Aim: This article examines how Swedish parents navigate the multifaceted challenges of parenthood while struggling with substance use problems, including both alcohol and illicit drugs, and societal stigma. It explores how parents present themselves as responsible caregivers while distinguishing between acceptable and harmful substance use in the context of parenting. Methods: The study uses data from unstructured 15 life story interviews, conducted over the phone or Zoom. The participants narrated their life stories related to substance use problems, covering various topics like education, relationships, and parenting. The interviews were analyzed using thematic analysis to reveal strategies used by participants to mitigate perceived harm from substance use problems, enabling them to present themselves as responsible parents. Results: Three main themes were identified: Hiding, compensating, and disappearing, focusing on time and place. The analysis shows that Swedish parents manage parenthood with substance use problems and societal stigma by concealing substance use problems and maintaining a ‘façade of normality’, often scheduling use when children are asleep. Some resort to hiding substances to create the illusion of moderation. Despite challenges, like needing alternative locations for substance use problems, parents emphasize active engagement in their children’s lives. Conclusion: This study highlights how parents with substance use problems navigate parenthood amid societal stigma, revealing their strategies and challenges. These insights are vital for healthcare professionals and policymakers crafting support interventions to address parental experiences and associated emotional burdens.

Background: Reducing risks and harms among people who inject drugs by, for example, Needle and Syringe exchange Programs (NSP) may be impeded in practice by, for example, policy restrictions, particularly in settings like Sweden where a zero-tolerance drug strategy prevails. In practice, risks and harms are produced through an interplay of multiple mutually reinforcing factors. Moreover, risk management strategies may constitute risks per se and generate new risks, potentially intensifying overall harm. This study aimed to increase our understanding of how such risks are generated in the lives of people who inject drugs. Methods: In 2022–2023, we interviewed 32 purposively selected research participants, primarily recruited through the Stockholm NSP. Drawing on actor-network theory, we analyzed the interviews to identify factors—constituent human and non-human actors—that constitute and generate risk and harm. These dynamics were conceptualized as risk-amplifying loops, in which harms are contingently enacted, may multiply, and the effects of policy and practice may become unintentional and unpredictable. Results: Four risk-amplifying loops were inductively elucidated: the Service deficit, Perpetrator-victim, Deprivation, and Solitude loops. In each, two actors—the drug and the person who injects drugs—were constituted differently. Furthermore, the loops were interlinked and more fully understood in relation to one another, forming a network that reflected the broader environment of injection drug use (IDU) in Sweden. Each loop was shaped and co-constituted by the prohibitionist framing of Swedish drug policy influencing access to services, the drug market, and the position of people who use drugs. Conclusions: Understanding drug-related harms as risk-amplifying loops highlights the emergent effects of the multiple and unfolding risks in the lives of people who inject drugs. This perspective facilitates discussion of impediments to effective harm reduction practices and points to potential sites for countermeasures and policy reform.

Abstract

Background: The article demonstrates how substance use can enhance capacities for action in various everyday practices and function as a productive force rather than simply a risky and harmful activity.

Methods: The data set comprises 33 life story interviews in which the participants self-identified as having experienced an addiction to substances. The data was analyzed as ‘counter-narratives’ by drawing on actor-network theory.

Results: The analysis identified four typical variants of how substance use can increase capacities for action. First, substance use can initially enhance the capacities to achieve life goals and then transform into a mediator thatstrengthens attachments to normal daily activities. Secondly, substance use can become linked to serving mutually reinforcing trajectories in everyday life: assisting breaks from worries, reinforcing daily continuity, andadvancing life goals. Third, substance use can enable a sudden change in life direction by facilitating a radical transition to a new reality and subsequently stabilizing it. Fourth, substance use can evolve into a mediator that divides life into two assemblages: one that enables fulfillment of daily responsibilities and another that mediates freedom to pursue pleasure.

