knowledge of the drinking trajectory and outcome from only a few years of follow-up to 16 years. Complete abstinence and unimproved drinking behaviour were the most stable drinking patterns observed over the long term, confirming study results obtained primarily from English-speaking countries.