Skip to main content

Factors Associated with Recovery and Flourishing Mental Health in a National Sample of Canadians with a History of Illicit Drug Dependence

Abstract

Research on recovery from drug dependence is largely focused on abstinence without consideration of other aspects of mental health. The present study seeks to identify among Canadians with a lifetime history of illicit drug dependence, the prevalence of, and factors associated with (1) remission, (2) absence of psychiatric disorders (APD), and (3) complete mental health (CMH). A sample of 20,305 respondents from the 2012 Canadian Community Health Survey-Mental Health was selected, including 460 with a history of drug dependence. Chi-square tests and logistic regression analyses were conducted. Among those with a history of drug dependence, 80.6% were in remission. Although 47.9% achieved APD and 37.9% were in CMH, these percentages were significantly lower than those without a history of drug dependence (90.3% and 74.1%, respectively). APD and CMH were more common among older respondents, those with higher levels of social support, and those without a history of depression or anxiety. The present study draws attention to the individuals who may be vulnerable to continued drug dependence, while also illuminating potential modifiable factors to support positive mental health outcomes among those with a history of illicit drug dependence.

This is a preview of subscription content, access via your institution.

References

  1. Althubaiti, A. (2016). Information bias in health research: Definition, pitfalls, and adjustment methods. Journal of Multidisciplinary Healthcare, 9, 211–217.

    PubMed  PubMed Central  Article  Google Scholar 

  2. Amato, L., Minozzi, S., Davoli, M., Vecchi, S., Ferri, M. M., & Mayet, S. (2008). Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification. The Cochrane Database of Systematic Reviews, 4, CD005031.

    Google Scholar 

  3. Arria, A. M., Garnier-Dykstra, L. M., Cook, E. T., Caldeira, K. M., Vincent, K. B., Baron, R. A., & O’Grady, K. E. (2013). Drug use patterns in young adulthood and post-college employment. Drug and Alcohol Dependence, 127(1-3), 23–30.

    PubMed  Article  PubMed Central  Google Scholar 

  4. Bøg, M., Filges, T., Brännström, L., Jørgensen, A. K., & Fredrikksson, M. K. (2017). 12-step programs for reducing illicit drug use. Campbell Systematic Reviews, 13(1), 1–149.

    Article  Google Scholar 

  5. Boisvert, R. A., Martin, L. M., Grosek, M., & Clarie, A. J. (2008). Effectiveness of a peer-support community in addiction recovery: Participation as intervention. Occupational Therapy International, 15(4), 205–220.

    PubMed  Article  PubMed Central  Google Scholar 

  6. Bolton, J. M., Robinson, J., & Sareen, J. (2009). Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Affective Disorders, 115(3), 367–375.

    PubMed  Article  PubMed Central  Google Scholar 

  7. Boschloo, L., Vogelzangs, N., Smit, J. H., van den Brink, W., Veltman, D. J., Beekman, A. T. F., & Penninx, B. W. J. H. (2011). Comorbidity and risk indicators for alcohol use disorders among persons with anxiety and/or depressive disorders: Findings from the Netherlands Study of Depression and Anxiety (NESDA). Journal of Affective Disorders, 131(1-3), 233–242.

    PubMed  Article  PubMed Central  Google Scholar 

  8. Brière, F. N., Rohde, P., Seeley, J. R., Klein, D., & Lewinsohn, P. M. (2014). Comorbidity between major depression and alcohol use disorder from adolescence to adulthood. Comprehensive Psychiatry, 55(3), 526–533.

    PubMed  Article  PubMed Central  Google Scholar 

  9. Calabria, B., Degenhardt, L., Briegleb, C., Vos, T., Hall, W., Lynskey, M., Callaghan, B., Rana, U., & McLaren, J. (2010). Systematic review of prospective studies investigating “remission” from amphetamine, cannabis, cocaine or opioid dependence. Addictive Behaviors, 35(8), 741–749.

    PubMed  Article  PubMed Central  Google Scholar 

  10. Statistics Canada. (2013). Canadian Community Health Survey (CCHS) – Mental Health. User Guide Microdata files.

  11. Center for Substance Abuse Treatment. (2007). National summit on recovery: Substance abuse and mental health services administration. (Conference Report No. (SMA) 07-4276.). DHHS Publication.

