Beyond the first try: How many quit attempts are necessary to achieve substance use cessation?

Highlights

• Substance use disorder requires multiple quit attempts before successful abstinence.
• Opioids and pain medication were the substances more challenging to quit (i.e., requiring significantly more attempts).
• Hallucinogen was the substance less challenging to quit (i.e., requiring fewer attempts).
• Individuals with more severe SUDs or a longer history of SUD might need more attempts before achieving abstinence.

Abstract

Substance use disorder (SUD) is a chronically relapsing disorder; thus, individuals with SUD may require several attempts before achieving abstinence. The goal of the present study was to investigate what variables are associated with the number of quit attempts before successful abstinence was achieved. Data were collected from 421 International Quit & Recovery Registry participants. Participants answered several questions for each substance they reported being in recovery, including how many times they had attempted to quit that substance and whether they still used that substance. The results showed that the number of quit attempts was associated with the substance one was trying to quit, SUD severity (i.e., mild, moderate, severe SUD) for that substance, the number of years using that substance, and the age of use onset. Pairwise comparisons among substances indicated that pain medication and opioids had a significantly higher number of quit attempts than all other substances (ps < .001) but were not different from each other (p = 1.0). Pairwise comparisons across levels of SUD severity showed a significantly higher number of attempts for those with moderate than mild SUD (p < .001) and for those with severe than mild or moderate SUD (ps < .001). Overall, the results indicate that individuals who use opioids and pain medication, have more severe SUD, and more years of use need significantly more attempts before achieving successful abstinence. Thus, those might benefit from more targeted and effective interventions.

Background and aims

Substance use disorder (SUD) is a chronically relapsing disorder. Thus, individuals with SUD may need several attempts before achieving abstinence. The present study investigated the variables associated with the number of quit attempts before achieving successful abstinence.

Methods

Data were collected from 421 International Quit & Recovery Registry participants. Participants answered several questions for each substance they reported being in recovery from, such as the age of first use, how many times they had attempted to quit that substance, and whether they still used that substance.

Results

The number of quit attempts was associated with the substance one was trying to quit, SUD severity (i.e., mild, moderate, severe SUD) for that substance, the number of years using that substance, and the age of use onset. Pairwise comparisons among substances indicated that pain medication and opioids had a significantly higher number of quit attempts than all other substances (ps < .001) but were not different from each other (p = 1.0). Pairwise comparisons across levels of SUD severity showed a significantly higher number of attempts for those with moderate than mild SUD (p < .001) and for those with severe than mild or moderate SUD (ps < .001).

Conclusions

Opioids and pain medication require significantly more attempts than all other substances, according to our findings. Thus, such substances might need more targeted and effective interventions. Additionally, more severe SUD and more years of use were also associated with more quit attempts. Such findings suggest the need for more effective early interventions to decrease the number of attempts before successful abstinence.