Westermeyer J, Peake E
Am J Psychiatry. 1983 Feb;140(2):189-94. doi: 10.1176/ajp.140.2.189.
In a 10-year follow-up of 45 alcoholic American Indians, 42 (93%) were located. Seven had been abstinent for 2 or more years, 26 still had drinking problems despite repeated treatment, and 9 had died. The authors hypothesize that the absence of stable employment and a stable marriage or family environment reduced the efficacy of treatment efforts in this population. Those who achieved 2 years of abstinence were characterized by stable employment and/or marriage, as well as by stronger interpersonal relationships and less depression than the others. The recovered subjects provided considerable help to other alcoholic persons in addition to serving as positive role models.