  12. Centers for Disease Control and Prevention (CDC). (2019). Annual surveillance report of drug-related risks and outcomes. United States Surveillance Special Report. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.

  13. Centers for Disease Control and Prevention (CDC). (2020). Underlying cause of death 1999-2018. Centers for Disease Control and Prevention. Center for Health Statistics.

  14. Chambers, R. A., Taylor, J. R., & Potenza, M. N. (2003). Developmental neurocircuitry of motivation in adolescence: A critical period of addiction vulnerability. The American Journal of Psychiatry, 160(6), 1041–1052.

    PubMed  PubMed Central  Article  Google Scholar 

  15. Charlson, F. J., Baxter, A. J., Dua, T., Degenhardt, L., Whiteford, H. A., & Vos, T. (2015). Excess mortality from mental, neurological and substance use disorders in the Global Burden of Disease Study 2010. Epidemiology and Psychiatric Sciences, 24(2), 121–140.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  16. Chen, C. Y., & Lin, K. M. (2009). Health consequences of illegal drug use. Current Opinion in Psychiatry, 22(3), 287–292.

    PubMed  Article  PubMed Central  Google Scholar 

  17. Cloud, W., & Granfield, R. (2008). Conceptualizing recovery capital: Expansion of a theoretical construct. Substance Use & Misuse, 43(12-13), 1971–1986.

    Article  Google Scholar 

  18. Davis, D. R., Kurti, A. N., Skelly, J. M., Redner, R., White, T. J., & Higgins, S. T. (2016). A review of the literature on contingency management in the treatment of substance use disorders, 2009-2014. Preventive Medicine, 92, 36–46.

    PubMed  PubMed Central  Article  Google Scholar 

  19. de Graaf, R., Bijl, R. V., ten Have, M., Beekman, A. T. F., & Vollebergh, W. A. M. (2004). Pathways to comorbidity: The transition of pure mood, anxiety and substance use disorders into comorbid conditions in a longitudinal population-based study. Journal of Affective Disorders, 82(3), 461–467.

    PubMed  Article  PubMed Central  Google Scholar 

  20. Dennis, M. L., Foss, M. A., & Scott, C. K. (2007). An eight-year perspective on the relationship between the duration of abstinence and other aspects of recovery. Evaluation Review, 31(6), 585–612.

    PubMed  Article  PubMed Central  Google Scholar 

  21. Ducray, K., Darker, C., & Smyth, B. P. (2012). Situational and psycho-social factors associated with relapse following residential detoxification in a population of Irish opioid dependent patients. Irish Journal of Psychological Medicine, 29(2), 72–79.

    PubMed  Article  PubMed Central  Google Scholar 

  22. Dugosh, K., Abraham, A., Seymour, B., McLoyd, K., Chalk, M., & Festinger, D. (2016). A systematic review on the use of psychosocial interventions in conjunction with medications for the treatment of opioid addiction. Journal of Addiction Medicine, 10(2), 93–103.

    PubMed  Article  CAS  PubMed Central  Google Scholar 

  23. Enoch, M. (2011). The role of early life stress as a predictor for alcohol and drug dependence. Psychopharmacology, 214(1), 17–31.

    CAS  PubMed  Article  PubMed Central  Google Scholar 

  24. Fuller-Thomson, E., & West, K. J. (2018). Flourishing despite a cancer diagnosis: Factors associated with complete mental health in a nationally-representative sample of cancer patients aged 50 years and older. Aging & Mental Health, 23(9), 1263–1274.

    Article  Google Scholar 

  25. Fuller-Thomson, E., Roane, J. L., & Brennenstuhl, S. (2016a). Three types of adverse childhood experiences, and alcohol and drug dependence among adults: An investigation using population-based data. Substance Use & Misuse, 51(11), 1451–1461.

    Article  Google Scholar 

  26. Fuller-Thomson, E., Agbeyaka, S., LaFond, D. M., & Bern-Klug, M. (2016b). Flourishing after depression: Factors associated with achieving complete mental health among those with a history of depression. Psychiatry Research, 242, 111–120.

    PubMed  Article  PubMed Central  Google Scholar 

  27. Fuller-Thomson, E., Jayanthikumar, J., Redmond, M. L., & Agbeyaka, S. (2020). Is recovery from cannabis dependence possible? Factors that help or hinder recovery in a national sample of Canadians with a history of cannabis dependence. Advances in Preventive Medicine, 2020, 9618398.

