This study has the limitations common to most large-scale mental health surveys. First, self-report of substance use and psychiatric disorders are prone to social desirability bias leading to underreport of substance use and SUD and overreport of remission. Second, diagnoses of SUD, individual SUD criteria endorsement, or age of remission reported may be subject to recall bias (the longer the time interval between the event and assessment, the higher the probability of incorrect recalls) and to cognitive impairment resulting from the use of drugs. Third, institutionalized individuals or those who experienced fatal or severe consequences due to their SUD may have not been sampled, leading to overestimation of the cumulative probability of remission. Fourth, lack of a uniform operational definition of dependence remission across population-based studies limits our ability to compare our results with estimates from previous reports [3–5, 8, 17]. Fifth, lack of information on the number and duration of dependence remission episodes experienced over the individual’s lifetime limits our understanding of the role of these factors on dependence remission and relapse. Sixth, factors that may help explain the