Conclusion: Generating knowledge about the relations, assemblages, and trajectories in which substance use actsas a productive force and identifying when and how it can become a mediator that limits, threatens, or impedesthe capacities of actors to live functional lives provides important information for health professionals andpractitioners. Such knowledge will deepen their understanding of the elements on which their prevention andtreatment efforts should focus.

Young People, Alcohol, and Risk theorises the social, cultural and economic shifts that have underpinned significant declines in young people’s drinking in high-income countries. Since the early 2000s, alcohol use among young people has declined significantly in most high-income countries. Situated within a theoretical framework of ‘social generations’ and ‘risk’, this book explores the key interrelated factors that have cumulatively shifted the social and cultural position of alcohol for young people in these countries. Drawing on interviews and survey data from the authors’ research in Australia, Sweden and the UK, as well as the broader international literature, the book explores the importance of changes in attitudes to alcohol, shifting family and parenting practices, digital technology use and changes in leisure practices, neoliberalism and individualism, health and wellbeing, and gendered practices. These factors have made salient the notion of risk for young people, resulting in a culture of caution. This book will be of interest to students and scholars across the social sciences, in particular those studying substance use, youth sociology, cultural studies and public health. It will be of use to policy makers and practitioners working with young people.

Greater use of communication technologies among young people, including mobile phones, social media and communication apps, has coincided with declines in youth alcohol use in many high-income countries. However, little research has unpacked how drinking as a practice within interconnected routines and interactions may be changing alongside these technologies. Drawing on qualitative interviews about drinking with young people aged 16–23 across three similar studies in Australia, the United Kingdom and Sweden, we identify how communication technologies may afford reduced or increased drinking. They may reduce drinking by producing new online contexts, forms of intimacy and competing activities. They may increase drinking by re-organising drinking occasions, rituals and contexts. And they may increase or reduce drinking by enabling greater fluidity and interaction between diverse practices. These countervailing dynamics have likely contributed to shifting drinking patterns and practices for young people that may be obscured beneath the population-level decline in youth drinking.

Background and aims: Sweden has experienced a substantial decrease in adolescent drinking over the past decades. Whether the reduction persists into early adulthood remains unclear. Using survey data, the present study aimed to determine whether reductions in indicators of alcohol use observed among adolescents remain in early adulthood and whether changes in alcohol intake are consistent among light/moderate and heavy drinkers.

Design: Data from the Swedish monthly Alcohol Monitoring Survey (2001–20) were used to construct five 5-year birth cohorts (1978–82, 1983–87, 1988–92, 1993–97 and 1998–2002).

Setting: Sweden.

Participants: A total of n = 52 847 respondents (48% females) aged 16 and 30 years were included in this study.

Measurements: For both males and females, temporal changes in the prevalence of any drinking, the prevalence of heavy episodic drinking (HED) and total alcohol intake in the past 30 days in centilitres were analysed.

Findings: The prevalence of any drinking in more recent cohorts remained low until young people came into their early (females) and mid- (males) 20s. Male cohorts differed in the prevalence of HED across age, with the later cohorts showing lower odds than earlier cohorts (odds ratios between 0.54 and 0.66). Among females, no systematic differences between cohorts across age could be observed. Later male birth cohorts in light/moderate drinkers had lower alcohol intake than earlier cohorts (correlation coefficients between −0.09 and −0.54). No statistically significant cohort effects were found for male heavy drinkers. Although differences in alcohol intake among females diminished as age increased, the cohorts did not differ systematically in their level of alcohol intake.

Conclusions: In Sweden, the reduced uptake of drinking in adolescents appears to fade as people move into adulthood. Observed reductions in alcohol intake among light and moderate drinkers appear to persist into adulthood. More recent male cohorts show a lower prevalence rate of heavy episodic drinking.

Introduction: To examine gender differences in drinking habits among Swedish ninth graders over the period 1989–2021.

