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  • 1.
    Abrahamson, Maria
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Moral norms in older Swedish women’s drinking narratives. Enduring patterns and successively new features2012In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, Vol. 29, no 4, 371-396 p.Article in journal (Refereed)
    Abstract [en]

    AIMS - To examine how the changes in women's relationship to alcohol during the 1960s appear in narratives of situated drinking occasions. DATA - Newly collected autobiographies written by women born between 1918 and 1951 are analysed using theories by William Labov on narrative construction and Kenneth Burke on the rhetoric of motives. RESULTS - The historically restrictive attitude to women at all drinking is present in the oldest women's narratives, while the liberalisation of attitudes to alcohol that took place in the 1960s likewise marks the narratives told by the younger women, even though they when writing are of pension able age. With the writers' diminishing age, the norms framing the narratives have changed, from sobriety among the oldest women to controlled moderation among the younger. And yet, the narratives also demonstrate a stable pattern of questioning women's drinking, although the focus has shifted from tasting alcohol at all to the state of becoming intoxicated. CONCLUSIONS - A controlling norm remains in place, which the women have internalised and made their own. The mitigating circumstances and the neutralising explanations that are presented throughout indicate that the women are conscious of the narratives' deviation from the prevailing norm, and show that women take a risk in drinking alcohol. When a woman drinks she risks her femininity.

  • 2.
    Abrahamsson, Sanne
    Kristianstad University, School of Health and Society.
    Socialtjänsten och mödrahälsovårdens arbete och samarbete kring gravida risk- och/eller missbrukare2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim with my study is to highlight, illuminate and examine the social and maternal health care motivational work of pregnant women with a risk or abuse of alcohol and / or drugs, and what actions can be considered for these women. In addition, the aim is to explore how social services and maternity care might interact in this type of case. The aim is to convey the subjective experience of each of the interviewees. For the purposes of this study, I have chosen to use the qualitative research method. I have interviewed social workers in individual and family care, and midwives. Study interview results show that pregnant misusers priority for both maternity care and social services. By the AUDIT, conducted by the maternal health care, shows that the woman has a risk and / or abuse woman offered a variety of activities that may be in the form of talks, drug testing and treatment. Cooperation is the key to success in this motivational work, and it's mainly collaboration between social services, maternal health and child health care. Cooperation seems to work fine, but could be improved with more time and more staff.

  • 3.
    Agahi, Neda
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Kelfve, Susanne
    Stockholm University, Faculty of Social Sciences, Department of Sociology. Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Lennartsson, Carin
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Kåreholt, Ingemar
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Jönköping University, Sweden.
    Alcohol consumption in very old age and its association with survival: A matter of health and physical function2016In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 159, 240-245 p.Article in journal (Refereed)
    Abstract [en]

    Background: Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and survival among the oldest old. Methods: Nationally representative data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD, ages 76-101; n=863) collected in 2010/2011 were used. Mortality was analyzed unti12014. Alcohol consumption was measured with questions about frequency and amount. Drinks per month were calculated and categorized as abstainer, light-to-moderate drinker (0.5-30 drinks/month) and heavy drinker (>30 drinks/month). Multinomial logistic regressions and Laplace regressions were performed. Results: Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional problems. In models adjusted only for age and sex, abstainers died earlier than drinkers. Among light-to-moderate drinkers, each additional drink/month was associated with longer survival, while among heavy drinkers, each additional drink/month was associated with shorter survival. However, after adjusting for personal and health-related factors, estimates were lower and no longer statistically significant. Conclusions: The association between alcohol consumption and survival in very old age seems to have an inverse J-shape; abstention and heavy use is associated with shorter survival compared to light-to moderate drinking. To a large extent, differences in survival are due to differences in baseline health and physical function.

  • 4.
    Agahi, Neda
    et al.
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Kelfve, Susanne
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden; Department of Sociology, Stockholm University, Stockholm, Sweden.
    Lennartsson, Carin
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Alcohol consumption in very old age and its association with survival: a matter of health and physical function2016In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 159, 240-245 p.Article in journal (Refereed)
    Abstract [en]

    Background

    Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and survival among the oldest old.

    Methods

    Nationally representative data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD, ages 76-101; n = 863) collected in 2010/2011 were used. Mortality was analyzed until 2014. Alcohol consumption was measured with questions about frequency and amount. Drinks per month were calculated and categorized as abstainer, light-to-moderate drinker (0.5–30 drinks/month) and heavy drinker (>30 drinks/month). Multinomial logistic regressions and Laplace regressions were performed.

    Results

    Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional problems. In models adjusted only for age and sex, abstainers died earlier than drinkers. Among light-to-moderate drinkers, each additional drink/month was associated with longer survival, while among heavy drinkers, each additional drink/month was associated with shorter survival. However, after adjusting for personal and health-related factors, estimates were lower and no longer statistically significant.

    Conclusions

    The association between alcohol consumption and survival in very old age seems to have an inverse J-shape; abstention and heavy use is associated with shorter survival compared to light-to-moderate drinking. To a large extent, differences in survival are due to differences in baseline health and physical function.

    Graphical abstract

  • 5. Ahacic, Kozma
    et al.
    Kåreholt, Ingemar
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Karolinska Institute .
    Helgason, Asgeir R.
    Allebeck, Peter
    Non-response bias and hazardous alcohol use in relation to previous alcohol-related hospitalization: comparing survey responses with population data2013In: Substance Abuse Treatment, Prevention, and Policy, ISSN 1747-597X, Vol. 8, 10- p.Article in journal (Refereed)
    Abstract [en]

    Background: This study examines whether alcohol-related hospitalization predicts survey non-response, and evaluates whether this missing data result in biased estimates of the prevalence of hazardous alcohol use and abstinence. Methods: Registry data on alcohol-related hospitalizations during the preceding ten years were linked to two representative surveys. Population data corresponding to the surveys were derived from the Stockholm County registry. The alcohol-related hospitalization rates for survey responders were compared with the population data, and corresponding rates for non-responders were based on the differences between the two estimates. The proportions with hazardous alcohol use and abstinence were calculated separately for previously hospitalized and non-hospitalized responders, and non-responders were assumed to be similar to responders in this respect. Results: Persons with previous alcohol-related admissions were more likely currently to abstain from alcohol (RR=1.58, p<.001) or to have hazardous alcohol use (RR=2.06, p<.001). Alternatively, they were more than twice as likely to have become non-responders. Adjusting for this skewed non-response, i. e., the underrepresentation of hazardous users and abstainers among the hospitalized, made little difference to the estimated rates of hazardous use and abstinence in total. During the ten-year period 1.7% of the population were hospitalized. Conclusions: Few people receive alcohol-related hospital care and it remains unclear whether this group's underrepresentation in surveys is generalizable to other groups, such as hazardous users. While people with severe alcohol problems - i.e. a history of alcohol-related hospitalizations -are less likely to respond to population surveys, this particular bias is not likely to alter prevalence estimates of hazardous use.

  • 6.
    Ahlberg, Rickard
    et al.
    Örebro University, School of Medical Sciences.
    Skårberg, Kurt
    Örebro University, School of Medical Sciences. Addiction Center.
    Brus, Ole
    Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Kjellin, Lars
    Örebro University, School of Health Sciences.
    Auricular acupuncture for substance use: a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services2016In: Substance Abuse Treatment, Prevention, and Policy, ISSN 1747-597X, E-ISSN 1747-597X, Vol. 11, no 1, 24Article in journal (Refereed)
    Abstract [en]

    Background: A common alternative treatment for substance abuse is auricular acupuncture. The aim of the study was to evaluate the short and long-term effect of auricular acupuncture on anxiety, sleep, drug use and addiction treatment utilization in adults with substance abuse.

    Method: Of the patients included, 280 adults with substance abuse and psychiatric comorbidity, 80 were randomly assigned to auricular acupuncture according to the NADA protocol, 80 to auricular acupuncture according to a local protocol (LP), and 120 to relaxation (controls). The primary outcomes anxiety (Beck Anxiety Inventory; BAI) and insomnia (Insomnia Severity Index; ISI) were measured at baseline and at follow-ups 5 weeks and 3 months after the baseline assessment. Secondary outcomes were drug use and addiction service utilization. Complete datasets regarding BAI/ISI were obtained from 37/34 subjects in the NADA group, 28/28 in the LP group and 36/35 controls. Data were analyzed using Chi-square, Analysis of Variance, Kruskal Wallis, Repeated Measures Analysis of Variance, Eta square (η(2)), and Wilcoxon Signed Ranks tests.

