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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, p. 371-396Article 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.
    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, p. 240-245Article 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.

  • 3. 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, E-ISSN 1747-597X, Vol. 8, p. 10-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.

  • 4.
    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: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 32, no 2, p. 109-132Article 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.

  • 5.
    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, p. 629-637Article 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.

  • 6. 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, p. 36-42Article 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.

  • 7. 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, p. 117-118Article in journal (Refereed)
  • 8.
    Axelsson, Martin
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    HR-medarbetares upplevelser kring spelprevention och policyimplementering på arbetsplatsen2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The complex concept regarding harmful use of different nature, could be related to the use of alcohol, drugs or gambling. Such activities could affect the efficiency and productivity of an employee in a workplace environment in a negative way. At the request of the Public Health Agency of Sweden, a group of scientist was given the task to evaluate a project regarding education concerning problematic gambling. The purpose of the current study is to evaluate a project regarding education concerning gambling and gambling prevention, and was carried out by the organization Alna. Thematic analysis was used and collection of data was done with semi structured interviews, with ten HR-employees whose five organisations was included in the project Gambling and gambling preventive efforts directed towards the labour market. The results show that the methods and tools used by Alna is perceived as efficient and valuable by the participants. Some obstacles which works against efficient implementation of updated policies and guidelines were identified and these could consist of time constraints, under staffing or subordinated priority of the gambling issue per se. Furthermore it seems that the education project regarding gambling prevention performed by Alna has contributed to the development of policies and guidelines regarding harmful use of different kinds with focus on the gambling issue.  

  • 9.
    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, p. 15-22Article 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.

  • 10. 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, p. 189-199Article 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.

  • 11.
    Bergmark, Anders
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    The role of psychopathology as motivator for drug dependency—some moderating remarks2013In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 4, p. 673-674Article in journal (Refereed)
  • 12. 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, p. 97-105Article 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.

  • 13. 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.

  • 14. Bloomfield, Kim
    et al.
    Grittner, Ulrike
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Piontek, Daniela
    Drinking patterns at the sub-national level: What do they tell us about drinking cultures in European countries?2017In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 34, no 4, p. 342-352Article in journal (Refereed)
    Abstract [en]

    Aim:

    A drinking pattern is not only a major drinking variable, but is also one indicator of a country's drinking culture. In the present study, we examine drinking patterns within and across the neighbouring countries of Denmark and Germany. The aim of the research is to determine to what extent drinking patterns differ or are shared at the sub-national level in the two countries.

    Method:

    Data came from the German 2012 Epidemiological Survey of Substance Use (n = 9084) 18-64 years (response rate 54%), and the Centre for Alcohol and Drug Research's 2011 Danish national survey (n = 5133) 15-79 years (response rate 64%), which was reduced to a common age range, producing a final n = 4016. The drinking pattern variable included abstention, moderate drinking, heavy drinking, risky single occasion drinking (RSOD), and was investigated with bivariate statistics and gender-specific hierarchical cluster analysis.

    Results:

    For men three clusters emerged: one highlighting abstention and RSOD, moderate/heavy drinking, RSOD and RSOD + heavy drinking. For women, two clusters appeared: one highlighting abstention and moderate/heavy drinking and the other highlighting RSOD and RSDO + heavy drinking. The clusters revealed different geographical patterning: for men, a west vs. east divide; for women, a north-south gradient.

    Conclusions:

    The analysis could identify for each gender clusters representing both separate and shared drinking patterns as well as distinctive geographical placements. This new knowledge can contribute to a new understanding of the dynamics of drinking cultures and could indicate new approaches to prevention efforts and policy initiatives.

  • 15.
    Bogren, Alexandra
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Alcohol short-circuits important part of the brain': Swedish newspaper representations of biomedical alcohol research2017In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 25, no 3, p. 177-187Article in journal (Refereed)
    Abstract [en]

    The media has a central role in communicating and constructing health knowledge, including communicating research findings related to alcohol consumption. However, research on news reporting about alcohol is still a relatively small field; in particular, there are few studies of the reporting of biomedical alcohol and drug research, despite the assumed increasing popularity of biomedical perspectives in public discourse in general. The present article addresses the representational `devices' used in Swedish press reporting about biomedical alcohol research, drawing on qualitative thematic analysis of the topics, metaphors, and optimist versus critical frames used in presenting biomedical research findings. In general, the press discourse focuses on genetic factors related to alcohol problems, on the role of the brain and the reward system in addiction, and on medication for treating alcohol problems. Metaphors of `reconstruction' and `reprograming' of the reward system are used to describe how the brain's function is altered in addiction, whereas metaphors of `undeserved reward' and `shortcuts' to pleasure are used to describe alcohol's effects on the brain. The study indicates that aspects of the Swedish press discourse of biomedical alcohol research invite reductionism, but that this result could be understood from the point of view of both the social organization of reporting and the intersection of reporting, science, and everyday understandings rather than from the point of view of the news articles only. Moreover, some characteristics of the media portrayals leave room for interpretation, calling for research on the meanings ascribed to metaphors of addiction in everyday interaction.

