Natural resolution of alcohol problems without treatment: environmental contexts surrounding the initiation and maintenance of stable abstinence or moderation drinking.

Environmental contexts surrounding the natural resolution of alcohol problems were investigated using untreated former problem drinkers who had maintained stable abstinence (n = 18) or moderation drinking (n = 17) for more than 2 years (M = 7.1 years resolved). Untreated active problem drinkers (n = 17) served as controls. During structured interviews, events were assessed retrospectively over a 4-year period that spanned the 2 years before and the 2 years after stable behavior change was initiated or over a matched recall interval for controls. Collaterals verified participant reports. Compared to nonresolved controls, both resolved groups reported improved life circumstances during the first year of maintenance, which concurs with treatment outcome studies showing that the circumstances during the posttreatment interval influence long-term outcomes. These positive changes diminished over time, however, among moderation drinkers only as their drinking remained normalized, which suggests that tolerating life changes during maintenance is a feature of successful moderation.