    Results: Participants in NADA, LP and control group improved significantly on the ISI and BAI. There was no significant difference in change over time between the three groups in any of the primary (effect size: BAI, η(2) = 0.03, ISI, η(2) = 0.05) or secondary outcomes. Neither of the two acupuncture treatments resulted in differences in sleep, anxiety or drug use from the control group at 5 weeks or 3 months.

    Conclusion: No evidence was found that acupuncture as delivered in this study is more effective than relaxation for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders. The substantial attrition at follow-up is a main limitation of the study.

    Trial registration: Clinical Trials NCT02604706 (retrospectively registered).

  • 7.
    Ahlm, Kristin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs: a retrospective study, 1992-20092013In: BMC Public Health, ISSN 1471-2458, Vol. 13, 216- p.Article in journal (Refereed)
    Abstract [en]

    Background: Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs.

    Methods: During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine.

    Results: During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (<= 18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688/4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons.

    Conclusion: Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.

  • 8.
    Ahmadi, Nader
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology.
    Foreword2013In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491, Vol. 48, no 13, 1283-1284 p.Article in journal (Other academic)
  • 9.
    Alho, Hannu
    et al.
    Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Dept Internal Med, Helsinki, Finland..
    Jansen, Jakob
    Arhus Municipal, Ctr Addict Treatment, Aarhus, Denmark..
    Krajci, Peter
    Oslo Univ Hosp, Div Mental Hlth & Addict, Dept Subst Use Disorder Treatment, Oslo, Norway..
    Littlewood, Richard
    Appliedstrategic, London, England..
    Runarsdottir, Valgendur
    Vogur Hosp, SAA Ctr Addict Treatment, Reykjavik, Iceland..
    Nyberg, Fred
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Misuse and diversion of agonist opioid treatment medicines: assessment of the scale of the problem and review of the changing environment for care in the Nordic countries2015In: Heroin Addiction and Related Clinical Problems, ISSN 1592-1638, Vol. 17, no 5, 43-49 p.Article, review/survey (Refereed)
    Abstract [en]

    Background: Opioid addiction is effectively treated via a multidisciplinary approach including agonist opioid treatment (AOT) and psychosocial intervention. Misuse and diversion of AOT medicines such as methadone and mono-buprenorphine comprise a significant problem occurring in the Nordic countries with some of the highest frequencies in Europe. Misuse and diversion are associated with poor treatment compliance and increases in risk of blood-borne infections, crime, and mortality. Regulations and guidelines for provision of AOT medication vary among the Nordic countries. Aim: The extent and impact of misuse and diversion in the Nordic countries has not been documented in the literature. This review of local sources summarizes the extent and impact of misuse and diversion of AOT medication to provide a basis for improving outcomes in opioid addiction care. Methods: PubMed was searched using the terms "methadone" or "buprenorphine" and "misuse" or "diversion". Titles and abstracts of search results were inspected for location and relevance. Government sources and mainstream media were also searched for relevant reports. Results: Misuse and diversion of AOT medicines is a significant issue in the Nordic countries; these opioids are available outside of treatment and are misused, including by young addicts. To address this problem, changes in medicines used in treatment in Finland and Iceland have already been implemented and considerations are under way in Norway and Sweden. Conclusions: All persons involved in AOT should take action to better understand AOT medication misuse and diversion as this can lead to a step change improvement in outcomes.

  • 10.
    Alm, Susanne
    Stockholm University, Faculty of Social Sciences, Department of Criminology.
    What happened to the Swedish problem drug users of the 1960's and 1970's?2015In: Nordisk Alkohol- og narkotikatidsskrift (NAT), ISSN 1455-0725, E-ISSN 1458-6126, Vol. 32, no 2, 109-132 p.Article in journal (Refereed)
    Abstract [en]

    AIMS & DESIGN - In this study we follow a Stockholm birth cohort born in 1953 (n = 14 294) from youth to middle age. The cohort members were in their teenage years when drug abuse was established as a considerable threat to Swedish society and some of the cohort members themselves became drug abusers (n=431). RESULTS - As expected, life became dramatically worse for those with documented drug abuse when young, than for the rest of the cohort members. While 72 percent of those without documented drug abuse were socially included at the age of 56, the corresponding share among those with documented drug abuse was 18 per cent. And while 5 percent in the former group were diseased at 56, this was true for 38 percent in the latter group. Supplementary analyses showed that social inclusion was also less stable among those with documented drug abuse than among the rest of the cohort, and that the flow from exclusion to inclusion was virtually nonexistent, which was not the case for those without experience of drug abuse. CONCLUSIONS - Gender specific analyses showed that the situation, at least in absolute terms, tended to be even worse for male drug abusers than for women. Gender differences in alcohol abuse, criminality, and with respect to parenthood are suggested as possible explanations to be further studied in future research.

  • 11.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Social relationships and subsequent health-related behaviours: linkages between adolescent peer status and levels of adult smoking in a Stockholm cohort2012In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 3, 629-637 p.Article in journal (Refereed)
    Abstract [en]

    Aims: Peer status reflects the extent to which an individual is accepted by the group. Some studies have reported that low peer status in adolescence is associated with a higher risk of smoking, while others found the reverse. No studies have investigated peer status influences on adult smoking. The aim of the study was therefore to examine the relationship between adolescents' peer status and the intensity of smoking in adulthood.

    Design: Prospective cohort study.

    Setting: Stockholm, Sweden.

    Participants: A subsample (n = 2329) of the cohort with information about adult smoking.

    Measurements: Peer status was assessed sociometrically at age 13 and information on smoking was gathered through a questionnaire at age 32. Relative risks (RR) for self-reported level of smoking were calculated using multinomial logistic regression. Several family-related and individual variables were included as control variables.

    Findings: Lower peer status in adolescence was associated with smoking of any intensity in adulthood. For example, the risk of heavy smoking was more than threefold (RR = 3.67) among individuals in the lowest status positions. The association with occasional smoking was abolished by controlling for factors related to adolescents' attitude to school and cognitive ability. For regular and heavy smoking the relationship was attenuated by controlling for these factors.

    Conclusions: Low peer status in adolescence appears to be a risk factor for smoking in adulthood. Part of this association may be explained by adolescents' feelings towards school and cognitive ability. However, being unpopular in adolescence remains a strong risk factor for regular and heavy smoking in adulthood.

  • 12. Amundsen, Ellen J.
    et al.
    Bretteville-Jensen, Anne L.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT, Institut für Therapiforschung, Germany.
    Estimating incidence of problem drug use using the Horwitz-Thompson estimator - A new approach applied to people who inject drugs in Oslo 1985-20082016In: International journal on drug policy, ISSN 0955-3959, E-ISSN 1873-4758, Vol. 27, 36-42 p.Article in journal (Refereed)
    Abstract [en]

    Background: The trend in the number of new problem drug users per year (incidence) is the most important measure for studying the diffusion of problem drug use. Due to sparse data sources and complicated statistical models, estimation of incidence of problem drug use is challenging. The aim of this study is to widen the palette of available methods and data types for estimating incidence of problem drug use over time, and for identifying the trends. Methods: This study presents a new method of incidence estimation, applied to people who inject drugs (PWID) in Oslo. The method took into account the transition between different phases of drug use progression - active use, temporary cessation, and permanent cessation. The Horwitz-Thompson estimator was applied. Data included 16 cross-sectional samples of problem drug users who reported their onset of injecting drug use. We explored variation in results for selected probable scenarios of parameter variation for disease progression, as well as the stability of the results based on fewer years of cross-sectional samples. Results: The method yielded incidence estimates of problem drug use, over time. When applied to people in Oslo who inject drugs, we found a significant reduction of incidence of 63% from 1985 to 2008. This downward trend was also present when the estimates were based on fewer surveys (five) and in the results of sensitivity analysis for likely scenarios of disease progression. Conclusion: This new method, which incorporates temporarily inactive problem drug users, may become a useful tool for estimating the incidence of problem drug use over time. The method may be less data intensive than other methods based on first entry to treatment and may be generalized to other groups of substance users. Further studies on drug use progression would improve the validity of the results.

