In the U.S., only a small proportion of individuals with Alcohol Use Disorders seek or receive treatment for their alcohol problems. Epidemiological data suggest that in any given year only about 12% seek help for their drinking (broadly defined to include a spectrum of help ranging from Alcoholics Anonymous to specialized alcoholism treatment).  Over the course of their lifetime, only 24% receive any kind of treatment.  When people do seek treatment, they typically do so between the ages of 40 and 44 years. Thus, the existing treatment system tends to accommodate middle-aged individuals, despite the peak prevalence for AUDs among younger individuals (Grant et al., 2004, Drug and Alc Dep., 74:223-234).  Many younger persons “mature out” of AUDs as they age, and many drinkers recover or remit from AUD without any professional intervention.  Some investigators have referred to this phenomenon as “natural recovery.”  Of persons with “past” Alcohol Dependence in the 2001-2002 survey year, 25% were still dependent, 27.3% were in partial remission, 11.8% were asymptomatic risk drinkers, 17.7% were low-risk drinkers, and 18.2% became complete abstainers (Dawson et al.,2005, Addiction, 100(3):281-292). 

To further illustrate the natural history of Alcohol Dependence, the inset displays past-year drinking status of the NESARC survey population by interval since Alcohol Dependence onset.  In 2001-2002, 64.9% of those who had experienced dependence onset within the past 5 years remained dependent compared with only 6.9% of those who had experienced an onset of dependence 20 or more years earlier.  Similarly, only 6.0% of persons with recent onset were abstinent or low-risk drinkers compared with 61.0% of those whose dependence originated 20 or more years earlier.