Remission from substance dependence without formal help among adolescents and young adults

Aim: To investigate remission without formal help (natural recovery; NR) from DSM-IV substance-use disorders among adolescents and young adults. Method: A representative community sample of adolescents and young adults from Munich, Germany, who were aged 14-24 years at baseline (N = 3,021), were followed in a prospective-longitudinal, epidemiological study. The course of DSM-IV substance use disorders and remission from them were assessed in face-to-face interviews using the Munich Composite International Diagnostic Interview. Results: 28.3 % of the sample met the criteria for nicotine dependence, 11.4 % for alcohol dependence, and 4.6 % for an illicit substance-use disorder at the final follow-up. Only a small proportion of the sample (3.5 %) had received formal help. Among the respondents who had received no formal help, dependence symptoms had first occurred, on average, before the age of 18 years and had continued for approximately 5 years at the time of the final follow-up. 20.2 % of the respondents had remitted. The highest rate of NR (37.4 %) was from illegal substance dependence. Cumulative probabilities according to length of dependence revealed patterns of probability of remission that depended on substance type and respondents' gender. Conclusions: Although remission without formal help appears relatively common during adolescence and young adulthood, rates are markedly lower than in adult populations. In addition to improving substance-use treatment and other services, it is necessary to support young people in their ability to change themselves during the early stages of their dependence. Specific interventions are needed for this.