  • 13.
    Anderberg, Mats
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of pedagogy.
    Dahlberg, Mikael
    Linnaeus University, Faculty of Social Sciences, Department of pedagogy.
    Ungdomar med missbruksproblem: en deskriptiv studie av Maria-mottagningarna i Stockholm, Göteborg och Malmö2014In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 91, no 4, 348-359 p.Article in journal (Refereed)
    Abstract [en]

    There is a lack of knowledge about the adolescents who are in contact with the outpatient care in Sweden for alcohol and drug problems. The purpose of this article is to describe the adolescents who receive treatment at Maria outpatient care in Stockholm, Gothenburg and Malmö, on the basis of an empirical material from the structured interview UngDOK. The descriptive cross-sectional study is based on a material on 755 adolescents who had begun a treatment contact. The study highlights the importance to include several risk and protective factors in the screening and assessment instruments addressed to adolescents entering care and treatment for substance abuse problems, to identify and pay attention to these factors in the treatment process.

  • 14.
    Anderberg, Mats
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of pedagogy.
    Dahlberg, Mikael
    Linnaeus University, Faculty of Social Sciences, Department of pedagogy.
    Riskfylld alkoholanvändning hos ungdomar med cannabisproblem2015In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, no 4, 484-494 p.Article in journal (Refereed)
    Abstract [en]

    Adolescent who use cannabis, also drink alcohol frequently. This article il-lustrates how risky alcohol consumption among adolescents entering treat-ment at the Maria clinics in Stockholm, Göteborg and Malmö for abuse of cannabis, is related to drog use patterns and to different background and risk factors. The study is based on structured interviews with 887 adolescents and the analysis distinguishes nine different risk factors that are strongly related to their combined use of cannabis and alcohol. A conclusion is that it is important to pay attention to adolescents risky alcohol consumption and, if necessary, also providing specific interventions targeting alcohol problems.

  • 15.
    Anderberg, Mats
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of pedagogy.
    Dahlberg, Mikael
    Linnaeus University, Faculty of Social Sciences, Department of pedagogy.
    Att upptäcka spelproblem: ett pilotprojekt vid ett socialkontor2015In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, no 4, 505-517 p.Article in journal (Refereed)
    Abstract [en]

    This article highlights the obstacles and opportunities in implementing a screening method to identify problem gambling among persons receiving income support within the social services in Gothenburg. The empirical ma-terial was collected through both a study of problem gambling with the two screening instruments NODS and NODS-PERC, and five interviews with ad-ministrators. The study shows that it is possible to identify problem gamblers in social services with both of the screening interviews, but it also illustrates the difficulties that existed under the implementation of this new approach in the social services.

  • 16.
    Anderson, Peter
    et al.
    Newcastle University, England; Maastricht University, Netherlands.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    Spak, Fredrik
    University of Gothenburg, Sweden.
    Reynolds, Jillian
    Hospital Clin Barcelona, Spain.
    Drummond, Colin
    Kings Coll London, England; South London and Maudsley NHS Fdn Trust, England.
    Segura, Lidia
    Govt Catalonia, Spain.
    Keurhorst, Myrna N.
    Radboud University of Nijmegen, Netherlands.
    Palacio-Vieira, Jorge
    Govt Catalonia, Spain.
    Wojnar, Marcin
    Medical University of Warsaw, Poland.
    Parkinson, Kathryn
    Newcastle University, England.
    Colom, Joan
    Govt Catalonia, Spain.
    Kloda, Karolina
    Pomeranian Medical University, Poland.
    Deluca, Paolo
    Kings Coll London, England.
    Baena, Begona
    Govt Catalonia, Spain.
    Newbury-Birch, Dorothy
    Newcastle University, England.
    Wallace, Paul
    UCL, England.
    Heinen, Maud
    Radboud University of Nijmegen, Netherlands.
    Wolstenholme, Amy
    Kings Coll London, England.
    van Steenkiste, Ben
    Maastricht University, Netherlands.
    Mierzecki, Artur
    Pomeranian Medical University, Poland.
    Okulicz-Kozaryn, Katarzyna
    State Agency Prevent Alcohol Related Problems, Poland.
    Ronda, Gaby
    Maastricht University, Netherlands.
    Kaner, Eileen
    Newcastle University, England.
    Laurant, Miranda G. H.
    Radboud University of Nijmegen, Netherlands; HAN University of Appl Science, Netherlands.
    Coulton, Simon
    University of Kent, England.
    Gual, Toni
    Hospital Clin Barcelona, Spain.
    Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the Optimizing Delivery of Health Care Intervention (ODHIN) five-country cluster randomized factorial trial2016In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 111, no 11, 1935-1945 p.Article in journal (Refereed)
    Abstract [en]

    AimTo test if training and support, financial reimbursement and option of referring screen-positive patients to an internet-based method of giving advice (eBI) can increase primary health-care providers delivery of Alcohol Use Disorders Identification Test (AUDIT)-C-based screening and advice to heavy drinkers. DesignCluster randomized factorial trial with 12-week implementation and measurement period. SettingPrimary health-care units (PHCU) in different locations throughout Catalonia, England, the Netherlands, Poland and Sweden. ParticipantsA total of 120 PHCU, 24 in each of Catalonia, England, the Netherlands, Poland and Sweden. InterventionsPHCUs were randomized to one of eight groups: care as usual, training and support (TS), financial reimbursement (FR) and eBI; paired combinations of TS, FR and eBI, and all of FR, TS and eBI. MeasurementsThe primary outcome measure was the proportion of eligible adult (age 18+ years) patients screened during a 12-week implementation period. Secondary outcome measures were proportion of screen-positive patients advised; and proportion of consulting adult patients given an intervention (screening and advice to screen-positives) during the same 12-week implementation period. FindingsDuring a 4-week baseline measurement period, the proportion of consulting adult patients who were screened for their alcohol consumption was 0.059 per PHCU (95% CI 0.034 to 0.084). Based on the factorial design, the ratio of the logged proportion screened during the 12-week implementation period was 1.48 (95% CI=1.13-1.95) in PHCU that received TS versus PHCU that did not receive TS; for FR, the ratio was 2.00 (95% CI=1.56-2.56). The option of referral to eBI did not lead to a higher proportion of patients screened. The ratio for TS plus FR was 2.34 (95% CI=1.77-3.10), and the ratio for TS plus FR plus eBI was1.68 (95% CI=1.11-2.53). ConclusionsProviding primary health-care units with training, support and financial reimbursement for delivering Alcohol Use Disorders Identification Test-C-based screening and advice to heavy drinkers increases screening for alcohol consumption. Providing primary health-care units with the option of referring screen-positive patients to an internet-based method of giving advice does not appear to increase screening for alcohol consumption.

  • 17. Anderson, Peter
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Addictions and European policy: Has the 'European project' stifled science-led policy?2011In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 30, no 2, 117-118 p.Article in journal (Refereed)
  • 18.
    Andersson, Maria
    et al.
    Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden & Spenshult Research and Development Center, Oskarström, Sweden.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Spenshult Research and Development Center, Oskarström, Sweden.
    Reasons to stop drinking alcohol among patients with rheumatoid arthritis – a mixed method study2016In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 75, no Suppl 2, 1295Article in journal (Refereed)
    Abstract [en]

    Background: Studies of alcohol use in patients with rheumatoid arthritis are sparse and studies of why patients choose to stop drinking alcohol in particular.

    Objectives: The aim of the current study was twofold: first to identify patients with RA who stopped drinking alcohol and compare those to patients drinking alcohol, and second, to explore reasons to stop drinking alcohol.

    Methods: In 2010 a self-completion postal questionnaire was sent to all 2,102 prevalent patients in the Better anti-rheumatic farmacotherapy (BARFOT) study enquiring about disease severity, physical function (HAQ) and health related quality of life (EQ5D), pain, fatigue, patient global assessment (PatGA) and lifestyle factors e.g. alcohol. The questions assessing alcohol included the question “Have you stopped drinking alcohol?” and an open question “Why have you stopped drinking alcohol?” A mixed method design was used and 1512 patients had answered the alcohol questions and was included in the study of those 86 had stopped drinking alcohol. Seventy-one patients answered the open question and their answers were analyzed with qualitative content analysis (1).