Methods: Annual school surveys with nationally representative samples of ninth-grade students in Sweden covering the period 1989–2021, total sample of 180,538 students. Drinking habits were measured with self-reports of frequency and quantity of use and frequency of heavy episodic drinking. Differences between genders were compared annually and differences were tested using logistic and ordinary least square regression models with cluster robust standard errors.

Results: Small gender differences in the prevalence of alcohol use during the first part of the study period were followed by an increasing gap over the past decade with girls being more likely to drink alcohol than boys. Boys consumed larger amounts of alcohol than girls during the first three decades of the studied period but no gender differences were found in later years. Binge drinking was more prevalent among boys during 1989 to 2000 but no systematic gender difference was found during the past 15 years.

Discussion and Conclusions: There used to be clear gender differences in drinking habits among ninth graders in Sweden with boys drinking more than girls. This gap has narrowed over the past three decades and among contemporary adolescents, no gender differences are found neither in binge drinking nor volume of drinking and the prevalence of drinking is even higher among girls.

Background. Drug policy is prone to build on rationales based on different moralities rather than evidence. Less is known about how moralities influence drug policy implementation in practice. The aim was to analyze expressions of moralities among local policy-makers, professionals, and drug users in the context of the Stockholm needle and syringe exchange program (NSP).

Methods. Using political documentation from Stockholm (2003–2016), focus group (12 NSP staff), and 32 drug user interviews, moralities concerning drug policy and harm reduction were analyzed based on moral foundations theory and boundary work.

Results. Three main moral dilemmas were identified concerning the subjects, aims, and orientation of drug policy: whether drug users are worthy of inclusion to society; if the general public should be prioritized or the health of drug users, and the orientation of practices as based on control or autonomy. Policy debate was driven by virtues such as purity and authority, whereas staff and drug users valued care, fairness and liberty.Conclusions. The prohibitionist and abstinence-oriented Swedish drug policy has created social boundaries on the practice-level. Hence, users’ perspectives, and those who care about them, should be extensively involved in political discussions to foster a more moral and humane drug policy.

This study analyzes how emerging adults negotiate their relation to alcohol in the context of declining youth drinking and how this relationship changes over time. The sample consists of longitudinal qualitative interview data (N = 28) with 9 boys and 19 girls aged 15 to 21. The participants were recruited through schools, social media and non-governmental organizations from mainly the Stockholm region and smaller towns in central Sweden to reach a heterogeneous sample in terms of sociodemographic factors and drinking practices. We interviewed the participants in-depth three times between 2017 and 2019. Thematic coding of the whole data with NVivo helped us select four cases for more detailed analysis, as they represented the typical trajectories and showed the variation in the material. We used the master narrative framework and Bamberg’s narrative positioning analysis to examine the data. The analysis demonstrates what kinds of narrative alignments in identity development encourage heavy drinking, moderate alcohol consumption, and fuel abstinence. The results suggest that the decline in youth drinking is produced by a co-effect of multiple master narratives that intersect and guide the identity development away from heavy drinking.

It has been suggested that a pivotal explanation for the drastic decrease in young people’s alcohol consumption is the younger generations concern with taking responsibility for a variety of areas in their lives. Emanating from this, the overall aim of this article is to consider how alcohol and drinking situations are enacted among a group of emerging adults in Sweden from this ‘generation sensible’, and how they describe the relation between alcohol, pleasure and control. The study is based on 23 qualitative interviews with people aged 19–23. Inspired by assemblage theory we analyzed how important human and non-human elements congregate in described drinking situations. The analysis showed that alcohol is enacted as a strong psychoactive substance and described like other (illegal) drugs, rather than being seen as more harmless and acceptable. Pleasure in drinking is made possible through control and planning, and in downplaying the importance of drinking and the transgressive power of intoxication. We suggest that the risk-taking element in drinking is stigmatized among groups of emerging adults. It is concluded that while alcohol is described as unimportant to several participants, alcohol assemblages are not, therefore participants work hard to shape drinking situations to counteract loss of control.