National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia.
Addict Behav. 2010 Aug;35(8):741-9. doi: 10.1016/j.addbeh.2010.03.019. Epub 2010 Apr 10.
To review and summarize existing prospective studies reporting on remission from dependence upon amphetamines, cannabis, cocaine or opioids.
Systematic searches of the peer-reviewed literature were conducted to identify prospective studies reporting on remission from amphetamines, cannabis, cocaine or opioid dependence. Searches were limited to publication between 1990 and 2009. Reference lists of review articles and important studies were searched to identify additional studies. Remission was defined as no longer meeting diagnostic criteria for drug dependence or abstinence from drug use; follow-up periods of at least three years were investigated. The remission rate was estimated for each drug type, allowing pooling across studies with varying follow-up times.
There were few studies examining the course of psychostimulant dependence that met inclusion criteria (one for amphetamines and four for cocaine). There were ten studies of opioid and three for cannabis dependence. Definitions of remission varied and most did not clearly assess remission from dependence. Amphetamine dependence had the highest remission rate (0.4477; 95%CI 0.3991, 0.4945), followed by opioid (0.2235; 95%CI 0.2091, 0.2408) and cocaine dependence (0.1366; 95%CI 0.1244, 0.1498). Conservative estimates of remission rates followed the same pattern with cannabis dependence (0.1734; 95%CI 0.1430, 0.2078) followed by amphetamine (0.1637; 95%CI 0.1475, 0.1797), opioid (0.0917; 95%CI 0.0842, 0.0979) and cocaine dependence (0.0532; 95%CI 0.0502, 0.0597).
The limited prospective evidence suggests that "remission" from dependence may occur relatively frequently but rates may differ across drugs. There is very little research on remission from drug dependence; definitions used are often imprecise and inconsistent across studies and there remains considerable uncertainty about the longitudinal course of dependence upon these most commonly used illicit drugs.
综述现有的前瞻性研究报告，这些研究报告涉及到安非他命、大麻、可卡因或类鸦片依赖的缓解情况。
对同行评议文献进行系统检索，以确定报告安非他命、大麻、可卡因或类鸦片依赖缓解情况的前瞻性研究。检索范围限于 1990 年至 2009 年期间的出版物。还检索了综述文章和重要研究的参考文献列表，以确定其他研究。缓解的定义为不再符合药物依赖的诊断标准或停止药物使用；调查了至少三年的随访期。估计了每种药物类型的缓解率，允许对具有不同随访时间的研究进行汇总。
符合纳入标准的研究很少（一项安非他命，四项可卡因）。有十项阿片类药物和三项大麻依赖的研究。缓解的定义各不相同，大多数研究没有明确评估对依赖的缓解。安非他命依赖的缓解率最高（0.4477；95%CI 0.3991，0.4945），其次是阿片类（0.2235；95%CI 0.2091，0.2408）和可卡因依赖（0.1366；95%CI 0.1244，0.1498）。对缓解率的保守估计也遵循同样的模式，大麻依赖（0.1734；95%CI 0.1430，0.2078），其次是安非他命（0.1637；95%CI 0.1475，0.1797），阿片类（0.0917；95%CI 0.0842，0.0979）和可卡因依赖（0.0532；95%CI 0.0502，0.0597）。
有限的前瞻性证据表明，依赖的“缓解”可能相对频繁发生，但不同药物的缓解率可能不同。关于药物依赖的缓解研究很少；使用的定义通常不准确，在不同的研究中也不一致，对这些最常用的非法药物的依赖的纵向过程仍然存在很大的不确定性。