    Results: Comparing patient with RA using alcohol or not, the patients who stopped drinking alcohol was older median age (min-max) 69 (36–90) vs. 66 (23–95), p=0.011, more men 42% vs. 29%, p=0.015, had worse physical function, median HAQ (min-max) 0.50 (0–3.00) vs. 1.00 (0–2.75), p<0.001, worse health related quality of life, median EQ5D (min-max), 0.69 (-0.59–1.00) vs. 0.76 (-0.02–1.00), p<0.001, worse self-perceived health, median PatGA (min-max) 5 (0–10) vs. 3 (0–10), <0.001, more pain, median (min-max) 5 (0–10) vs. 3 (0–10), p<0.001, and more fatigue median (min-max) 6 (0–10) vs 4 (0–10), p<0.001. There were no differences between the groups regarding disease duration, swollen and tender joints. The qualitative content analysis resulted in five categories describing the reasons for patient with RA to stop drinking alcohol: disease and treatment, health and wellbeing, work and family, faith and belief and dependences and abuse.

    Conclusions: Patients with RA who stopped drinking alcohol have a lower physical function, health related quality of life, self-perceived health and more pain and fatigue comparing to patients with RA drinking alcohol. The reasons to stop drinking alcohol were of different nature such as medical, physical, mental, social and spiritual

  • 19.
    Aziz, Abdul Maruf Asif
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Brothers, Shaun
    University of Miami Health System, University of Miami, Miami, USA.
    Sartor, Gregory
    University of Miami Health System, University of Miami, Miami, USA.
    Holm, Lovisa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Heilig, Markus
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Wahlestedt, Claes
    University of Miami Health System, University of Miami, Miami, USA.
    Thorsell, Annika
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    The nociceptin/orphanin FQ receptor agonist SR-8993 as a candidate therapeutic for alcohol use disorders: validation in rat models2016In: Psychopharmacology, ISSN 0033-3158, E-ISSN 1432-2072, Vol. 233, no 19-20, 3553-3563 p.Article in journal (Refereed)
    Abstract [en]

    RATIONALE: Alcoholism is a complex disorder in which diverse pathophysiological processes contribute to initiation and progression, resulting in a high degree of heterogeneity among patients. Few pharmacotherapies are presently available, and patient responses to these are variable. The nociceptin/orphanin FQ (NOP) receptor has been suggested to play a role both in alcohol reward and in negatively reinforced alcohol seeking. Previous studies have shown that NOP-receptor activation reduces alcohol intake in genetically selected alcohol-preferring as well as alcohol-dependent rats. NOP activation also blocks stress- and cue-induced reinstatement of alcohol-seeking behavior.

    OBJECTIVES: Here, we aimed to examine a novel, potent, and brain-penetrant small-molecule NOP-receptor agonist, SR-8993, in animal models of alcohol- as well as anxiety-related behavior using male Wistar rats.

    RESULTS: SR-8993 was mildly anxiolytic when given to naïve animals and potently reversed acute alcohol withdrawal-induced ("hangover") anxiety. SR-8993 reduced both home-cage limited access drinking, operant responding for alcohol, and escalation induced through prolonged intermittent access to alcohol. SR-8993 further attenuated stress- as well as cue-induced relapse to alcohol seeking. For the effective dose (1.0 mg/kg), non-specific effects such as sedation may be limited, since a range of control behaviors were unaffected, and this dose did not interact with alcohol elimination.

    CONCLUSION: These findings provide further support for NOP-receptor agonism as a promising candidate treatment for alcoholism and establish SR-8993 or related molecules as suitable for further development as therapeutics.

  • 20.
    Barclay, Kieron
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. London School of Economics and Political Science, UK; Max Planck Institute for Demographic Research, Germany.
    Myrskylä, Mikko
    Tynelius, Per
    Berglind, Daniel
    Rasmussen, Finn
    Birth order and hospitalization for alcohol and narcotics use in Sweden2016In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 167, 15-22 p.Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies have shown that birth order is an important predictor of later life health as well as socioeconomic attainment. In this study, we examine the relationship between birth order and hospitalization for alcohol and narcotics use in Sweden. Methods: We study the relationship between birth order and hospitalization related to alcohol and narcotics use before and after the age of 20 using Swedish register data for cohorts born 1987-1994. We apply Cox proportional hazard models and use sibling fixed effects, eliminating confounding by factors shared by the siblings. Results: Before age 20 we find that later born siblings are hospitalized for alcohol use at a higher rate than first-borns, and there is a monotonic increase in the hazard of hospitalization with increasing birth order. Second-borns are hospitalized at a rate 47% higher than first-borns, and third-borns at a rate 65% higher. Similar patterns are observed for hospitalization for narcotics use. After age 20 the pattern is similar, but the association is weaker. These patterns are consistent across various sibling group sizes. Conclusions: Later born siblings are more likely to be hospitalized for both alcohol and narcotics use in Sweden. These birth order effects are substantial in size, and larger than the estimated sex differences for the risk of hospitalization related to alcohol and drug use before age 20, and previous estimates for socioeconomic status differences in alcohol and drug abuse.

  • 21. Been, Frederic
    et al.
    Bifisma, Lubertus
    Benaglia, Lisa
    Berset, Jean-Daniel
    Botero-Coy, Ana M.
    Castiglioni, Sara
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Zobel, Frank
    Schaub, Michael P.
    Buecheli, Alexander
    Hernandez, Felix
    Delemont, Olivier
    Esseiva, Pierre
    Ort, Christoph
    Assessing geographical differences in illicit drug consumption-A comparison of results from epidemiological and wastewater data in Germany and Switzerland2016In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 161, 189-199 p.Article in journal (Refereed)
    Abstract [en]

    Background: Wastewater analysis is an innovative approach that allows monitoring illicit drug use at the community level. This study focused on investigating geographical differences in drug consumption by comparing epidemiological, crime and wastewater data. Methods: Wastewater samples were collected in 19 cities across Germany and Switzerland during one week, covering a population of approximately 8.1 million people. Self-report data and consumption offences for the investigated areas were used for comparison and to investigate differences between the indicators. Results: Good agreement between data sources was observed for cannabis and amphetamine-type stimulants, whereas substantial discrepancies were observed for cocaine. In Germany, an important distinction could be made between Berlin, Dortmund and Munich, where cocaine and particularly amphetamine were more prevalent, and Dresden, where methamphetamine consumption was clearly predominant. Cocaine consumption was relatively homogenous in the larger urban areas of Switzerland, although prevalence and offences data suggested a more heterogeneous picture. Conversely, marked regional differences in amphetamine and methamphetamine consumption could be highlighted. Conclusions: Combining the available data allowed for a better understanding of the geographical differences regarding prevalence, typology and amounts of substances consumed. For cannabis and amphetamine-type stimulants, the complementarity of survey, police and wastewater data could be highlighted, although notable differences could be identified when considering more stigmatised drugs (i.e. cocaine and heroin). Understanding illicit drug consumption at the national scale remains a difficult task, yet this research illustrates the added value of combining complementary data sources to obtain a more comprehensive and accurate picture of the situation.

  • 22. Bejerot, Susanne
    et al.
    Bejerot, Nils
    Representativitet i en studie av intravenöst missbruk bland arrestanter i Stockholm1984In: SCI: de två första verksamhetsåren / [ed] J. Ewers, J. Hartelius, Markaryd: Scipio , 1984, 90-97 p.Chapter in book (Refereed)
  • 23.
    Benderix, Ylva
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Education, Psychology and Sport Science.
    Fridell, Mats
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Education, Psychology and Sport Science.
    Billsten, Johan
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Education, Psychology and Sport Science.
    Holmberg, Robert
    Utvärdering av "Kunskap till Praktik" ett nationellt stöd till implementering av Nationella Riktlinjer för missbruks och beroendevård. delrapport I  2008 - 20112012Report (Other (popular science, discussion, etc.))
  • 24.
    Bendtsen, P.
    et al.
    Linköping University, Sweden.
    Johansson, K.
    Linköping University, Sweden.
    Åkerlind, Ingemar
    Linköping University, Sweden.
    Feasibility of an email-based electronic screening and brief intervention (e-SBI) to college students in Sweden2006In: Addictive Behaviors, ISSN 0306-4603, Vol. 31, no 5, 777-87 p.Article in journal (Refereed)
    Abstract [en]

    An email-based electronic screening and brief intervention (e-SBI) with personalized normative feedback on alcohol habits was offered to all 3,875 second term students at Linköping University, Sweden. The students received an email with a link to a computerized alcohol habit test and were offered personalized feedback directly on the computer screen. The students evaluated the test and were asked to state whether they were going to consider changing or actually change their alcohol habits. The response rate was 44%, with 742 female and 843 male students participating. The students displayed a strong gender difference in drinking pattern. A three-fold higher percentage of males than females were risky drinkers with regard to a high average weekly volume consumption. The gender differences were less pronounced regarding heavy episodic drinking that was reported by 51% of the females and 70.5% of the males. The email-based computerized normative feedback was appreciated by the students and one-third of the females and one-fifth of the males believed that they would benefit from the normative feedback; 8% of the females and 3% of the males believed that they would actually change their habits after the feedback. Students with a risky drinking pattern, previous experiences of blackouts, being dissatisfied with their current drinking and students that had considered to change their habits before the e-SBI, yielded a stronger motivation to change their drinking after having performed the intervention compared to students without such characteristics. The e-SBI with normative feedback was simple to administer and has the potential to be used repeatedly and on a large scale with minimum effort in terms of cost and time.

