Alcohol Use Disorder in Remission

Alcohol use disorder in remission is the clinical term for when someone with AUD has experienced significant improvement in their symptoms. Understanding remission criteria helps you track recovery progress and know what to expect on the path to lasting change.

What You'll Discover:

• What alcohol use disorder in remission means clinically.

• The difference between early and sustained remission.

• How remission is determined using DSM-5 criteria.

• What recovery looks like after achieving remission.

• Whether remission means you're "cured."

• How to maintain remission long-term.

Recovery from alcohol use disorder is possible. The DSM-5 recognizes this by including specific criteria for when AUD is considered "in remission."

Understanding what remission means clinically helps you set realistic expectations for recovery and recognize meaningful progress when it happens.

What Is AUD Remission?

Remission means the symptoms that qualified someone for an AUD diagnosis have subsided. The person no longer meets full criteria for the disorder.

For AUD specifically, remission is defined by how many of the 11 diagnostic criteria the person meets. Remember, AUD is diagnosed when someone meets 2 or more criteria. Remission begins when symptoms decrease significantly.

The DSM-5 defines two types of AUD remission:

Early remission - When someone with AUD has met none of the 11 criteria (except cravings) for at least 3 months but less than 12 months.

Sustained remission - When someone has met none of the criteria (except cravings) for 12 months or longer.

The distinction matters clinically because early remission represents initial progress, while sustained remission indicates more stable, long-term recovery.

The 11 Criteria and How Remission Works

To understand remission, it helps to review the criteria that define AUD.

For remission, you need to meet none of these criteria (cravings excepted) for the specified time period. This doesn't mean perfect behavior. It means the problematic patterns have resolved.

Why Cravings Are Excepted

You might notice that cravings are specifically excepted from the remission criteria. Someone can experience occasional cravings and still be in remission.

This exception reflects the reality that cravings can persist even in sustained recovery. The brain pathways formed during problematic drinking don't disappear completely. Occasional urges to drink don't negate recovery as long as other criteria aren't met.

However, frequent or intense cravings may signal risk for relapse. They're worth monitoring and addressing even if they don't technically prevent remission status.

Timeline of Recovery and Remission

Understanding what to expect at different stages helps you track progress.

First 30 days - Initial adjustment period. Physical withdrawal (if applicable) resolves. Sleep and mood may be unstable. Cravings are often strongest during this time.

Months 1-3 - Pre-remission period. Brain chemistry begins stabilizing. Energy and mood typically improve. New routines are forming but not yet solid.

Months 3-6 (Early remission begins) - If you've met no criteria except cravings for 3 months, you enter early remission. Many people notice significant quality of life improvements. Physical health markers often show measurable change.

Months 6-12 - Continued early remission. Changes become more automatic. The effort required to maintain recovery typically decreases. Social and professional life often shows improvement.

12 months and beyond (Sustained remission) - After one year, you enter sustained remission. Research shows relapse risk decreases significantly. Recovery feels more natural and requires less conscious effort.

Early Remission: The First Year

Early remission covers months 3 through 12 of recovery. This period is clinically significant for several reasons.

Brain healing - Research from the National Institutes of Health shows that the brain continues healing and rebalancing throughout the first year of reduced drinking. Neurotransmitter function improves gradually.

Habit formation - New patterns take time to solidify. Early remission is when new coping mechanisms and routines become established.

Vulnerability - Relapse risk is highest during early remission. The changes aren't yet stable, and triggers can still be powerful.

Physical improvement - Liver function, sleep quality, and other health markers continue improving throughout early remission.

During early remission, people often notice significant improvements in mood, energy, relationships, and overall life quality. However, this period requires ongoing attention and effort.

Sustained Remission: Beyond One Year

After 12 months of meeting remission criteria, someone moves from early to sustained remission. This represents more stable recovery.

Lower relapse risk - While relapse remains possible, the risk decreases significantly after the first year. Neural pathways have had more time to remodel.

Established patterns - By this point, new habits and coping mechanisms are more automatic. Recovery requires less constant effort.

Deeper healing - Physical and psychological healing has progressed further. Many health markers have normalized.

Perspective shift - People in sustained remission often report that their relationship with alcohol has fundamentally changed. The appeal has diminished.

Sustained remission is the goal of recovery, though it doesn't mean the work is completely done. Ongoing awareness and maintenance help protect the gains you've made.

Does Remission Mean You're Cured?

This is a complex question that people in recovery often wrestle with.

The medical view - Clinically, AUD is considered a chronic condition. Remission means symptoms are managed, not that the underlying vulnerability has disappeared. This is similar to diabetes or hypertension being "controlled" rather than "cured."

The practical view - Many people in sustained remission function as if they never had a drinking problem. They may be able to drink moderately (though this isn't recommended for everyone) or may simply not think about alcohol much anymore.

Individual variation - Some people in remission can never safely drink again. Others may be able to have occasional drinks without returning to problematic patterns. Individual factors determine which applies.

The safest approach is to treat remission as ongoing management rather than a cure. This mindset helps maintain the changes that led to remission.

Paths to Remission

People achieve AUD remission through various routes.

Abstinence - Complete abstinence from alcohol is the traditional and often safest path to remission. Without drinking, most AUD criteria become impossible to meet.

Moderation - Some people, particularly those with mild AUD, achieve remission while continuing to drink at reduced levels. This requires careful monitoring and isn't appropriate for everyone.