  • 16. Bowden, Jacqueline A.
    et al.
    Delfabbro, Paul
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Miller, Caroline L.
    Wilson, Carlene
    Prevalence, perceptions and predictors of alcohol consumption and abstinence among South Australian school students: a cross-sectional analysis2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, article id 549Article in journal (Refereed)
    Abstract [en]

    Background: Alcohol consumption by young people (particularly early initiation) is a predictor for poorer health in later life. In addition, evidence now clearly shows a causal link between alcohol and cancer. This study investigated prevalence, predictors of alcohol consumption among adolescents including perceptions of the link between alcohol and cancer, and the role of parents and peers. Methods: A sample of Australian school students aged 12-17 years participated in a survey (n = 2885). Logistic regression analysis was undertaken to determine predictors. Results: Alcohol use increased with age and by 16, most had tried alcohol with 33.1% of students aged 12-17 reporting that they drank at least occasionally (95% CI = 31.0-35.2). Awareness of the link between alcohol and cancer was low (28.5%). Smoking status and friends' approval were predictive of drinking, whereas parental disapproval was protective. Those aged 14-17 who did not think the link between alcohol and cancer was important were more likely to drink, as were those living in areas of least disadvantage. The only factors that predicted recent drinking were smoking and the perception that alcohol was easy to purchase. Conclusions: An education campaign highlighting the link between alcohol and cancer may have positive flow-on effects for young people, and schools should incorporate this messaging into any alcohol education programs. Consideration should be given to factors that serve to regulate under-aged accessibility of alcohol.

  • 17. 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, E-ISSN 2063-5303, Vol. 3, no 3, p. 189-198Article 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.

  • 18. 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, p. 130-137Article 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.

  • 19. 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, p. 401-406Article 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.

  • 20. 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, p. 25-32Article 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.

  • 21. 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, p. 612-619Article 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.

  • 22. 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 M.
    How much alcohol is consumed outside of the lifetime risk guidelines in Australia?2018In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 37, no 1, p. 42-47Article in journal (Refereed)
    Abstract [en]

    Introduction and Aims. This study aims to estimate the prevalence of long-term risky drinking within the Australian population and the proportion of standard drinks that is consumed outside of the long-term risk (LTR) guidelines of two Australian standard drinks (ASD) per day.

    Design and Methods. Recruited by phone, 2020 Australian adults with an oversampling of risky drinkers were asked detailed questions about how much alcohol they consumed at a range of locations in 2013. Descriptive statistical analyses of data weighted to be representative of the Australian adult population were undertaken, with a focus on the ASD consumed above the LTR guidelines.

    Results. Although 28% of respondents drink at levels above the LTR drinking guidelines, 56% of all ASD consumed are above the two per day recommended to reduce LTR. Three-quarters of cask wine and liqueurs were consumed outside of the LTR guidelines, as were 58% of all ASD consumed in the home, similar to the proportion of ASD consumed above the guidelines in pubs (55%).

    Discussion and Conclusions. While the minority of Australians drink to LTR levels, the majority of alcohol is consumed by long-term risky drinkers. More research and policy focus on the patterns of alcohol consumption that lead to long-term risk, particularly outside of licensed premises, is required.

  • 23. 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, p. 227-234Article 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.

  • 24. 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, p. 647-653Article 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.

  • 25. 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, E-ISSN 1477-7517, Vol. 9, p. 21-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.