  • 25.
    Berglund, Kristina J.
    et al.
    Department of Psychology, University of Gothenburg.
    Balldin, Jan
    Department of Psychiatry and Neurochemistry of the Sahlgrenska Academy at the University of Gothenburg .
    Berggren, Ulf
    Department of Psychiatry and Neurochemistry of the Sahlgrenska Academy at the University of Gothenburg .
    Gerdner, Arne
    Jönköping University, School of Health Science, HHJ. Research Platform of Social Work. Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work.
    Fahlke, Claudia
    Department of Psychology, University of Gothenburg .
    Childhood Maltreatment Affects the Serotonergic System in Male Alcohol-Dependent Individuals2013In: Alcoholism: Clinical and Experimental Research, ISSN 0145-6008, E-ISSN 1530-0277, Vol. 37, no 5, 757-762 p.Article in journal (Refereed)
    Abstract [en]

    Background: Reduced central serotonergic neurotransmission has been demonstrated in individuals with excessive alcohol consumption and/or alcohol dependence. Childhood maltreatment has also been found to have a negative impact on central serotonergic neurotransmission. The aim of this study was to evaluate the impact of childhood maltreatment on central serotonergic dysfunction in alcohol-dependent individuals.

    Methods: Adult men with a diagnosis of alcohol dependence (n=18) were recruited from outpatient treatment units for alcoholism. Central serotonergic neurotransmission was assessed by a neuroendocrine method, that is, the prolactin (PRL) response to the selective 5-HT reuptake inhibitor citalopram. Childhood maltreatment was assessed retrospectively by the Childhood Trauma Questionnaire.

    Results: Alcohol-dependent individuals with childhood experience of emotional abuse had significantly lower PRL response compared with those without such abuse (3 +/- 5 and 64 +/- 24mU/l, respectively; t=6.51, p<0.001). Among those who reported childhood emotional abuse, 4 of 7 individuals had flat PRL responses in comparison with none in those with no report of such abuse (p<0.01).

    Conclusions: This is the first study to show that self-reported childhood maltreatment, in particular emotional abuse, in male alcohol-dependent individuals is associated with a quite dramatic (more than 90%) reduction in central serotonergic neurotransmission. It should, however, be noted that the number of individuals is relatively small, and the results should therefore be considered as preliminary.

  • 26.
    Bergstrand, Marcus
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Education, Psychology and Sport Science.
    Frantz, Petra
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Education, Psychology and Sport Science.
    Stora Starka Män- Behandling och missbruk av anabola androgena steroider2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna kvalitativa studie handlar om några behandlares upplevelser och erfarenheter kring vilka personer som hamnar i missbruk av anabola androgena steroider(AAS). Den belyser även vilken behanding som finns för problematiken. För att erhålla empiri används semistrukturerade intervjuer på fyra personer som arbetar med behandling av AAS. Resultatet visar att man kan kategorisera AAS-användare i tre olika grupper. När klienter kommer till behandling är det viktigt att man ser till helhetsbilden och att man ser varje individ för sig. Metoder som finns är terapi för det sjuka kroppsidealet, hjälp med träningsmissbruket, läkemedelsassisterad behandling samt annan psykosocial terapi. En intressant slutsats är att det finns hjälp att få vid AAS-missbruk, men tyvärr finns det inte resurser att hjälpa alla. Det finns fortfarande mycket kvar att lära inom ämnet och man behöver forska kring fler och bättre behandlingsmetoder som kan passa vid detta missbruk.

  • 27. Berman, Anne H.
    et al.
    Wennberg, Peter
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Sinadinovic, Kristina
    Changes in Mental and Physical Well-Being Among Problematic Alcohol and Drug Users in 12-Month Internet-Based Intervention Trials2015In: Psychology of Addictive Behaviors, ISSN 0893-164X, E-ISSN 1939-1501, Vol. 29, no 1, 97-105 p.Article in journal (Refereed)
    Abstract [en]

    Twelve-month well-being outcomes were investigated for 835 participants in 1 of 2 randomized controlled trials offering online assessment and brief intervention for either problematic alcohol (n = 633) or drug use (n = 202). The well-being of participants who had reduced their substance use to a less problematic level (regardless of intervention) over 12 months was compared with that of participants who had maintained or increased their use. At a 12-month follow-up, the 227 alcohol trial participants with reduced use showed better well-being in comparison to the 406 with stable or increased use, in physical health and sleep quality, as well as general well-being, ability to concentrate, lower stress, better social life satisfaction and sense of control, and a lower rate of depressed mood. Among the 70 drug trial participants who had reduced their drug use over 12 months, 80% had ceased all drug use, and at follow-up they had fewer alcohol-related problems than the stable group. No differences in well-being between these groups were identified. Self-reported access to additional treatment modalities beyond the trial interventions (e.g., speaking to someone about problematic use and accessing additional Internet-based interventions) was higher among participants in both cohorts with reduced substance use in comparison to those with stable/increased use. Drug users who reduced their use accessed prescribed medication to a larger extent than those whose use remained stable or increased. Points to consider when conducting future research on well-being and problematic substance use are discussed.

  • 28.
    Billsten, Johan
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Holmberg, Robert
    Lund university.
    Benderix, Ylva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Evidensbaserad praktik inom missbruks- och beroendevården2014In: Implementering av evidensbaserad praktik / [ed] Per Nilsen, Falkenberg: Gleerups Utbildning AB, 2014, 1, 233-245 p.Chapter in book (Other academic)
  • 29. Bjerge, Bagga
    et al.
    Houborg, Esben
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Perälä, Riikka
    Concepts and policies directed at drug use i Denmark, Finland and Sweden2016In: Concepts of Addictive Behaviours across Time and Place / [ed] Matilda Hellman, Virginia Berridge, Karen Duke, Alex Mold, Oxford: Oxford University Press, 2016Chapter in book (Refereed)
    Abstract [en]

    The Nordic countries are often thought of in terms of social democratic welfare regimes with numerous shared cultural aspects. Based on research from Denmark, Finland, and Sweden, this chapter explores how historical developments, specific ways of constructing policies, and welfare institutions articulate specific conceptions of what drug-related issues are and how they should be managed in three seemingly very similar welfare states. The Nordic welfare states are often described as quite alike and fairly open and inclusive in their approach to welfare policies and concerns, but the chapter demonstrates that similar political systems adopt different policy responses to similar conditions. To explore the similarities and differences, we are inspired by the analytical concepts of policy space and political rationalities; we use this approach to provide an overview of drug policy history in the three countries and present a closer examination of the topics of sanctions against drug users, coercive treatment, and substitution treatment nationally as well as cross-nationally.

