Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 2001 Jul;91(7):1107–1113. doi: 10.2105/ajph.91.7.1107

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

R K Price 1, N K Risk 1, E L Spitznagel 1
PMCID: PMC1446707  PMID: 11441739

Abstract

OBJECTIVES: 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.

Full Text

The Full Text of this article is available as a PDF (95.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blomqvist J. Paths to recovery from substance misuse: change of lifestyle and the role of treatment. Subst Use Misuse. 1996 Nov;31(13):1807–1852. doi: 10.3109/10826089609064002. [DOI] [PubMed] [Google Scholar]
  2. Breslau N., Peterson E., Schultz L., Andreski P., Chilcoat H. Are smokers with alcohol disorders less likely to quit? Am J Public Health. 1996 Jul;86(7):985–990. doi: 10.2105/ajph.86.7.985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Burman S. The challenge of sobriety: natural recovery without treatment and self-help groups. J Subst Abuse. 1997;9:41–61. doi: 10.1016/s0899-3289(97)90005-5. [DOI] [PubMed] [Google Scholar]
  4. Cantwell B., McBride A. J. Self detoxication by amphetamine dependent patients: a pilot study. Drug Alcohol Depend. 1998 Jan 1;49(2):157–163. doi: 10.1016/s0376-8716(97)00160-9. [DOI] [PubMed] [Google Scholar]
  5. Carroll K. M., Rounsaville B. J. Contrast of treatment-seeking and untreated cocaine abusers. Arch Gen Psychiatry. 1992 Jun;49(6):464–471. doi: 10.1001/archpsyc.1992.01820060044007. [DOI] [PubMed] [Google Scholar]
  6. Chen K., Kandel D. B. The natural history of drug use from adolescence to the mid-thirties in a general population sample. Am J Public Health. 1995 Jan;85(1):41–47. doi: 10.2105/ajph.85.1.41. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Chiauzzi E. J., Liljegren S. Taboo topics in addiction treatment. An empirical review of clinical folklore. J Subst Abuse Treat. 1993 May-Jun;10(3):303–316. doi: 10.1016/0740-5472(93)90079-h. [DOI] [PubMed] [Google Scholar]
  8. Cunningham J. A. Untreated remissions from drug use: the predominant pathway. Addict Behav. 1999 Mar-Apr;24(2):267–270. doi: 10.1016/s0306-4603(98)00045-8. [DOI] [PubMed] [Google Scholar]
  9. Frenkel S. I., Morgan D. W., Greden J. F. Heroin use among soldiers in the United States and Vietnam: a comparison in retrospect. Int J Addict. 1977 Dec;12(8):1143–1154. doi: 10.3109/10826087709027274. [DOI] [PubMed] [Google Scholar]
  10. Gerstein D. R., Lewin L. S. Treating drug problems. N Engl J Med. 1990 Sep 20;323(12):844–848. doi: 10.1056/NEJM199009203231230. [DOI] [PubMed] [Google Scholar]
  11. Hser Y. I., Anglin D., Powers K. A 24-year follow-up of California narcotics addicts. Arch Gen Psychiatry. 1993 Jul;50(7):577–584. doi: 10.1001/archpsyc.1993.01820190079008. [DOI] [PubMed] [Google Scholar]
  12. Humphreys K., Moos R. H., Finney J. W. Two pathways out of drinking problems without professional treatment. Addict Behav. 1995 Jul-Aug;20(4):427–441. doi: 10.1016/0306-4603(95)00005-w. [DOI] [PubMed] [Google Scholar]
  13. Johnson R. J., Kaplan H. B. Stability of psychological symptoms: drug use consequences and intervening processes. J Health Soc Behav. 1990 Sep;31(3):277–291. [PubMed] [Google Scholar]
  14. Kessler R. C., Borges G., Walters E. E. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry. 1999 Jul;56(7):617–626. doi: 10.1001/archpsyc.56.7.617. [DOI] [PubMed] [Google Scholar]
  15. Klingemann H. K. Coping and maintenance strategies of spontaneous remitters from problem use of alcohol and heroin in Switzerland. Int J Addict. 1992 Dec;27(12):1359–1388. doi: 10.3109/10826089209047356. [DOI] [PubMed] [Google Scholar]
  16. McAuliffe W. E., Breer P., Ahmadifar N. W., Spino C. Assessment of drug abuser treatment needs in Rhode Island. Am J Public Health. 1991 Mar;81(3):365–371. doi: 10.2105/ajph.81.3.365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Nurco D. N., Cisin I. H., Balter M. B. Addict careers. III. Trends across time. Int J Addict. 1981 Dec;16(8):1357–1372. doi: 10.3109/10826088109039191. [DOI] [PubMed] [Google Scholar]
  18. O'Brien C. P., McLellan A. T. Myths about the treatment of addiction. Lancet. 1996 Jan 27;347(8996):237–240. doi: 10.1016/s0140-6736(96)90409-2. [DOI] [PubMed] [Google Scholar]
  19. Regier D. A., Farmer M. E., Rae D. S., Locke B. Z., Keith S. J., Judd L. L., Goodwin F. K. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA. 1990 Nov 21;264(19):2511–2518. [PubMed] [Google Scholar]
  20. Regier D. A., Narrow W. E., Rae D. S., Manderscheid R. W., Locke B. Z., Goodwin F. K. The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry. 1993 Feb;50(2):85–94. doi: 10.1001/archpsyc.1993.01820140007001. [DOI] [PubMed] [Google Scholar]
  21. Robins L. N., Helzer J. E., Davis D. H. Narcotic use in southeast Asia and afterward. An interview study of 898 Vietnam returnees. Arch Gen Psychiatry. 1975 Aug;32(8):955–961. doi: 10.1001/archpsyc.1975.01760260019001. [DOI] [PubMed] [Google Scholar]
  22. Schutte K. K., Brennan P. L., Moos R. H. Remission of late-life drinking problems: a 4-year follow-up. Alcohol Clin Exp Res. 1994 Aug;18(4):835–844. doi: 10.1111/j.1530-0277.1994.tb00048.x. [DOI] [PubMed] [Google Scholar]
  23. Sobell L. C., Cunningham J. A., Sobell M. B. Recovery from alcohol problems with and without treatment: prevalence in two population surveys. Am J Public Health. 1996 Jul;86(7):966–972. doi: 10.2105/ajph.86.7.966. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Stall R., Biernacki P. Spontaneous remission from the problematic use of substances: an inductive model derived from a comparative analysis of the alcohol, opiate, tobacco, and food/obesity literatures. Int J Addict. 1986 Jan;21(1):1–23. doi: 10.3109/10826088609063434. [DOI] [PubMed] [Google Scholar]
  25. Tucker J. A., Vuchinich R. E., Gladsjo J. A. Environmental events surrounding natural recovery from alcohol-related problems. J Stud Alcohol. 1994 Jul;55(4):401–411. doi: 10.15288/jsa.1994.55.401. [DOI] [PubMed] [Google Scholar]
  26. Virgo K. S., Price R. K., Spitznagel E. L., Ji T. H. Substance abuse as a predictor of VA medical care utilization among Vietnam veterans. J Behav Health Serv Res. 1999 May;26(2):126–139. doi: 10.1007/BF02287486. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES