Do alcoholics recover?

cataract surgery in the same hands. Rehabilitation is much easier than with other methods. The postoperative vision and orientation seem natural, and the patient can often see well without an additional optical correction. With this technique cataract surgery can be offered to patients with unilateral lens opacities which used to be left untreated when the fellow eye remained unaffected. Provided, therefore, that preoperative assessment excludes the presence of other conditions affecting the eye and any general disease which would have an adverse influence, the prospects for cataract surgery are good. In uncomplicated cases over 95%0 of patients may expect to achieve a final corrected vision of 6/12 or better. Doctors weary of exhortations to identify alcoholics, and many resent the suggestion that they should be treating them, too. Do not alcoholics inevitably slide downhill, perhaps with brief plateaux, with few if any recovering? This stereotype might, however, be based only on a few recalcitrant and unrepresentative bad pennies. Doctors seldom meet recovered alcoholics in their clinics or surgeries. What are the prospects for recovery? And how much difference is made by medical intervention ? A series of surveys in the United States, with follow-ups after two to three years, have shown that people move into and out of problem drinking.1 2 Two-thirds have improved by the second interview and half are free of problems. Even if follow-up is complete (which is only sometimes the case1) such surveys may be criticised. Possibly they may not detect "real" alcoholics in the first place: they may miss homeless individuals and people who are never in when the interviewer calls. Perhaps, moreover, "real" alcoholics go undetected because they lie. Neither these two criticisms nor the pitfall of loss to follow-up applied to two recently reported longer-term studies, both of defined populations. The Lundby cohort consisted of all adults living in a Swedish town on 1 July 1947. In 1957 all were reinterviewed by a psychiatrist, and 96 of the 1312 men were classified as alcoholics. They were interviewed again 15 years later, and information from official sources, families, and neighbours collated.3 Of the 96 alcoholics, 29 had recovered, 42 were unchanged or worse, and 25 had died (though only four of them died below the age of 65). Vaillant and Milofsky have used data on inner-city teenagers originally studied in the 1940s and reinterviewed at ages 25, 31, and 47.4 Arrest and clinic records …