  • 30. Bramness, Jorgen G.
    et al.
    Henriksen, Beate
    Persson, Olle
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Mann, Karl
    A Bibliometric Analysis of European versus USA Research in the Field of Addiction. Research on Alcohol, Narcotics, Prescription Drug Abuse, Tobacco and Steroids 2001-20112014In: European Addiction Research, ISSN 1022-6877, E-ISSN 1421-9891, Vol. 20, no 1, 16-22 p.Article in journal (Refereed)
    Abstract [en]

    Background: To compare the publication and citation rate within the areas of drug abuse and dependence research in Europe with that in the USA. Methods: This is a bibliometric study using the Thomson Reuters Web of Knowledge as data source, 40 key words were used as search terms, but certain scientific publications not concerning the issue were excluded. Scientific publications from Denmark, England, Finland, France, Germany, Italy, the Netherlands, Norway, Spain, Sweden, and the USA were studied. The number of publications in each country and in each year in addition to the citation indices for these publications was retrieved. Results: Approximately two thirds of the publications came from the USA. Both in absolute and relative figures, Europe lagged behind. The trend over the last decade was a greater gap between the amount of research performed in Europe versus the USA. There were thematic differences. Smaller European countries had a greater relative publication rate. The citations were relatively evenly distributed. Conclusions: It has been claimed that 85% of the world's research within the field of drug abuse and dependence is carried out in the USA. This study challenges this figure, but European research within this field is lagging behind. Copyright (C) 2013 S. Karger AG, Basel

  • 31. Bramness, Jørgen G.
    et al.
    Henriksen, Beate
    Person, Olle
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Mann, Karl
    Bibliographic Searches for a Bibliometric Analysis on Drug Addiction Reply2015In: European Addiction Research, ISSN 1022-6877, E-ISSN 1421-9891, Vol. 21, no 1, 32-32 p.Article in journal (Refereed)
  • 32. Braun, Barbara
    et al.
    Ludwig, Monika
    Sleczka, Pawel
    Buehringer, Gerhard
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Gamblers seeking treatment: Who does and who doesn't?2014In: Journal of Behavioral Addictions, ISSN 2062-5871, Vol. 3, no 3, 189-198 p.Article in journal (Refereed)
    Abstract [en]

    Background and aims: As only a minority of pathological gamblers (PGr) presents for treatment, further knowledge about help-seeking behavior is required in order to enhance treatment utilization. The present study investigated factors associated with treatment participation in gamblers in Germany. As subclinical pathological gamblers (SPGr, fulfilling one to four DSM-IV-criteria) are target of early intervention due to high risk of transition to pathological gambling, they were subject of special interest. Methods: The study analyzed data from a general population survey (n = 234, SPGr: n = 198, PGr: n = 36) and a treatment study (n = 329, SPGr: n = 22, PGr: n = 307). A two-step weighting procedure was applied to ensure comparability of samples. Investigated factors included socio-demographic variables, gambling behavior, symptoms of pathological gambling and substance use. Results: In PGr, regular employment and non-German nationality were positively associated with being in treatment while gambling on the Internet and gaming machines and fulfilling more DSM-IV-criteria lowered the odds. In SPGr, treatment attendance was negatively associated with married status and alcohol consumption and positively associated with older age, higher stakes, more fulfilled DSM-IV criteria and regular smoking. Conclusions: In accordance to expectations more severe gambling problems and higher problem awareness and/or external pressure might facilitate treatment entry. There are groups with lower chances of being in treatment: women, ethnic minorities, and SPGr. We propose target group specific offers, use of Internet-based methods as possible adaptions and/or extensions of treatment offers that could enhance treatment attendance.

  • 33.
    Bravo, Maria J.
    et al.
    Secretaría del Plan Nacional sobre el Sida, Madrid.
    Barrio, Gregorio
    Centro Universitario de Salud Pública (CUSP), Madrid.
    de la Fuente, Luis
    Secretaría del Plan Nacional sobre el Sida, Madrid.
    Royuela, Luis
    Centro Universitario de Salud Pública (CUSP), Madrid.
    Domingo, Laura
    Proyecto Itínere, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
    Silva, Teresa
    Proyecto Itínere, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
    Reasons for selecting an initial route of heroin administration and for subsequent transitions during a severe HIV epidemic2003In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 98, no 6, 749-760 p.Article in journal (Refereed)
    Abstract [en]

    Aim  To identify the most important reasons for selecting a particular route of heroin administration and for subsequent transitions during a period of epidemic HIV transmission. To study temporal trends in these reasons.

    Design  Cross-sectional survey.

    Participants  Nine hundred heroin users in three Spanish cities: 305 in Seville, 297 in Madrid and 298 in Barcelona.

    Measurements  A separate analysis was made of the reasons for five types of behaviour: (a) selecting injection as the initial usual route of heroin administration (URHA); (b) changing the URHA to injection; (c) never having injected drugs; (d) selecting the smoked or sniffed route as the initial URHA; and (e) changing the URHA to a non-injected route. Subjects were invited to evaluate the importance of each reason included in a closed list. Spontaneously self-perceived reasons were also explored in an open-ended question for each of the five types of behaviour studied.

    Findings  The primary reason selected for each type of behaviour was: (a) pressure of the social environment; (b) belief that injection is a more efficient route than smoking or sniffing heroin; (c) concern about health consequences (especially fears of HIV and overdose), and fear of blood or of sticking a needle into one's veins; (d), pressure of the social environment and (e) concern about health consequences and vein problems. For women, having a sexual partner who injected heroin played a decisive role in initiating or changing to injection. Few people spontaneously mentioned market conditions for purchasing heroin as an important reason for any behaviour, nor did many mention risk of overdose as reasons for (c) or (d).

    Conclusions  These findings should be considered when designing interventions aimed at preventing initiation of injecting or facilitating the transition to non-injected routes.

  • 34. Bronner, Kerstin Birgitta Thelin
    et al.
    Wennberg, Peter
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Kallmen, Hakan
    Schult, Marie-Louise Birgitta
    Alcohol habits in patients with long term musculoskeletal pain: comparison with a matched control group from the general population2012In: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 35, no 2, 130-137 p.Article in journal (Refereed)
    Abstract [en]

    This prospective study aimed to describe alcohol habits in patients with chronic pain compared with those in a matched control group from the general Swedish population. In total, 100 consecutive patients enrolled were matched against 100 individuals in a control group on the basis of age and sex. Alcohol habits were measured using the Alcohol Use Disorders Identification Test in both groups. The patients were recruited if they underwent a biopsychosocial pain analysis for possible participation in pain rehabilitation. The patients with chronic pain drank alcohol significantly less, less often, in smaller quantities, and became intoxicated less than the control group did. The study was rather small and at a single site, but its strengths were the comprehensive and simple design and the possibility to describe the sample's representativeness compared with other clinics on the basis of data from a national quality register.

  • 35.
    Bruhn, Linnea
    Karlstad University.
    Motiverande samtal -En dynamisk process i arbetet med barn och ungdomar med övervikt: - En kvalitativ studie om professionella inom hälso- och sjukvårdens upplevelser av att använda MI tillsammans med överviktiga barn och ungdomar2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The unhealthy lifestyles such as poor diets and lack of physical activity can lead to overweight and obesity for children and adolescents today. To not have the unhealthy lifestyles lead to future complications it’s important to give them the help and support they need to get motivated to change theirs behavior. Motivational interviewing (MI) is a method to help people change their behavior, this study will focus on a healthy lifestyle changes. A profession in healthcare uses the MI as a method to support the lifestyle change for children and adolescents with obesity. The purpose of this study is to examine what the professions experiences is concerning how the method works with children and adolescents with overweight. This study has used a qualitative method with six interviews. The interviews were recorded and analyzed. The result of this study showed that professions experiences MI as a very positive and useful method, also that the professions needed to use the method continuity to maintain the knowledge. The potential of MI as a method was that the professions often could see a positive change in the patient and the respondent had a positive view in using MI in the future. The author of this study believes that it’s incredibly important to keep working with MI as it probably can "save" money both for society and the work hours for professions in healthcare.

  • 36.
    Brunnberg, Elinor
    et al.
    Örebro University, Department of Behavioural, Social and Legal Sciences.
    Lindén Boström, Margareta
    Örebro University, Department of Health Sciences.
    Berglund, Mats
    Lund University.
    School adjustment, self-rated health and substance use in -16 year old hard-of-hearing students: a comparative study : life and health : young people 20052007Conference paper (Other academic)
  • 37.
    Cai, Bing
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences.
    Bredenberg, Susanne
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences.
    Engqvist, Håkan
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences.
    Development and evaluation of a tampering resistant transdermal fentanyl patch2015In: International Journal of Pharmaceutics, ISSN 0378-5173, E-ISSN 1873-3476, Vol. 488, no 1-2, 102-107 p.Article in journal (Refereed)
  • 38. Callina, Sarah
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Centre for Alcohol Policy Research, Australia; Monash University, Australia.
    Harm, tangible or feared: Young Victorians' adverse experiences from others' drinking or drug use2014In: International journal on drug policy, ISSN 0955-3959, E-ISSN 1873-4758, Vol. 25, no 3, 401-406 p.Article in journal (Refereed)
    Abstract [en]

    Background: Harms from alcohol experienced by someone other than the drinker have received increasing attention of late, but have not been compared to harms from others' drug use. The aim of the current study is to compare the reported harms that are attributable to the alcohol use of others to those attributable to drugs, distinguishing between different types of harm in order to highlight how reported harms may be influenced by perception and social standing of use of the substance. Method: Respondents aged 16-24 from Victoria, Australia, completed the Victorian Youth Alcohol and Drug Survey (n = 5001), including questions on demographics, drug and alcohol consumption, on the types of harms they experienced attributable to drugs and alcohol, as well as harms they perpetrated after using drugs or alcohol. Results: For both drug and alcohol related harms, reports of harms loaded into two groups using multiple correspondence analysis: tangible harms such as assault, and amenity impacts such as being annoyed by people under the influence. Amenity impacts attributed to alcohol were more likely to be experienced by those who reported drug use and vice versa, while the tangible impacts were more likely to be reported by those who used both drugs and alcohol. Conclusions: Reports of amenity impacts from others appear to be influenced by the perception of the drug in question more than tangible impacts such as assault. Particularly for amenity impacts, the greater stigma attached to drug use may make respondents more likely to consider themselves harmed by drugs than they would when compared to alcohol, something that needs to be taken into account when assessing harms by either alcohol or drugs.

