The overall rate of current SUDs among these offenders was 21% 15 years following a screening referral. This rate, while substantial, is similar to those of other studies of the natural history of substance-related problems. A review of studies that followed people treated for alcohol dependence for 15 to 40 years finds that different samples recruited at different times and followed for different intervals show a wide range of outcomes.30 Most of these longitudinal studies report that rates of SUDs decline steadily after age 40. This would explain the high recovery rate in the present study population. The youngest subjects in the present study were 18 years old at screening; hence, the youngest members of this population were at least 33 years old. In one study of 96 individuals, 27 died after 16 years of follow-up, 11 were lost to follow-up, and 48 of the remainder were still alcoholic.31 Another study of 207 alcoholics followed from 40 to 50 years, finds 23% were deceased and of 137 survivors who were followed, 48% were still alcoholic.32 Other studies find rates ranging
