Of the COGA participants who develop an AUD, a majority have periods of abstinence from alcohol lasting from 3 months to more than 5 years. 111 Individuals with periods of abstinence tend to have more severe histories of AUD, characterized by a younger age at onset, a greater number of symptoms, and co‐occurring drug use disorders. They are also more likely to have accessed professional treatment and attended alcoholics anonymous. 111 , 112 In contrast to abstainers, individuals who no longer have symptoms of AUD but continue drinking at low‐risk levels have fewer lifetime AUD symptoms and are less likely to access treatment. Overall, among those who have met criteria for AUD, abstainers in COGA resemble clinical samples in their severity of AUD and high rates of treatment, and low‐risk drinkers resemble “natural remitters” from population‐based samples in their lower severity and lack of treatment. 113 , 114
