title: The natural course of cannabis use, abuse and dependence during the first decades of life.
abstract: OBJECTIVE
  There has been little available information on the long-term natural course, persistence and remission of cannabis use, abuse and dependence. The current study estimated rates and risk factors associated with stability and variation in cannabis use patterns, cannabis abuse and cannabis dependence in a community sample over a 10-year period.
  
  
  METHODS
  Prospective longitudinal, epidemiological study with a 4- and 10-year follow-up of a community sample (n = 3021) aged 14-24 years at baseline in Munich, Germany.
  
  
  METHODS
  Cannabis use, abuse and dependence and associated risk factors were assessed by face-to-face interviews using the Munich Composite International Diagnostic Interview. Findings At baseline, one-third of the sample (34.2%) had used cannabis at least once. The cumulative incidence of cannabis use 10 years later was 50.7%. Fifty-six per cent of all repeated users (five times or more) at baseline reported cannabis use at 4-year follow-up. Ten years later, this proportion had decreased slightly to only 46.3%. Repeated (five times or more) users were almost three times more likely to report repeated use at 10-year follow up (OR = 2.8, 95% CI = 1.6-4.7), compared with those who had used cannabis fewer times. Peer use of cannabis, life-events and alcohol dependence also predicted use of cannabis at 10-year follow-up.
  
  
  CONCLUSIONS
  Among youth who have used cannabis repeatedly (five times or more) cannabis use is fairly stable and rates of remission relatively low until age 34 years. Patterns of progression suggest that early targeted preventive measures should delay first use and reduce the number of experiences using cannabis, as these factors appear critical in progression to persistent cannabis use and cannabis dependence.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Germany. axel@mpipsykl.mpg.de
authors.forename: Axel
authors.initials: A
authors.lastname: Perkonigg
authors.forename: Renee D
authors.initials: RD
authors.lastname: Goodwin
authors.forename: Agnes
authors.initials: A
authors.lastname: Fiedler
authors.forename: Silke
authors.initials: S
authors.lastname: Behrendt
authors.forename: Katja
authors.initials: K
authors.lastname: Beesdo
authors.forename: Roselind
authors.initials: R
authors.lastname: Lieb
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
mesh_terms: D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology* / Q000517:prevention & control; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000517:prevention & control