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Remission from substance use disorders: A systematic review and meta-analysis
M-J Fleury1, Akram Djouini2, Christophe Huỳnh2
1Department of Psychiatry, McGill University, Montreal, Canada.
Drug and Alcohol Dependence
|September 12, 2016
Summary
Substance use disorders (SUDs) show remission rates between 35-54% over a mean of 17 years. Annual remission is low (6-9%), suggesting SUDs are chronic conditions requiring long-term management.
Area of Science:
- Addiction Medicine
- Psychiatry
- Public Health
Background:
- Substance use disorders (SUDs) are a significant public health concern.
- Understanding remission rates is crucial for effective treatment and patient outcomes.
- Variability in reported remission rates necessitates a systematic review of existing evidence.
Purpose of the Study:
- To systematically review and meta-analyze remission rates for substance use disorders (SUDs).
- To provide weighted mean estimates of SUD remission rates.
- To explore study characteristics influencing remission rate variations.
Main Methods:
- Comprehensive literature search (2000-2015) for studies with ≥3-year follow-up or lifetime remission data.
- Remission defined as meeting no diagnostic criteria for SUDs for ≥6 months.
- Single-group summary meta-analysis, calculating pooled estimated annual remission rates (PEARRs).
- Meta-regression and subgroup analyses to identify influencing variables.
Main Results:
- 21 studies met eligibility criteria from 8855 identified.
- Estimated SUD remission rates ranged from 35.0% to 54.4% after a mean follow-up of 17 years.
- Projected pooled estimated annual remission rates (PEARRs) were 6.8% to 9.1%.
- Higher remission rates correlated with longer follow-up periods and lower sample retention.
Conclusions:
- Findings support the view of SUDs as chronic, long-term disorders for many individuals.
- Further longitudinal research is essential to understand SUD trajectories.
- Increased availability of chronic-care-oriented treatments (e.g., assertive community treatment) is recommended.
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