One-year changes in methamphetamine use, dependence and remission in a community-recruited cohort

Abstract

Aims: Investigate changes to a prospective cohort of methamphetamine users over 12 months, predictors of remission from methamphetamine dependence and past-month abstinence from methamphetamine use.

Method: Structured interviews were administered to 255 regular methamphetamine users at baseline (2010) and 12 months (2011). A multivariate generalised estimating equation (GEE) model identified adjusted associations with past-month abstinence at follow-up. A multivariate logistic regression analysis identified factors independently associated with remission from methamphetamine dependence.

Results: Most (60%) participants were methamphetamine-dependent at baseline. Remission from dependence (n = 38) was independently associated with age (OR: 0.93; 95% CI: 0.88–1.00), maintaining/gaining employment since baseline (OR: 3.14; 95% CI: 1.21–8.14) and a greater increase in self-perceived social support (OR: 1.08; 95% CI: 1.01–1.16). Past-month abstinence at follow-up was independently associated with being female (OR: 1.94; 95% CI: 1.10–3.44), recent criminal behaviours (OR: 0.46; 95% CI: 0.26–0.82), recent ecstasy (OR: 0.30; 95% CI: 0.12–0.72) and benzodiazepine use (OR: 0.53; 95% CI: 0.29–0.96), and being less methamphetamine-dependent (OR: 0.79; 95% CI: 0.72–0.88). Drug treatment was not independently associated with either outcome at follow-up.

Conclusions: Our findings highlight the potential for natural remission from methamphetamine dependence; however, targeted interventions should be developed for individuals who are likely to maintain dependent/harmful use patterns.

• Drug dependence
• methamphetamine
• polysubstance use
• prospective cohort study

Acknowledgements

The authors wish to thank the participants who took part in the study, and the staff of community-based organisations who assisted with recruitment. The assistance of colleagues at the Burnet Institute and National Drug Research Institute (NDRI) who assisted with study design, participant recruitment, interviewing and follow-up, is also greatly appreciated, namely: Cerissa Papanastasiou, Rebecca Jenkinson, Rebecca Winter, Shelley Cogger, Daniel O'Keefe, O'Maelenn Gouillou, David Moore, Nicola Thomson and Robyn Dwyer. The authors also gratefully acknowledge the contribution to this work of the Victorian Operational Infrastructure Support Program.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.