Remission from substance use disorders: A systematic review and meta-analysis.
This paper presents a systematic review and meta-analysis of available evidence on remission rates for substance use disorders (SUDs), providing weighted mean estimates of SUD remission rates. The review also explores study-level characteristics that may explain variations in remission rates across studies.



A comprehensive search strategy identified studies published between 2000 and 2015 with follow-up periods of at least three years or reported lifetime remission outcomes for potential inclusion in the review. Remission was defined as not meeting diagnostic criteria for abuse or dependence for a minimum period of six months, as of final follow-up. A single-group summary meta-analysis was performed. Pooled estimated annual remission rates (PEARRs) were calculated. Meta-regression techniques and subgroup analyses were used to explore the association between study remission rates and key selected variables.



Of 8855 studies identified, 21 met the eligibility criteria. The results suggested that 35.0% to 54.4% of individuals with SUDs achieved remission, and this occurred after a mean follow-up period of 17 years. The PEARRs projected few cases of SUD remission, between 6.8% and 9.1% in any given year. Studies that reported higher remission rates had longer follow-up periods, and lower sample retention rates.



Results support the contention that SUDs are more likely to be "chronic" or long term disorders than acute disorders for a substantial number of individuals. However, more longitudinal research is required. Treatment geared to chronicity, such as assertive community treatment and intensive case management, needs to be more readily available for SUD populations.
Department of Psychiatry, McGill University, Montreal, Canada. Electronic address: marie-josee.fleury@douglas.mcgill.ca.
M-J
MJ
Fleury
Centre de recherche et d'expertise en dépendance du Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal (Addiction Rehabilitation Center-University Institute), Montreal, Canada. Electronic address: akram.djouini.crdm@ssss.gouv.qc.ca.
Akram
A
Djouini
Centre de recherche et d'expertise en dépendance du Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal (Addiction Rehabilitation Center-University Institute), Montreal, Canada. Electronic address: Christophe.huynh.crdm@ssss.gouv.qc.ca.
Christophe
C
Huỳnh
Department of Psycho-education, Université du Québec à Trois-Rivières, Trois-Rivières, Canada. Electronic address: joel.tremblay@uqtr.ca.
Joël
J
Tremblay
Centre de réadaptation en dépendance du CIUSSS de la Capitale-Nationale (Addiction Rehabilitation Center), Université Laval, Québec, Canada. Electronic address: francine.ferland.ciussscn@ssss.gouv.qc.ca.
Francine
F
Ferland
CIUSSS de-la-Mauricie-et-du-Centre-du-Québec (Addiction Rehabilitation Center), Trois-Rivières, Canada. Electronic address: jean-marc_menard@ssss.gouv.qc.ca.
J-M
JM
Ménard
School of Psychology, Université Laval, Québec, Canada. Electronic address: genevieve.belleville@psy.ulaval.ca.
Geneviève
G
Belleville
D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012074:Remission Induction; D019966:Substance-Related Disorders / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
Long-term course; Predictors; Remission; Substance use disorders; Treatment