Insights from individuals successfully recovered from cannabis use disorder: natural versus treatment-assisted recoveries and abstinent versus moderation outcomes

BACKGROUND: Increasing understanding of the pathways and processes of recovery from cannabis use disorder may help in designing effective and attractive interventions to promote recovery. We report insights from individuals who had successfully recovered from cannabis use disorder with a variety of pathways. Recovered individuals describe their perceptions of why they developed the problem, why they were successful in recovering, and the advice they would offer to individuals with similar problems. METHODS: Media announcements were used to recruit 119 volunteers who met lifetime but not past year criteria for cannabis use disorder. Participants were asked open-ended questions which were content analyzed and compared between individuals who whose recoveries were treatment-assisted (45%) versus natural (55%) and between individuals who were abstinent (57%) versus those who continued non-problematic consumption (43%). RESULTS: Participants most frequently described their problems as having developed due to the use of cannabis to cope, because of environmental and social influences, and enjoyment of the positive effects. Success in recovery was attributed to focusing on reasons for change, goal commitment to change, and conquering denial/self-deception. Treatment-assisted participants were more likely to perceive that they overcame their cannabis problem due to treatment/self-help and conquering underlying issues, whereas naturally recovered participants were more likely to describe focusing on reasons for change, will power, and lost enjoyment/lifestyle change. Treatment-assisted participants were more likely to recommend seeking help/social support and naturally recovered participants were more likely to endorse reflecting on reasons for change, engaging in hobbies/distracting activities, and stimulus control/avoidance/change social environment. The majority recommended professional treatment (79.1%) and self-help materials (76.9%), and a little over half (53.2%) would also recommend natural recovery. CONCLUSIONS: These insights from people with lived experience further support previous research that treatment-assisted and natural recoveries are for the most part similar with respect to the recovery process. However, participants, whether or not they had had treatment involvement, recommended the use of treatment and self-help materials to sharpen their focus on the reasons to change and to enhance their commitment to change. At the same time, they saw value in the efforts of individuals to recovery without help. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13722-018-0118-0) contains supplementary material, which is available to authorized users.