Natural outcome of cannabis use disorder: a 3-year longitudinal follow-up

Addiction. 2015 Dec;110(12):1963-74. doi: 10.1111/add.13071. Epub 2015 Aug 26.

Abstract

Aims: To assess the prevalence and correlates of remission from cannabis use disorders (CUDs), focusing on the proportion of individuals with CUDs that remit without abstaining from cannabis use.

Design: Three-year longitudinal study.

Setting: Wave 1 (2001) and wave 2 (2004) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of US adults aged 18 years and over.

Participants: Our sample included 444 individuals diagnosed with DSM-IV cannabis abuse and/or dependence during the 12 months prior to wave 1 of the NESARC.

Measurements: Baseline socio-demographic and clinical correlates were analysed for possible outcomes of CUDs after 3 years: abstinent remission, non-abstinent remission and sustained disorder.

Findings: Approximately two-thirds (67%) of individuals with baseline CUD remitted at follow-up. Approximately 37% of those who remitted were non-abstinent. Remission was associated with Hispanic ethnicity [odds ratio (OR)=2.59; 95% confidence interval (CI)=1.27-4.87], baseline daily or almost daily use of cannabis (OR=1.91; 95% CI=1.15-3.16), baseline use of other drugs (OR=1.63; 95% CI=1.04-2.56) and two or more medical conditions at baseline (OR=8.40; 95% CI=2.67-26.41). Non-abstinent remission was associated with baseline daily or almost daily use of cannabis (OR=1.92; 95% CI=1.05-3.51).

Conclusions: A substantial level of remission from cannabis use disorders (CUDs), including non-abstinent remission, suggests that the nature of CUDs may be more unstable than reported previously.

Keywords: Abuse; NESARC; cannabis use disorder; dependence; longitudinal follow-up; non-abstinent remission.

MeSH terms

  • Adult
  • Age of Onset
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Marijuana Abuse / epidemiology
  • Marijuana Abuse / rehabilitation*
  • Middle Aged
  • Recurrence
  • Remission Induction
  • Remission, Spontaneous
  • Socioeconomic Factors
  • United States / epidemiology
  • Young Adult