This article explores howself-choice and treatment-entry pressuresare associated with one-year treatment outcome (dependencesymptoms, 0–6, 12 months) among alcohol and drugmisusers, respectively. Informal pressures (from family andfriends), formal pressures (related to work, healthcare, socialservices, social allowances, child custody) and legal pressures(related to the police, criminal justice system, compulsorytreatment) were analysed.A sample (N = 1,210) representativeof the addiction treatment system of Stockholm County wasinterviewed when starting a new treatment episode and afterone year. Regression analyses indicated that self-choice andpressures are associated with outcome among alcohol misusersbut not among drug misusers when controlling for backgroundfactors and severity. Self-choice (without pressures) correlatedwith a good outcome (a lower number of dependence criteria).Pressures were generally associated with poorer outcome.Alcohol misusers who had experienced threats regarding childcustody did better in comparison with those not experiencingsuch pressure. The difference in results by drug type andimplications were discussed.