Introduction: The consensus on recovery from alcohol use disorder (AUD) has shifted toward encompassing psychological wellbeing and quality of life dimensions. However, few studies have explored the long-term recovery process and its dimensions, timing, styles, and modes. The aim of this study was to investigate the extent, timing, and process of psychological wellbeing and quality of life recovery in alcohol use disorder (AUD) patients, as well as the relationship with classic dimensions of AUD recovery.Method: A cross-sectional study has been carried out with 348 participants with AUD, in different abstinence periods (1 month–28 years), and 171 control subjects. Participants underwent a psychological evaluation, which included self-informed measures of psychological wellbeing, quality of life, negative emotionality, and coping strategies related to alcohol consumption avoidance. Statistical analysis included linear and non-linear regression models between psychological dimensions and maintenance of abstinence, as well as matching the scores of the sample with AUD to those of controls. Scatter plots were used to explore inflection points. In addition, mean comparison tests were performed between participants with AUD and controls and by gender.Results: In general, according to the regression models, there were pronounced increases in indices of wellbeing and coping strategies (and pronounced decreases in negative emotionality) during the first 5 years of abstinence, followed by less pronounced improvements. The matching of AUD subjects in wellbeing and negative emotionality indices with controls occurs at different times: (a) 1 year or less: physical health; (b) 1–4 years: psychological health; (c) 4–10 years: social relationships, wellbeing, and negative emotionality; and (d) more than 10 years: autonomy and self-acceptance. There are statistically significant differences by gender for the negative emotionality and physical health variables.Conclusion: Recovery from AUD is a long process that involves improvements in wellbeing and quality of life. Four stages can be described in this process, with the most pronounced changes occurring during the first 5 years of abstinence. However, AUD patients take more time to obtain similar scores to controls in several psychological dimensions.

Introduction: Current literature does not dispose from a widely accepted definition of recovery in alcohol use disorder (AUD), and most proposals originate from anglophone countries. This study introduces a pioneering consensus in Spain on the definition of recovery in AUD. Method: The Delphi method was used. The expert panel, comprising 54 multidisciplinary professionals from the Community of Madrid. Results: A high level of consensus (≥80% agreement) was reached for 45% of the items and majority (≥60%) for 84%. Recovery is understood as a dynamic, personalized, and voluntary process, potentially enduring throughout one's lifespan. It entails a transformative lifestyle shift aimed at achieving a significant improvement in overall quality of life, encompassing physical and mental health, interpersonal relationships, and environmental factors. The journey of recovery is marked by heightened psychological well-being, is characterized by empowerment, personal growth, existential purpose, and positive identity reconstruction. Recovery is supported by substance use management, requires proactive individual agency and involves both personal and societal responsibilities. Conclusions: This study represents a milestone as it is the first consensus in the Community of Madrid on the meaning of recovery in AUD. The proposed definition of recovery could be a potential reference for similar regions within Spain or even for other countries with cultural similarities. The elucidation of a clear framework of recovery provides a solid basis for future research efforts and clinical interventions in the Spanish AUD landscape.

El bienestar es un elemento clave de las definiciones actuales de recuperación en el trastorno por uso de alcohol (TUA). No obstante, es preciso desarrollar un marco unificado para conceptualizar la recuperación, caracterizar sus elementos y los mecanismos para lograrla. El objetivo del estudio fue proponer un modelo que relacionara las dimensiones psicológicas implicadas en la recuperación del TUA. Se evaluó a 348 participantes con diferentes períodos de abstinencia (rango:1 mes-28 años), mediante autoinformes de bienestar psicológico, calidad de vida, emocionalidad negativa y estrategias de afrontamiento. El análisis estadístico contó con un análisis factorial exploratorio (AFE) para identificar las dimensiones subyacentes a los indicadores evaluados y un modelo de ecuaciones estructurales (SEM) que las interrelacionó. El AFE identificó 3 factores que explicaron el 54,95% de la varianza: i) Afrontamiento; ii) Malestar Funcional (gestión emocional y capital de recuperación); iii) Salud Mental Positiva (bienestar y calidad de vida). El SEM mostró buenos índices de ajuste (GFI = 1,00, SRMR = ,137) y explicó el 85% de la varianza en Salud Mental Positiva (R2 = ,85). Los resultados muestran que el tiempo de abstinencia se asocia con el aumento del empleo de estrategias de afrontamiento, lo que contribuye a la mejora del malestar funcional, y esto favorece la salud mental positiva. Esta investigación representa la primera propuesta metodológicamente sólida realizada en España para un modelo clínico de recuperación centrado en el bienestar, que redefine la comprensión de la recuperación en el TUA y proporciona soporte para intervenciones clínicas y evaluaciones más efectivas.