Remission from drug abuse over a 25-year period: patterns of remission and treatment use

Abstract

A B S T R A C TObjectives. Using an epidemiologically obtained sample, we examined patterns of illicit drug use, abuse, and remission over a 25-year period and recent treatment use.Methods. The surviving members of the cohort (n = 841), previously surveyed in 1972 and 1974, comprised 3 subsamples of Vietnam War enlisted men and civilian controls. Retrospectively obtained year-to-year measures from the 1996-1997 survey included use and remission of sedatives, stimulants, marijuana, cocaine, and opiates, as well as substance abuse and psychiatric treatment use.Results. Relatively stable patterns of frequent use in adulthood were found, with the mean duration from initiation to the last remission ranging from 9 to 14 years. A majority attempted to quit; however, most did not use traditional drug treatment in their last attempts. Fewer than 9% of the then-current drug users were treated in inpatient or outpatient settings at the time of data collection.Conclusions. Most drug abusers who had started using drugs by their early 20s appeared to gradually achieve remission. Spontaneous remission was the rule rather than the exception. Nonetheless, considerable unmet needs existed for those who had continued use into middle age. (Am J Public Health.

Probability and predictors of cannabis use disorders relapse: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

“…However, the odds of CUD relapse found in our study are much lower than those reported in studies of clinical samples (Catalano et al, 1990; Haney et al, 2010; Perkonigg et al, 2008; Price et al, 2001; Stephens et al, 1994a, 1994b; Witkiewitz and Marlatt, 2004), possibly due to lower average severity of CUD, less psychiatric comorbidity and health issues (Arendt et al, 2007a; Chen et al, 2011), and less exposure to high-risk environments (Benowitz, 2008; Lopez-Quintero et al, 2011; Piasecki, 2006), among community rather than clinical samples. However, exact comparisons with previous findings are difficult because of the different definitions of relapse, follow-up periods and specific characteristics of the samples included across studies (Okuda et al, 2010).…”

Gender Differences in Substance Abuse Treatment and Barriers to Care Among Persons With Substance Use Disorders With and Without Comorbid Major Depression

“…Assessment of the potential gender differences in the association of MDE comorbidity with treatment barriers has important clinical implications for identifying interventions aimed at improving treatment access since a small number of individuals with SUD ever enter treatment for their conditions (Cohen et al, 2007; Price et al, 2001). Identifying appropriate targets for improving acceptability of and access to these treatments is a first step to increase service utilization.…”

Drug use disorders and post-traumatic stress disorder over 25 adult years: Role of psychopathology in relational networks

“…Army servicemen (pay grades E1–E9), who had positive urine tests (drug positive status at baseline) for opiates, amphetamines, or barbiturates at the time of their departure from Vietnam in September 1971, comprised half of the original veteran sample; the other half of veterans were drawn from the entire roster of September 1971 returnees (drug-negative status). Further details are described elsewhere (Robins 1974; Robins and Helzer, 1975; Price et al, 2001). All aspects of the series of follow-up studies involving this cohort were approved by the appropriate Institutional Review Boards.…”