Voluntary versus involuntary abstinence in the treatment of alcoholics.

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Abstract
Of 123 men alocholics who completed a voluntary Fixed Interval Drinking Decisions Progrsm (FIDD), 46 chose to abstain for the entire 4-wk optional-drinking period, 47 drank in varying degrees and the remaining 30 were compelled to abstain for medical reasons. Responses of 99 patients at 6-mo. follow-up showed that the outcome for involuntary abstainers was significantly better than that for drinkers but significantly poorer than that for voluntary abstainers. More involuntary abstainers than drinkers reported at the follow-up that they were drinking less than they had before the program: involuntary abstainers began drinking later and became intoxicated later in the follow-up period than did drinkers. Compared with voluntary abstainers, involuntary abstainers less often achieved abstinence for the entire 6 mo. (10 vs. 32%), reported a significantly lower abstinence rate during the last month of the follow-up period (53 vs. 15%) and started drinking earlier in the follow-up period. The better outcomes of the voluntary abstainers may be attributed at least in part to the confidence and ego-enhancement they gained by refusing freely available alcohol in the presence of other drinking alcoholics.

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