Medication-assisted treatment - Naltrexone and other medications can support the journey to remission by reducing cravings and making moderation more achievable.

Therapy and support - Counseling, support groups, and other interventions help people develop the tools needed for remission.

Self-directed change - Some people achieve remission through their own efforts without formal treatment, though professional support typically improves outcomes.

The best path depends on AUD severity, individual circumstances, available resources, and personal preferences.

Medical Documentation and Remission

Understanding how remission appears in medical records matters for practical reasons.

ICD-10 codes - Healthcare providers use specific diagnostic codes to document AUD in remission. These codes distinguish between early and sustained remission.

Insurance implications - Remission status may affect insurance coverage for ongoing treatment. Documentation of progress can support continued care when needed.

Medical history - An AUD diagnosis, even in remission, remains part of your medical history. This is relevant for certain medications, surgeries, and health decisions.

Employment and legal considerations - In some contexts, remission status versus active AUD may have different implications. Understanding your clinical status helps you navigate these situations.

Maintaining Remission

Achieving remission is important, but maintaining it is the longer-term challenge.

Monitor for warning signs - Early recognition of returning patterns allows for quick intervention. Be honest with yourself about changes in drinking behavior or mindset.

Continue what works - If therapy, support groups, medication, or other interventions helped you achieve remission, consider continuing them.

Address underlying issues - Mental health conditions, stress, and life circumstances that contributed to AUD may need ongoing attention.

Build a supportive life - Relationships, activities, and routines that don't center on drinking help maintain remission.

Have a plan for triggers - Know what situations increase risk and have strategies ready.

Stay connected - Isolation increases relapse risk. Maintain connections with people who support your recovery.

What If You Relapse?

Relapse doesn't mean failure or that remission is impossible. It's a common part of the recovery process for many people.

It happens - Studies show that relapse rates for AUD are similar to relapse rates for other chronic conditions like diabetes and hypertension. It's the norm, not the exception.

It's information - Relapse provides information about what wasn't working. Analyzing what led to relapse helps strengthen recovery strategies.

Start again - After a relapse, the path back to remission is the same as before. Address what happened and recommit to the approaches that work.

Seek support - A relapse may indicate that additional support is needed. Consider adjusting your treatment approach.

Medication-assisted treatment with naltrexone can help prevent relapse or limit its severity. Taking naltrexone before drinking can reduce how much you consume even if a relapse begins.

Common Questions About AUD Remission

Can I drink again after achieving remission?

This depends on your individual situation. Some people with mild AUD can eventually drink moderately. Those with severe AUD or physical dependence history are generally advised to maintain abstinence. If you're considering drinking after remission, discuss it with a healthcare provider first.

How long does it take to reach remission?

The minimum for early remission is 3 months of meeting no criteria. However, the path to that point varies. Some people achieve it quickly, while others take longer. What matters is consistent progress, not speed.

Will my diagnosis ever go away?

AUD in remission is still technically a diagnosis. However, in sustained remission, it reflects history rather than current condition. For practical purposes, it indicates you had a problem that you've successfully managed.

Does remission reset if I have a drink?

Not necessarily. Having a single drink doesn't automatically mean you've relapsed or lost remission status. What matters is whether you meet any criteria. A single controlled drink is different from drinking more than intended or experiencing consequences.

Can I stop treatment once I'm in remission?

This depends on what treatment you're receiving and your individual circumstances. Some people taper off treatment gradually, while others continue maintenance approaches long-term. Discuss changes to your treatment plan with your provider.

Is remission the same as recovery?

The terms are related but distinct. Remission is a clinical term with specific criteria. Recovery is a broader concept that includes remission but also encompasses lifestyle changes, personal growth, and improved quality of life. You can be in clinical remission while still working on broader recovery goals.

What percentage of people achieve remission?

Research suggests that about 20-30% of people with AUD achieve remission without formal treatment. With treatment, success rates improve significantly. The National Institute on Alcohol Abuse and Alcoholism reports that roughly one-third of people with AUD are in full remission a year after treatment begins.

How do I know if I'm really in remission?

Review the 11 AUD criteria honestly. If you haven't met any of them (except possibly cravings) for at least 3 months, you likely meet criteria for early remission. A healthcare provider can make a formal assessment and document your status.

Life in Remission

What does life look like for someone in sustained AUD remission?

Freedom - Many people describe freedom from the constant mental energy spent on drinking decisions, managing consequences, and feeling guilty about consumption.

Improved health - Physical health typically improves significantly. Liver function, blood pressure, sleep, and weight often normalize.

Better relationships - Relationships damaged by drinking often heal. New relationships form without alcohol as the social glue.

Emotional growth - Without alcohol numbing emotions, people often develop better emotional awareness and coping skills.

Time and money - Resources previously devoted to drinking become available for other pursuits.

Ongoing awareness - Most people in remission remain aware of their history with alcohol. This awareness helps maintain the changes.

Conclusion

Alcohol use disorder in remission means the symptoms that defined your AUD have significantly improved. Early remission (3-12 months) represents initial progress, while sustained remission (12+ months) indicates more stable recovery.

Remission is achievable through various paths including abstinence, moderation with appropriate support, and medication-assisted treatment. Maintaining remission requires ongoing attention, but gets easier as recovery progresses.

If you're working toward remission or want to start the journey, effective treatments exist. Understanding where you are on the spectrum helps guide appropriate next steps.

Take the online Alcohol Use Assessment to evaluate your current situation and see what treatment options could help you achieve remission.