    PubMed  PubMed Central  Article  Google Scholar 

  28. Han, B., Gfroerer, J. C., & Colliver, J. D. (2010). Associations between duration of illicit drug use and health conditions: Results from the 2005–2007 National Surveys on Drug Use and Health. Annals of Epidemiology, 20(4), 289–297.

    PubMed  Article  PubMed Central  Google Scholar 

  29. Hedegaard, H., Miniño, A. M., & Warner, M (2020) Drug overdose deaths in the United States, 1999–2018. NCHS Data Brief, no 356. Hyattsville, MD: National Center for Health Statistics

  30. Huang, D. Y. C., Evans, E., Hara, M., Weiss, R. E., & Hser, Y. (2011). Employment trajectories: Exploring gender differences and impacts of drug use. Journal of Vocational Behaviour, 79(1), 277–289.

    Article  Google Scholar 

  31. Kadam, M., Sinha, A., Nimkar, S., Matcheswalla, Y., & De Sousa, A. (2017). A comparative study of factors associated with relapse in alcohol dependence and opioid dependence. Indian Journal of Psychological Medicine, 39(5), 627–633.

    PubMed  PubMed Central  Article  Google Scholar 

  32. Kariisa, M., Scholl, L., Wilson, N., Seth, P., & Hoots, B. (2019). Drug overdose deaths involving cocaine and psychostimulants with abuse potential — United States, 2003–2017. Morbidity and Mortality Weekly Report, 68, 388–395.

    PubMed  PubMed Central  Article  Google Scholar 

  33. Kaskutas, L. A., Bond, J., & Humphreys, K. (2002). Social networks as mediators of the effect of Alcoholics Anonymous. Addiction, 97(7), 891–900.

    PubMed  Article  PubMed Central  Google Scholar 

  34. Kassani, A., Niazi, M., Hassanzadeh, J., & Menati, R. (2015). Survival analysis of drug abuse relapse in addiction treatment centers. International Journal of High Risk Behaviors & Addiction, 4(3), e23402–e23402.

    Article  Google Scholar 

  35. Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73(3), 539–548.

    PubMed  Article  PubMed Central  Google Scholar 

  36. Lamers, S. M. A., Westerhof, G. J., Bohlmeijer, E. T., ten Klooster, P. M., & Keyes, C. L. M. (2011). Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF). Journal of Clinical Psychology, 67(1), 99–110.

    PubMed  Article  PubMed Central  Google Scholar 

  37. Lopez-Quintero, C., Hasin, D. S., & de los, C. J., Abigail, P., Shuai, W., Grant, B. F., & Carlos, B. (2010). Probability and predictors of remission from life-time nicotine, alcohol, cannabis or cocaine dependence: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Addiction, 106(3), 657–669.

    PubMed  PubMed Central  Article  Google Scholar 

  38. Magill, M., & Ray, L. A. (2009). Cognitive-behavioral treatment with adult alcohol and illicit drug users: A meta-analysis of randomized controlled trials. Journal of Studies on Alcohol and Drugs, 70(4), 516–527.

    PubMed  PubMed Central  Article  Google Scholar 

  39. Mattick, R. P., Breen, C., Kimber, J., & Davoli, M. (2009). Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. The Cochrane Database of Systematic Reviews, 3, CD002209.

    Google Scholar 

  40. Mattick, R. P., Breen, C., Kimber, J., & Davoli, M. (2014). Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. The Cochrane Database of Systematic Reviews, 2, CD002207.

  41. Matzger, H., Delucchi, K., Weisner, C., & Ammon, L. (2004). Does marital status predict long-term drinking? Five-year observations of dependent and problem drinkers. Journal of Studies on Alcohol, 65(2), 255–265.

    PubMed  Article  PubMed Central  Google Scholar 

  42. McGaffin, B. J., Deane, F. P., Kelly, P. J., & Ciarrochi, J. (2015). Flourishing, languishing and moderate mental health: Prevalence and change in mental health during recovery from drug and alcohol problems. Addiction Research & Theory, 23(5), 351–360.

    Article  Google Scholar 

  43. McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric Clinics of North America, 33(3), 511–525.

    PubMed  PubMed Central  Article  Google Scholar 

  44. Minozzi, S., Saulle, R., De Crescenzo, F., & Amato, L. (2016). Psychosocial interventions for psychostimulant misuse. The Cochrane Database of Systematic Reviews, 9(9), CD011866.

