Persistence/recurrence of and remission from DSM-5 substance use disorders in the United States: Substance-specific and substance-aggregated correlates

Sean Esteban McCabe; Brady T West; Stephen Strobbe; Carol J Boyd

doi:10.1016/j.jsat.2018.07.012

Persistence/recurrence of and remission from DSM-5 substance use disorders in the United States: Substance-specific and substance-aggregated correlates

J Subst Abuse Treat. 2018 Oct:93:38-48. doi: 10.1016/j.jsat.2018.07.012. Epub 2018 Jul 25.

Authors

Sean Esteban McCabe¹, Brady T West², Stephen Strobbe³, Carol J Boyd⁴

Affiliations

¹ University of Michigan, Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, and Institute for Research on Women and Gender, 426 N. Ingalls St., Ann Arbor, MI 48109, USA. Electronic address: plius@umich.edu.
² University of Michigan, Survey Research Center, Institute for Social Research, P.O. Box 1248, Ann Arbor, MI 48106, USA.
³ University of Michigan, Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, and Department of Psychiatry, 426 N. Ingalls St., Ann Arbor, MI 48109, USA.
⁴ University of Michigan, Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, Department of Psychiatry, and Institute for Research on Women and Gender, 426 N. Ingalls St., Ann Arbor, MI 48109, USA.

Abstract

This study examined demographic and psychosocial correlates associated with persistence/recurrence of and remission from at least one of ten DSM-5 substance use disorders (SUDs) and three substance-specific SUDs (i.e., alcohol, cannabis, and prescription opioids). Data were collected from structured diagnostic interviews and national prevalence estimates were derived from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. An estimated 25.4% of the U.S. population had at least one prior-to-past-year (prior) SUD. Among individuals with any prior SUDs, the prevalence of past-year substance use and DSM-5 symptomology was as follows: abstinence (14.2%), asymptomatic use (36.9%), symptomatic use (10.9%), and persistent/recurrent SUD (38.1%). Among individuals with prior SUDs, design-based multinomial logistic regression analysis revealed that young adulthood, higher educational attainment, higher personal income, never having been married, being divorced/separated/widowed, lack of lifetime substance use treatment, and stressful life events predicted significantly greater odds of past-year persistent/recurrent SUDs, relative to abstinence. In addition, remission from a prior tobacco use disorder decreased the probability of past-year persistent/recurrent SUD, relative to abstinence. Stressful life events were the only common correlates across the aggregation of all SUDs and each substance-specific SUD, but differences were found for specific stressful life events between drug classes. Nearly half (49%) of adults with prior DSM-5 SUDs continued to report past-year symptomatic substance use, while only one in seven individuals were abstinent. The findings suggest the value of examining remission associated with both substance-specific SUDs and aggregation of SUDs based on the shared and unique correlates of persistent/recurrent SUDs; this is especially true for stressful life events, which could be useful targets for enhancing clinical care and interventions.

Keywords: Abstinence; DSM-5; Remission; Stress; Substance use disorders.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Adult
Aged
Alcoholism / epidemiology*
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Interviews as Topic
Life Change Events
Logistic Models
Male
Marijuana Abuse / epidemiology*
Middle Aged
Opioid-Related Disorders / epidemiology*
Prevalence
Recurrence
Risk Factors
Stress, Psychological / epidemiology
Substance-Related Disorders / epidemiology*
United States / epidemiology
Young Adult

Abstract

Publication types

MeSH terms

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