Temporary and constant remission: a record-linkage study of a national cohort of people with psychoactive drug use disorders

Background: Individuals seeking treatment for psychoactive drug use disorders often experience financial difficulties, social and family troubles, general health problems, and legal issues. These difficulties often persist after discharge from treatment where many remain marginalized. The study aimed to assess the proportion of patients in a national cohort who obtained a year of remission from psychoactive drug use disorders, or five consecutive years.

Methods: 33,273 consecutive new admissions to treatment for drug use disorders in Denmark were tracked through criminal justice registers, hospital registers and registers for socio-economic status for five years. Patients were classified as remitted in a given year, if they satisfied the following criteria: no hospitalizations for alcohol or drug use disorders, no charges for any criminal offences, and either working or studying more than 50% of the time. Logistic regression was used to assess clinical and socio-demographic predictors.

Results: 14.5% satisfied criteria for remission in the first year after treatment. In the following four years, 34.5% satisfied criteria for remission at some point, and 4.9% satisfied criteria for remission in every year. Remission was associated with not having opioids as primary drug, the absence of a psychiatric history, co-habitation with a partner, and working or studying at baseline. Patients aged under 25 were the most likely to satisfy criteria for remission at some point, but the least likely to satisfy criteria for remission constantly.

Conclusions: A substantial proportion of people with psychoactive drug use disorders will experience periods of high functioning with employment and absence of arrests and substance-related hospitalizations. Yet, only a small minority transition from treatment to stable remission characterized by constant employment and the absence of arrests or substance-related hospitalizations.