  • 39. Callinan, Sarah
    et al.
    Laslett, Anne-Marie
    Rekve, Dag
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Waleewong, Orratai
    Benegal, Vivek
    Casswell, Sally
    Florenzano, Ramon
    Hoang, Thi
    Vu, Thi
    Hettige, Siri
    Huckle, Taisia
    Ibanga, Akanidomo
    Obot, Isidore
    Rao, Girish
    Siengsounthone, Latsamy
    Rankin, Georgia
    Thamarangsi, Thaksaphon
    Alcohol's harm to others: An international collaborative project2016In: The international journal of alcohol and drug research, ISSN 1925-7066, Vol. 5, no 2, 25-32 p.Article in journal (Refereed)
    Abstract [en]

    Aims: This paper outlines the methods of a collaborative population survey project measuring the range and magnitude of alcohol's harm to others internationally. Setting: Seven countries participating in the World Health Organization (WHO) and ThaiHealth Promotion Foundation (ThaiHealth) research project titled The Harm to Others from Drinking, along with two other countries with similar studies, will form the core of a database which will incorporate data from other countries in the future. Measures: The WHO-ThaiHealth research project developed two comparable versions of a survey instrument, both measuring harm from others' drinking to the respondent and the respondent's children. Design: Surveys were administered via face-to-face methods in seven countries, while similar surveys were administered via computer-assisted telephone interviews in two additional countries. Responses from all surveys will be compiled in an international database for the purpose of international comparisons. Discussion: Harms from the alcohol consumption of others are intertwined with the cultural norms where consumption occurs. The development of this database will make it possible to look beyond reports and analyses at national levels, and illuminate the relationships between consumption, harms, and culture. Conclusions: This database will facilitate work describing the prevalence, patterning, and predictors of personal reports of harm from others' drinking cross-nationally.

  • 40. Callinan, Sarah
    et al.
    Livingston, Michael
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia; University of Melbourne, Australia.
    Dietze, Paul
    Drinking Contexts and Alcohol Consumption: How Much Alcohol Is Consumed in Different Australian Locations?2016In: Journal of Studies on Alcohol and Drugs, ISSN 1937-1888, E-ISSN 1938-4114, Vol. 77, no 4, 612-619 p.Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to examine where Australians in different demographic groups and drinker categories consume their alcohol. Method: Results were taken from the Australian arm of the International Alcohol Control study, a telephone survey of 2,020 Australian adults with an oversample of risky drinkers. The 1,789 respondents who reported consuming alcohol in the past 6 months were asked detailed questions about the location of their alcohol consumption and how much alcohol they consumed at each place. Results: Sixty-three percent of all alcohol consumption reported by respondents was consumed in the drinker's own home, with much less consumed at pubs, bars, and nightclubs (12%). This is driven primarily by the number of people who drink in the home and the frequency of these events, with the amount consumed per occasion at home no more than in other people's homes or pubs, and significantly less than at special events. The average consumption on a usual occasion at each of these locations was more than five Australian standard drinks (above the Australian low-risk guideline for episodic drinking). Short-term risky drinkers had the highest proportion of consumption in pubs (19%), but they still consumed 41% of their units in their own home. Conclusions: The majority of alcohol consumed in Australia is consumed in the drinker's own home. Efforts to reduce long-term harms from drinking need to address off-premise drinking and, in particular, drinking in the home.

  • 41. Callinan, Sarah
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). University of Melbourne, Australia; Turning Point Alcohol & Drug Centre, Australia.
    Livingston, Michael
    Changes in Australian attitudes to alcohol policy: 1995–20102014In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 33, no 3, 227-234 p.Article in journal (Refereed)
    Abstract [en]

    Introduction and Aims

    In 2009 Wilkinson and colleagues reported a downward trend in support for alcohol policyrestrictions in Australia between 1995 and 2004. The aim of the current study is to examine more recent data on policy supportin Australia, specifically for policies covering alcohol availability up to 2010, and to examine specific demographic shifts insupport.

    Design and Methods

    Data was taken from the National Drug Strategy Household Surveys from 1995, 1998,2001, 2004, 2007 and 2010 (n = 80 846), primarily responses to attitude items on policy restriction and demographicquestions. The effects of age, sex, drinking patterns and income over time on three items addressing restriction of alcoholavailability were assessed using a factorial analysis of variance.

    Results

    Although availability items are among the lesspopular policy restrictions put forward in the National Drug Strategy Household Surveys, 2004 actually represented a turningpoint in the decrease in popularity, with an increase in support since then.Though some groups show consistently higher ratesof support than others for policy restrictions, the rate of change in support was fairly uniform across demographic and drinkinggroups.

    Discussion and Conclusions

    Despite the lack of an obvious catalyst, there has been an increase in support foralcohol policy restriction as it relates to general availability and accessibility since 2004. Furthermore, this increase does notappear to be a reflection of a change in a specific group of people, but appears to be occurring across the Australian population.

  • 42. Callinan, Sarah
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Centre for Alcohol Policy Research, Turning Point, Australia; University of Melbourne, Australia.
    Livingston, Michael
    Jiang, Heng
    Who Purchases Low-Cost Alcohol in Australia?2015In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 50, no 6, 647-653 p.Article in journal (Refereed)
    Abstract [en]

    Debates surrounding potential price-based polices aimed at reducing alcohol-related harms tend to focus on the debate concerning who would be most affected-harmful or low-income drinkers. This study will investigate the characteristics of people who purchase low-cost alcohol using data from the Australian arm of the International Alcohol Control study. 1681 Australians aged 16 and over who had consumed alcohol and purchased it in off-licence premises were asked detailed questions about both practices. Low-cost alcohol was defined using cut-points of 80A cent, $1.00 or $1.25 per Australian standard drink. With a $1.00 cut-off low income (OR = 2.1) and heavy drinkers (OR = 1.7) were more likely to purchase any low-cost alcohol. Harmful drinkers purchased more, and low-income drinkers less, alcohol priced at less than $1.00 per drink than high income and moderate drinkers respectively. The relationship between the proportion of units purchased at low cost and both drinker category and income is less clear, with hazardous, but not harmful, drinkers purchasing a lower proportion of units at low cost than moderate drinkers. The impact of minimum pricing on low income and harmful drinkers will depend on whether the proportion or total quantity of all alcohol purchased at low cost is considered. Based on absolute units of alcohol, minimum unit pricing could be differentially effective for heavier drinkers compared to other drinkers, particularly for young males.

  • 43.
    Capusan, Andrea J.
    et al.
    Department of Psychiatry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Bendtsen, Preben
    Department of Medical Specialist and Department of Medicine and Health Sciences, Linköping University, Motala, Sweden.
    Marteinsdottir, Ina
    Centre for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping Sweden.
    Larsson, Henrik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Comorbidity of Adult ADHD and Its Subtypes With Substance Use Disorder in a Large Population-Based Epidemiological Study2016In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of the study is to explore the role and possible substance preference in ADHD and subtypes in substance use disorder (SUD).

    Method: Using self-report data on ADHD Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) symptoms and SUD (alcohol, illicit drugs, and nicotine) in 18,167 Swedish twins, aged 20 to 45 years, we obtained odds ratios (OR) from mixed effect logistic regression, controlling for age, sex, education, and nonindependence of twin data.

