title: Natural outcome of cannabis use disorder: a 3-year longitudinal follow-up.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Three-year longitudinal study.
  
  
  METHODS
  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 18 years and over.
  
  
  METHODS
  Our sample included 444 individuals diagnosed with DSM-IV cannabis abuse and/or dependence during the 12 months prior to wave 1 of the NESARC.
  
  
  METHODS
  Baseline socio-demographic and clinical correlates were analysed for possible outcomes of CUDs after 3 years: abstinent remission, non-abstinent remission and sustained disorder.
  
  
  RESULTS
  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.
authors.affiliation: Ariel University, Ariel, Israel.|Addiction Medicine and Dual Diagnosis Services, Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Feingold
authors.affiliation: New York State/American Program, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Jonah
authors.initials: J
authors.lastname: Fox
authors.affiliation: Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
authors.affiliation: Addiction Medicine and Dual Diagnosis Services, Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel.|Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shaul
authors.initials: S
authors.lastname: Lev-Ran
mesh_terms: D000328:Adult; D017668:Age of Onset; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology / Q000534:rehabilitation*; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D012075:Remission, Spontaneous; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Abuse; NESARC; cannabis use disorder; dependence; longitudinal follow-up; non-abstinent remission