Summary of Studies of Course

Vaillant11 observed that individuals with AUDs who survive will often recover. Our review suggests that this conclusion also applies to persons with other SUDs. In successfully followed samples, about 3.9% of community-dwelling men with AUDs, 4.9% of individuals treated for AUDs, and 4.0% of persons with drug use disorders in treated samples achieved remission in each follow-up year. These findings indicated that a chronic, progressive course of SUDs is not inevitable, which was confirmed in a recent review by Heyman33 of population-based surveys that concluded that about 80% of individuals formerly dependent on an illegal drug had been in remission for at least a year. Generally, the likelihood that an individual ceased being dependent on a particular drug remained the same, no matter how long ago he or she had first become dependent. Thus, addiction may be a way of life that can rather abruptly shift to a new, better state.


Although the long-term prognosis may be positive for many persons with SUDs who survive, unfortunately, the course of SUDs ends in premature death for a significant number of individuals. After focusing on the extent to which people with SUDs die prematurely, we consider whether people who are in remission and those who receive any or more treatment reduce their mortality risk in comparison to those who continue to actively use substances or receive no or less treatment.

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