    Results: Increased ADHD symptoms were significantly associated with increased odds for all SUD. ORs ranged between 1.33 for regular nicotine (95% confidence interval [CI] = [1.12, 1.59]); 2.54 for multiple drug use (95% CI = [2.00, 3.23]), and 3.58 for alcohol dependence (95% CI = [2.86, 4.49]).

    Conclusion: ADHD symptoms and subtypes in the population are associated with increased risks for all SUD outcomes, with no difference between ADHD subtypes, no substance preference, and no sex differences for the comorbidity. Clinicians need to consider ADHD evaluation and treatment as part of management of SUD in adults.

  • 44.
    Cederlöf, Martin
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
    Kuja-Halkola, Ralf
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Sjölander, Arvid
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
    Östberg, Per
    Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Sweden.
    Lundström, Sebastian
    Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Sweden; Gillberg Neuropsychiatry Centre, University of Gothenburg, Sweden.
    Kelleher, Ian
    Department of Psychiatry, Royal College of Surgeons in Ireland, Ireland.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
    A longitudinal study of adolescent psychotic experiences and later development of substance use disorder and suicidal behavior2017In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 181, 13-16 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: Psychotic experiences are associated with later substance use disorder and suicidal behavior, but individual psychotic experiences have not been examined in a longitudinal data set. Also, the potential dose-response relationship between these phenomena remains unknown.

    Method: Cohort study including 9242 adolescents who participated in The Child and Adolescent Twin Study in Sweden (CATSS). At ages 15 and/or 18, seven psychotic experiences (auditory and visual hallucinations, and five delusions) were assessed via questionnaires. Outcomes at follow-up were physician-assigned diagnoses of substance use disorder and suicide attempts ascertained from the Swedish Patient Register. Associations were estimated with Cox regressions and expressed as hazard ratios.

    Results: All psychotic experiences were associated with later substance use disorder and/or suicide attempts, with hazard ratios ranging from 1.6 to 3.0. A dose-response relationship was observed between psychotic experiences and later substance use disorder, and suicide attempt.

    Discussion: Auditory and visual hallucinations as well as delusions in adolescence are associated with later development of substance use disorder and suicide attempt, and there is a dose-response relationship between the load of psychotic experiences and these adverse outcomes. Clinicians should assess subclinical hallucinations as well as delusions in psychiatric evaluations of adolescents.

  • 45. Cunningham, John A.
    et al.
    Blomqvist, Jan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Koski-Jannes, Anja
    Raitasalo, Kirsimarja
    Societal images of Cannabis use: comparing three countries2012In: Harm Reduction Journal, ISSN 1477-7517, Vol. 9, 21- p.Article in journal (Refereed)
    Abstract [en]

    Background: Differences in beliefs about Cannabis were compared between Canada, Sweden and Finland using nationally representative population surveys containing similar items. Findings: Compared to Finnish and Swedish respondents, Canadians were both more likely to have tried Cannabis and to view Cannabis as a less serious problem for society. Conclusions: These findings emphasize the extent to which views about Cannabis can vary. It is possible that views about Cannabis are, at least in part, a social construction influenced by media, social policy and exposure to the drug that varies from country to country.

  • 46. Danielsson, Anna-Karin
    et al.
    Agardh, Emilie
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Allebeck, Peter
    Falkstedt, Daniel
    Cannabis use in adolescence and risk of future disability pension: A 39-year longitudinal cohort study2014In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 143, 239-243 p.Article in journal (Refereed)
    Abstract [en]

    Aims: This study aimed at examining a possible association between cannabis use in adolescence and future disability pension (DP). DP can be granted to any person in Sweden aged 16-65 years if working capacity is judged to be permanently reduced due to long-standing illness or injury. Methods: Data were obtained from a longitudinal cohort study comprising 49,321 Swedish men born in 1949-1951 who were conscripted to compulsory military service aged 18-20 years. Data on DP was collected from national registers. Results: Results showed that individuals who used cannabis in adolescence had considerably higher rates of disability pension throughout the follow-up until 59 years of age. In Cox proportional-hazards regression analyses, adjustment for covariates (social background, mental health, physical fitness, risky alcohol use, tobacco smoking and illicit drug use) attenuated the associations. However, when all covariates where entered simultaneously, about a 30% increased hazard ratio of DP from 40 to 59 years of age still remained in the group reporting cannabis use more than 50 times. Conclusions: This study shows that heavy cannabis use in late adolescence was associated with an increased relative risk of labor market exclusion through disability pension.

  • 47. Danielsson, Anna-Karin
    et al.
    Falkstedt, Daniel
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Allebeck, Peter
    Agardh, Emilie
    Cannabis use among Swedish men in adolescence and the risk of adverse life course outcomes: results from a 20 year-follow-up study2015In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 110, no 11, 1794-1802 p.Article in journal (Refereed)
    Abstract [en]

    AimsTo examine associations between cannabis use in adolescence (at age 18) and unemployment and social welfare assistance in adulthood (at age 40) among Swedish men. DesignLongitudinal cohort study. Setting and ParticipantsA total of 49321 Swedish men born in 1949-51, who were conscripted to compulsory military service at 18-20 years of age. MeasurementsAll men answered two detailed questionnaires at conscription and were subject to examinations of physical aptitude psychological functioning and medical status. By follow-up in national databases, information on unemployment and social welfare assistance was obtained. FindingsIndividuals who used cannabis at high levels in adolescence had increased risk of future unemployment and of receiving social welfare assistance. Adjusted for all confounders (social background, psychological functioning, health behaviours, educational level, psychiatric diagnoses), an increased relative risk (RR) of unemployment remained in the group reporting cannabis use >50 times [RR=1.26, 95% confidence interval (CI)=1.04-1.53] only. For social welfare assistance, RR in the group reporting cannabis use 1-10 times was 1.15 (95% CI=1.06-1.26), RR for 11-50 times was 1.21 (95% CI=1.04-1.42) and RR for >50 times was 1.38 (95% CI=1.19-1.62). ConclusionsHeavy cannabis use among Swedish men in late adolescence appears to be associated with unemployment and being in need of social welfare assistance in adulthood. These associations are not explained fully by other health-related, social or behavioural problems.

  • 48.
    Daoura, Loudin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Haaker, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Nylander, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Early environmental factors differentially affect voluntary ethanol consumption in adolescent and adult male rats2010In: Alcoholism: Clinical and Experimental Research, ISSN 0145-6008, E-ISSN 1530-0277, Vol. 34, no S3, 92A- p.Article in journal (Other academic)
  • 49.
    Daoura, Loudin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Haaker, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Nylander, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Adolescent and adult male Wistar rats exposed to postnatal maternal separation differ in voluntary ethanol intake2010In: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 20, no 1, S36- p.Article in journal (Other academic)
  • 50. Davstad, Ingrid
    et al.
    Allebeck, Peter
    Leifman, Anders
    Stenbacka, Marlene
    Romelsjö, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Self-reported drug use and mortality among a nationwide sample of Swedish conscripts - A 35-year follow-up2011In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 118, no 2-3, 383-390 p.Article in journal (Refereed)
    Abstract [en]

    Background: Drug users in clinical samples have elevated mortality compared with the general population, but little is known about mortality among users of drugs within the general population. Aim: To determine whether self-reported use of illicit drugs and non-prescribed sedatives/hypnotics among young men in the general population is related to mortality. Methods: A 35-year follow-up of 48 024 Swedish men, born 1949-1951 and conscripted in 1969/1970, among whom drug use was reported by 8767 subjects. Cross-record linkage was effected between individual data from the Swedish conscription and other national registers. Deaths and causes of death/1000 person-years were calculated. Cox PH regression was used to estimate hazard ratios (HRs) for death with 95% confidence intervals (95% CIs). An HR was calculated for users of different dominant drugs at conscription compared with non-users by age interval, after adjusting for confounders and hospitalisation with a drug-related diagnosis. Results: Drug users showed elevated mortality (HR 1.61, p < 0.05) compared with non-users. After adjusting for risk factors, users of stimulants (HR 4.41, p < 0.05), cannabis (HR 4.27, p < 0.05), opioids (HR 2.83, p > 0.05), hallucinogens (HR 3.88, p < 0.05) and unspecified drugs (HR 4.62, p < 0.05) at conscription with a drug-related diagnosis during follow-up showed an HR approaching the standard mortality ratios in clinical samples. Among other drug users (95.5%), only stimulant users showed statistically significantly increased mortality (HR 1.96, p < 0.05). Conclusions: In a life-time perspective, drug use among young men in the general population was a marker of premature death, even a long time after exposure.

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