Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May;37(4):546-556.
doi: 10.1111/dar.12679. Epub 2018 Mar 5.

The impact of cohort substance use upon likelihood of transitioning through stages of alcohol and cannabis use and use disorder: Findings from the Australian National Survey on Mental Health and Wellbeing

Louisa Degenhardt  1 , Meyer Glantz  2 , Chrianna Bharat  1 , Amy Peacock  1 , Luise Lago  1 , Nancy Sampson  3 , Ronald C Kessler  3
Affiliations

The impact of cohort substance use upon likelihood of transitioning through stages of alcohol and cannabis use and use disorder: Findings from the Australian National Survey on Mental Health and Wellbeing

Louisa Degenhardt et al. Drug Alcohol Rev. 2018 May.

Abstract

Introduction and aims: We used population-level Australian data to estimate prevalence, age of onset and speed of transitions across stages of alcohol and cannabis use, abuse and dependence, and remission from disorder, and consider the potential impacts that an individual's age cohort's level of substance use predicted transitions into and out of substance use.

Design and methods: Data on use, DSM-IV use disorders, and remission from these disorders were collected from participants (n = 8463) in the 2007 Australian National Survey of Mental Health and Wellbeing using the Composite International Diagnostic Interview.

Results: Lifetime prevalence (95% confidence interval) of alcohol use, regular use, abuse and dependence were 94.1% (93.3-94.8%), 64.5% (62.9-66.2%), 18.7% (17.4-19.9%) and 4.0% (3.4-4.6%). Lifetime prevalence of cannabis use, abuse and dependence were 19.8% (18.6-20.9%), 4.4% (3.8-5.0%) and 1.9% (1.5-2.4%). Among those with the disorder, rates of remission from cannabis abuse, alcohol abuse, cannabis dependence and alcohol dependence were 90.5% (87.4-93.6%), 86.2% (83.8-88.7%), 79.6% (71.1-88.1%) and 53.8% (46.6-61.0%). Increases in the estimated proportion of people in the respondent's age cohort who used alcohol/cannabis as of a given age were significantly associated with most transitions from use through to remission beginning at the same age.

Discussion and conclusions: Clear associations were documented between cohort-level prevalence of substance use and personal risk of subsequent transitions of individuals in the cohort from use to greater substance involvement. This relationship remained significant over and above associations involving the individual's age of initiation. These findings have important implications for our understanding of the causal pathways into and out of problematic substance use.

Keywords: alcohol; cannabis; cohort; remission; use disorder.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Age of onset of alcohol use, regular use, use disorder, and remission, and cannabis use, use disorder and remission, Australia; Y-axis scales range from 0–100% for alcohol and 0–21% for cannabis
Figure 2:
Figure 2:
Age of onset curve for alcohol and cannabis use among selected birth cohorts, Australia
Figure 3:
Figure 3:
Transition times between alcohol use, regular use, use disorder and remission, and cannabis use, use disorder and remission, Australia
See this image and copyright information in PMC

References

    1. Lopez-Quintero C, Cobos JP, Hasin DS, Okuda M, Wang S, Grant BF, et al. Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend 2011;115:120–30. - PMC - PubMed
    1. Butterworth P, Slade T, Degenhardt L. Factors associated with the timing and onset of cannabis use and cannabis use disorder: Results from the 2007 Australian National Survey of Mental Health and Well-Being. Drug Alcohol Rev 2014;33:555–64. - PubMed
    1. Calabria B, Degenhardt L, Briegleb C, Vos T, Hall W, Lynskey M, et al. Systematic review of prospective studies investigating “remission” from amphetamine, cannabis, cocaine or opioid dependence. Addict Behav 2010;35:741–9. - PubMed
    1. Behrendt S, Wittchen H-U, Höfler M, Lieb R, Beesdo K. Transitions from first substance use to substance use disorders in adolescence: is early onset associated with a rapid escalation? Drug Alcohol Depend 2009;99:68–78. - PubMed
    1. Coffey C, Carlin JB, Lynskey M, Li N, Patton GC. Adolescent precursors of cannabis dependence: findings from the Victorian Adolescent Health Cohort Study. Br J Psychiatry 2003;182:330–6. - PubMed

Publication types