In a 15-year Swedish cohort of 12,143 people with cannabis use disorder, 23% were readmitted, with schizophrenia (54% higher risk), low education (40% higher risk), and ages 18-35 being the strongest predictors.
Addiction treatment providers, mental health policymakers, public health researchers.
23% of CUD patients readmitted; schizophrenia and low education were top risk factors
What the researchers found
About 80% of CUD visits were outpatient. 23% of individuals were readmitted during follow-up. Fully adjusted risks: schizophrenia and psychotic disorders (HR 1.54), low education (HR 1.40), personality disorders (HR 1.27), mood disorders (HR 1.27). Risk was highest in ages 18-35. Flexible parametric modeling showed the age-specific risk pattern.
Why it matters
Nearly 1 in 4 people with CUD were readmitted to care, highlighting the chronic and relapsing nature of the condition. The strong association with psychotic disorders and low education points to specific subgroups that need more intensive or tailored treatment.
The numbers in context
12,143 individuals. 23% readmitted. ~80% outpatient visits. Schizophrenia: HR 1.54. Low education: HR 1.40. Personality disorders: HR 1.27. Mood disorders: HR 1.27. Highest risk: ages 18-35.
How the study worked
Nationwide Swedish cohort study (2001-2016) of 12,143 individuals aged 17+ with CUD. Predictors from national registers: education, income, psychiatric comorbidity. Cox and flexible parametric survival analyses.
What this study cannot tell us
Swedish healthcare system may differ from other countries. CUD identified through healthcare contacts, missing those who do not seek treatment. Cannot determine cannabis use patterns or severity. Readmission may reflect treatment access rather than relapse.
How to read the evidence
Nationwide register-based cohort with 15-year follow-up and flexible survival models, providing strong epidemiological evidence.
When this study was published
Published 2023, using 2001-2016 Swedish register data.
The bigger picture
The finding that low education is as strong a predictor as psychiatric comorbidity suggests socioeconomic factors play a major role in CUD treatment outcomes. Addressing social determinants alongside psychiatric treatment could improve outcomes.
Questions still open
- Would addressing educational and socioeconomic factors reduce CUD readmission rates?
- Should CUD patients with comorbid psychosis receive integrated dual-diagnosis treatment from the start?
Common questions
How often do people with cannabis use disorder relapse?
What predicts worse CUD outcomes?
Read the original research
Risk of readmission among individuals with cannabis use disorder during a 15-year cohort study: the impact of socio-economic factors and psychiatric comorbidity.
Addiction (Abingdon, England), 118(7), 1295-1306
Citation
Rabiee, Rynaz; Sjöqvist, Hugo; Agardh, Emilie; Lundin, Andreas; Danielsson, Anna-Karin. (2023). Risk of readmission among individuals with cannabis use disorder during a 15-year cohort study: the impact of socio-economic factors and psychiatric comorbidity.. Addiction (Abingdon, England), 118(7), 1295-1306. https://doi.org/10.1111/add.16158
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