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

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 18years and over. Participants: Our sample included 444 individuals diagnosed with DSM-IV cannabis abuse and/or dependence during the 12months prior to wave 1 of the NESARC. Measurements: Baseline socio-demographic and clinical correlates were analysed for possible outcomes of CUDs after 3years: 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.