Substance Use Disorders and Remission Rates

Varun KM Dhara

Department of Internal Medicine, Shri Sathya Sai Medical College and Research Institute, Kanchipuram, Tamil Nadu, India

Corresponding Author: Varun KM Dhara, Department of Internal Medicine, Shri Sathya Sai Medical College and Research Institute, Kanchipuram, Tamil Nadu, India, Phone: +91 8247758398, e-mail: varun.dhara31@gmail.com

How to cite this article Dhara VKM. Substance Use Disorders and Remission Rates. J Basic Clin Appl Health Sci 2019;2(4):158.

Source of support: Nil

Conflict of interest: None

Keywords: Addiction, Remission, Substance use disorder.

Respected Editor,

This is a viewpoint on an original article published in your esteemed journal.

“Remission rates of select mental illness and substance use disorders in India” by Dr Anusa AM SBV Journal of Basic, Clinical and Applied Health Science—Volume 2|Issue 1|January–March 2019.

As a young physician, I was always fascinated by the complexity and various implications of substance use disorders in the global community. However, Indian perspective on the issue was little ambiguous to me. After reading this article, I feel I have learnt a lot of valuable points. In the introductory part of the article, clear description of the gravity of the issue and its demographic distribution is enlightening. It stresses on the point that there are volumes of literature on the existence of these disorders but very few that capture the effects of treatment and remission rates in the Indian community. This study aims to fill that lacunae and pave a way for future clinicians to see the existing treatment modalities in a new light of evidence-based approach. This observational study focuses on select mental health disorders and specific substance use disorders like alcohol, cannabis, opioid, and cocaine (Table 1).^1–6 It takes in to account seven major surveys and one mixed estimation study for analysis of data.

The discussion part of the article has a few important points like how remission is difficult to find in general population and mathematical conversion of few observational cross-sectional data that can be used as a prospective data on remission rates. The complex paradigm of these disorders and their multifaceted core is a real challenge to any clinician to treat. Few limitations of the study are it is only taking data from the year 2016 and any innate flaws from those studies might have been carried on to the current results. For future implications, one can do a few number of cross-sectional studies in a year at a given location that can be compiled to analyze the trend at the place of research.

**Table 1**: Important aspects of substance use disorders
Substance use disorders	Peak age of occurrence of disorder (years)	Overall incidence of disorder (per lakh)	Remission (years)
(1) Alcohol	30–34	940 in males	Peaks by 40
(1) Alcohol	30–34	270 in females	Peaks by 40
(2) Cannabis	20–24	49 in males	Peaks by 20 then unsteady pattern
(2) Cannabis	20–24	17 in females	Peaks by 20 then unsteady pattern
(3) Opioid	30–34 in males	31 in males	Peaks by 40
(3) Opioid	25–29 in females	28 in females	Peaks by 40
(4) Cocaine	30–40	3.3 in males	Peaks by 20 then a slow decline
(4) Cocaine	30–40	1.8 in females	Peaks by 20 then a slow decline

REFERENCES

1. John WS, Zhu H, Mannelli P, Schwartz RP, Subramaniam GA, Wu LT. Prevalence, patterns, and correlates of multiple substance use disorders among adult primary care patients. Drug Alcohol Depend 2018;187:79–87. DOI: 10.1016/j.drugalcdep.2018.01.035.

2. Ghosh A, Sarkar S. Current legislation governing the care of individuals with substance use disorders in India: rationale and implications. Indian J Social Psychiatry 2018;34(3):189–192. DOI: 10.4103/ijsp.ijsp_60_18.

3. Fairman BJ, Furr-Holden CD, Johnson RM. When marijuana is used before cigarettes or alcohol: demographic predictors and associations with heavy use, cannabis use disorder, and other drug-related outcomes. Prev Sci 2019;20(2):225–233. DOI: 10.1007/s11121-018-0908-3.

4. Hendrickson R, Nishanth JH, Michael S. Diagnostic prevalence of common psychiatric comorbidities of alcohol use disorders in India: a systematic review. Int J Ment Health Addict 2019;17(5):1268–1296. DOI: 10.1007/s11469-018-9951-3.

5. Kerridge BT, Pickering R, Chou P, Saha TD, Hasin DS. DSM-5 cannabis use disorder in the national epidemiologic survey on alcohol and related conditions-III: gender-specific profiles. Addict Behav 2018;76:52–60. DOI: 10.1016/j.addbeh.2017.07.012.

6. McHugh RK, Votaw VR, Sugarman DE, Greenfield SF. Sex and gender differences in substance use disorders. Clin Psychol Rev 2018;66:12–23. DOI: 10.1016/j.cpr.2017.10.012.

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