title: Remission from substance dependence: differences between individuals in a general population longitudinal survey who do and do not seek help.
abstract: BACKGROUND
  Only a minority of individuals who have substance use disorders receives treatment, and those who do typically have more severe disorders. The current study examines the relationship of help-seeking with remission from alcohol and/or drug dependence and other outcomes.
  
  
  METHODS
  Data from the Wave 1 (2001-2002) and Wave 2 (2004-2005) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were used to examine remission at Wave 2 among respondents who had past-year substance dependence disorders at Wave 1 (N=1262). Multi-group structural equation modeling was used to compare individuals with (n=356) and without (n=906) prior help-seeking at Wave 1 on subsequent help-seeking and other factors that influence outcomes.
  
  
  RESULTS
  Baseline help-seekers sought help at higher levels over the follow-up period (31% vs. 8%) and had lower rates of remission (50% vs. 68%), as compared with those without prior help-seeking, respectively. Among baseline help-seekers, there were stronger relationships between baseline stress and mental disorders and having sought help since baseline; age and past-year level of stress at follow-up; level of stress and health status at follow-up; and social support and mental disorders at follow-up. Among baseline non-help-seekers, there were stronger relationships between being female and past-year stress at follow-up, and between having sought help since baseline and physical health status at follow-up.
  
  
  CONCLUSIONS
  Findings extend our understanding of the factors associated with recovery from substance dependence, including "natural recovery", use of services outside of addiction treatment, and gender differences in help-seeking and remission.
authors.affiliation: UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States. Electronic address: cgrella@mednet.ucla.edu.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Grella
authors.forename: Judith A
authors.initials: JA
authors.lastname: Stein
mesh_terms: D000328:Adult; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012074:Remission Induction; D012727:Sex Characteristics; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*
keywords: Help-seeking; Natural recovery; Recovery; Remission; Substance dependence; Treatment