    PubMed  PubMed Central  Google Scholar 

  45. Morisano, D., Babor, T. F., & Robaina, K. A. (2014). Co-occurrence of substance use disorders with other psychiatric disorders: Implications for treatment services. Nordic Studies on Alcohol and Drugs, 31(1), 5–25.

    Article  Google Scholar 

  46. Najt, P., Fusar-Poli, P., & Brambilla, P. (2011). Co-occurring mental and substance abuse disorders: A review on the potential predictors and clinical outcomes. Psychiatry Research, 186(2), 159–164.

    PubMed  Article  PubMed Central  Google Scholar 

  47. National Drug Intelligence Center. (2011). The economic impact of illicit drug use on American society. Washington, D.C.: United States Department of Justice, 2011, Q0317–Q0002.

    Google Scholar 

  48. Patrick, M. E., Schulenberg, J. E., & O’Malley, P. M. (2016). High school substance use as a predictor of college attendance, completion, and dropout: A national multicohort longitudinal study. Youth & Society, 48(3), 425–447.

  49. Quinn, B., Stoové, M., & Dietze, P. (2016). One-year changes in methamphetamine use, dependence and remission in a community-recruited cohort. Journal of Substance Use, 21(3), 279–286.

    Google Scholar 

  50. Scherbaum, N., & Specka, M. (2008). Factors influencing the course of opiate addiction. International Journal of Methods in Psychiatric Research, 17(Suppl 1), S39–S44.

  51. Serras, A., Saules, K. K., Cranford, J. A., & Eisenberg, D. (2010). Self-injury, substance use, and associated risk factors in a multi-campus probability sample of college students. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 24(1), 119–128.

    Article  Google Scholar 

  52. Skinner, M. L., Haggerty, K. P., Fleming, C. B., Catalano, R. F., & Gainey, R. R. (2010). Opiate-addicted parents in methadone treatment: Long-term recovery, health, and family relationships. Journal of Addictive Diseases, 30(1), 17–26.

    Article  Google Scholar 

  53. Smedslund, G., Berg, R. C., Hammerstrøm, K. T., Steiro, A., Leiknes, K. A., Dahl, H. M., & Karlsen, K. (2011). Motivational interviewing for substance abuse. The Cochrane Database of Systematic Reviews, 5, CD008063.

  54. Stevens, E., Jason, L. A., Ram, D., & Light, J. (2015). Investigating social support and network relationships in substance use disorder recovery. Substance Abuse, 36(4), 396–399.

    PubMed  Article  PubMed Central  Google Scholar 

  55. Substance Abuse and Mental Health Services Administration (SAMHSA) (2020) Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. (NSDUH Series H-55, HHS Publication No. Pep20-07-01-001). Rockville, MD: Center for Behavioral Health Statistics and Quality.

  56. Swahn, M. H., Ali, B., Bossarte, R. M., Van Dulmen, M., Crosby, A., Jones, A. C., & Schinka, K. C. (2012). Self-harm and suicide attempts among high-risk, urban youth in the U.S.: Shared and unique risk and protective factors. International Journal of Environmental Research and Public Health, 9(1), 178–191.

    PubMed  PubMed Central  Article  Google Scholar 

  57. Tice, P., Lipari, R. N., & Van Horn, S. L. (2017). Substance use among 12 grade aged youths, by dropout status. The CBHSQ Report. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD.,

  58. Wittchen, H. U. (1994). Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): A critical review. Journal of Psychiatric Research, 28(1), 57–84. 

Download references

Funding

This work was supported by the Social Sciences and Humanities Research Council Grant # 435-2016-0660 (PI: Esme Fuller-Thomson).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Esme Fuller-Thomson.

Ethics declarations

Ethics Review

These analyses were based on de-identified public use data gathered by Statistics Canada (the Canadian equivalent of the US Census Bureau) and therefore an ethics review was not required.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

MacNeil, A., Fuller-Thomson, E. Factors Associated with Recovery and Flourishing Mental Health in a National Sample of Canadians with a History of Illicit Drug Dependence. Int J Ment Health Addiction (2021). https://doi.org/10.1007/s11469-021-00579-y

Download citation

Keywords

  • Recovery
  • Resilience
  • Complete mental health
  • Drug dependence
  • Substance use disorder