Are former heavy drinkers in the UK less likely to identify as being in recovery compared to those in the USA? A pilot test

The Alcoholics Anonymous (AA) movement created the term "in recovery" to express the continuing requirement for vigilance in order to sustain sobriety (which includes abstinence from alcohol intake) and avoid a return to dangerous drinking. This term, or identity, may be adopted by someone who considers themselves to be in recovery for the rest of their lives. Recovery is considered to entail gains in health and wellbeing, and has been described as a social process in which individuals learn to absorb new norms and values as part of a recovery-oriented identity, but it is not specifically defined in the AA literature. While AA and the 12-step program have a global reach, they have their roots in the United States. Could the extent to which former heavy drinkers embrace the recovery identity vary by nation, given its association with AA and other 12-step movements?

For example, in the last decade, the United Kingdom has seen a legislative shift that has resulted in reductions in alcohol and drug treatment programs as well as a shift in service focus toward sobriety rather than harm reduction. Given the recent adoption of a sobriety orientation, it's possible that the recovery identity isn't as widespread among former heavy drinkers in the UK as it is in the US.This is an important topic because present and past heavy drinkers who refuse to embrace a recovery identity may be less likely to access and benefit from 12-step treatment programs.

The current pilot study offers early analyses to evaluate the hypothesis that former heavy drinkers in the United States are more likely to have a recovery identity than those in the United Kingdom. Because the data is not typical of the general population, the research is classified as a pilot. Nonetheless, the sample size is sufficient to give a preliminary test of this prediction and to determine if more study on the subject is warranted.


The survey was conducted through the Prolific website, and participants were asked to complete a brief survey (about 15 minutes) regarding their alcohol consumption. A convenience sample of former heavy drinkers conducted the online cross-sectional survey. This sample was drawn from people who were asked to fill out an alcohol consumption questionnaire. Items from a survey by Kelly et al. were included in the survey to measure self-reported present and historical levels of alcohol use, alcohol dependence at the time of highest alcohol consumption (ICD-10 criteria), and questions about identifying as now or ever being in recovery (2018).

Out of the 5002 people who completed the survey, 150 were recognized as former heavy drinkers from the United Kingdom or the United States. The proportions of participants reporting alcohol dependency and previous year abstinence did not differ substantially between the UK and the US (p =.841 and 0.300, respectively). Participants in the United States were more likely than those in the United Kingdom to say they had a drinking problem but no longer do (24.1 percent vs. 56.0 percent; p =.001), and that they were currently (4.2 percent vs. 21.2 percent; p =.003) or ever (7.4 percent vs. 30.2 percent; p =.001) in recovery.

A thorough understanding of the factors that influence people's willingness to adopt a recovery identity could be extremely useful in informing ongoing policy decisions about the best ways to encourage people who drink too much to seek help and then provide them with engaging tools to help them resolve their drinking problems. While the current data suggests that former heavy drinkers in the United States and the United Kingdom may have dramatically different perspectives on recovery, more research is needed to generalize the findings at a population level. Future research should also look at how different aspects of prior heavy drinking (e.g., age of beginning, length) affect the recovery identities of former heavy drinkers in the United States and the United Kingdom.

Cunningham, J.A., Godinho, A. Are former heavy drinkers in the UK less likely to identify as being in recovery compared to those in the USA? A pilot test. Subst Abuse Treat Prev Policy 16, 74 (2021).
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