Systematic review of prospective studies investigating "remission" from amphetamine, cannabis, cocaine or opioid dependence

Calabria, Bianca, Degenhardt, Louisa, Briegleb, Christina, Vos, Theo, Hall, Wayne, Lynskey, Michael, Callaghan, Bridget, Rana, Umer and McLaren, Jennifer (2010) Systematic review of prospective studies investigating "remission" from amphetamine, cannabis, cocaine or opioid dependence. Addictive Behaviors, 35 8: 741-749. doi:10.1016/j.addbeh.2010.03.019


Author Calabria, Bianca
Degenhardt, Louisa
Briegleb, Christina
Vos, Theo
Hall, Wayne
Lynskey, Michael
Callaghan, Bridget
Rana, Umer
McLaren, Jennifer
Title Systematic review of prospective studies investigating "remission" from amphetamine, cannabis, cocaine or opioid dependence
Journal name Addictive Behaviors   Check publisher's open access policy
ISSN 0306-4603
1873-6327
Publication date 2010-08
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.addbeh.2010.03.019
Volume 35
Issue 8
Start page 741
End page 749
Total pages 9
Place of publication Oxford, England, U. K.
Publisher Pergammon
Collection year 2011
Language eng
Formatted abstract
Aims: To review and summarize existing prospective studies reporting on remission from dependence upon amphetamines, cannabis, cocaine or opioids. Methods: Systematic searches of the peer-reviewed literature were conducted to identify prospective studies reporting on remission from amphetamines, cannabis, cocaine or opioid dependence. Searches were limited to publication between 1990 and 2009. Reference lists of review articles and important studies were searched to identify additional studies. Remission was defined as no longer meeting diagnostic criteria for drug dependence or abstinence from drug use; follow-up periods of at least three years were investigated. The remission rate was estimated for each drug type, allowing pooling across studies with varying follow-up times. Results: There were few studies examining the course of psychostimulant dependence that met inclusion criteria (one for amphetamines and four for cocaine). There were ten studies of opioid and three for cannabis dependence. Definitions of remission varied and most did not clearly assess remission from dependence. Amphetamine dependence had the highest remission rate (0.4477; 95%CI 0.3991, 0.4945), followed by opioid (0.2235; 95%CI 0.2091, 0.2408) and cocaine dependence (0.1366; 95%CI 0.1244, 0.1498). Conservative estimates of remission rates followed the same pattern with cannabis dependence (0.1734; 95%CI 0.1430, 0.2078) followed by amphetamine (0.1637; 95%CI 0.1475, 0.1797), opioid (0.0917; 95%CI 0.0842, 0.0979) and cocaine dependence (0.0532; 95%CI 0.0502, 0.0597). Conclusions: The limited prospective evidence suggests that "remission" from dependence may occur relatively frequently but rates may differ across drugs. There is very little research on remission from drug dependence; definitions used are often imprecise and inconsistent across studies and there remains considerable uncertainty about the longitudinal course of dependence upon these most commonly used illicit drugs.
© 2010 Elsevier Ltd.
Keyword Remission
Dependence
Cannabis
Opioid
Cocaine
Amphetamine
33-Year Follow-up
Methamphetamine Use
Treatment Outcomes
Heroin Users
Disease
Epidemiology
Australia
Burden
Abuse
Addiction
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 10 April 2010.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: UQ Centre for Clinical Research Publications
Official 2011 Collection
School of Public Health Publications
 
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Created: Sun, 04 Jul 2010, 00:07:59 EST