  • 26. Dahlberg, Mikael
    et al.
    Anderberg, Mats
    Wennberg, Peter
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Psychometric properties of the UngDOK: A structured interview for adolescents with substance-use problems2017In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, Vol. 34, no 2, p. 160-172Article in journal (Refereed)
    Abstract [en]

    Aim: This article describes and discusses the Swedish UngDOK interview and its psychometric properties. Method: The study is based on empirical data from 1633 intake interviews collected by 15 units in ten cities and focused primarily on the two central sections of intake form: alcohol and drug use and mental health. The statistical analyses concern internal consistency, test-retest reliability, discriminant validity and internal non-response. Results: The reliability of AUDIT-C and the mental health domain was good with regard to both internal consistency and test-retest. The test-retest values were generally satisfactory, except for frequency of drug use and association with peers who use drugs. The discriminant validity shows that the interview clearly distinguishes adolescents with more profound problems from a group with milder problems and that a minor degree of inconsistency and non-response bias may occur in empirical material based upon self-reported information. Conclusion: The study showed that the psychometric properties of the UngDOK interview are generally satisfactory and may be regarded as a valuable option for practices engaged in treating adolescents with substance-use problems.

  • 27. 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, p. 239-243Article 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.

  • 28. 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, p. 1794-1802Article 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.

  • 29. Danielsson, Anna-Karin
    et al.
    Wennberg, Peter
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Hibell, Björn
    Romelsjö, Anders
    Alcohol use, heavy episodic drinking, and subsequent problems among adolescents in 23 European countries: does the prevention paradox apply?2012In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 107, no 1, p. 71-80Article in journal (Refereed)
    Abstract [en]

    Aims  According to the prevention paradox, a majority of alcohol-related problems in a population can be attributed to low to moderate drinkers simply because they are more numerous than heavy drinkers, who have a higher individual risk of adverse outcomes. We examined the prevention paradox in annual alcohol consumption, heavy episodic drinking (HED) and alcohol-related problems among adolescents in 23 European countries.

    Design and setting  Survey data from the 2007 European School Survey Project on Alcohol and Drugs (ESPAD) among 16-year-old students were analysed.

    Participants  A total of 38 370 alcohol-consuming adolescents (19 936 boys and 18 434 girls) from 23 European countries were included.

    Measurements  The upper 10% and the bottom 90% of drinkers by annual alcohol intake, with or without HED, and frequency of HED, were compared for the distribution of 10 different alcohol-related problems.

    Findings  Although the mean levels of consumption and alcohol-related problems varied largely between genders and countries, in almost all countries the heavy episodic drinkers in the bottom 90% of consumers by volume accounted for most alcohol-related problems, irrespective of severity of problem. However, adolescents with three or more occasions of HED a month accounted for a majority of problems.

    Conclusions  The prevention paradox, based on measures of annual consumption and heavy episodic drinking, seems valid for adolescent European boys and girls. However, a minority with frequent heavy episodic drinking accounted for a large proportion of all problems, illustrating limitations of the concept. As heavy episodic drinking is common among adolescents, our results support general prevention initiatives combined with targeted interventions.

  • 30. 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, p. 383-390Article 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.

  • 31. de Matos, Elena Gomes
    et al.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Pabst, Alexander
    Piontek, Daniela
    Does a Change Over All Equal a Change in All? Testing for Polarized Alcohol Use Within and Across Socio-Economic Groups in Germany2015In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 50, no 6, p. 700-707Article in journal (Refereed)
    Abstract [en]

    This study aimed at testing whether drinking volume and episodic heavy drinking (EHD) frequency in Germany are polarizing between consumption levels over time. Polarization is defined as a reduction in alcohol use among the majority of the population, while a subpopulation with a high intake level maintains or increases its drinking or its EHD frequency. The polarization hypothesis was tested across and within socio-economic subgroups. Analyses were based on seven cross-sectional waves of the Epidemiological Survey of Substance Abuse (ESA) conducted between 1995 and 2012 (n = 7833-9084). Overall polarization was estimated based on regression models with time by consumption level interactions; the three-way interaction with socio-economic status (SES) was consecutively introduced to test the stability of effects over socio-economic strata. Interactions were interpreted by graphical inspection. For both alcohol use indicators, declines over time were largest in the highest consumption level. This was found within all SES groups, but was most pronounced at low and least pronounced at medium SES. The results indicate no polarization but convergence between consumption levels. Socio-economic status groups differ in the magnitude of convergence which was lowest in medium SES. The overall decline was strongest for the highest consumption level of low SES.

  • 32. Dietze, Paul
    et al.
    Agius, Paul A.
    Livingston, Michael
    Callinan, Sarah
    Jenkinson, Rebecca
    Lim, Megan S. C.
    Wright, Cassandra J. C.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Correlates of alcohol consumption on heavy drinking occasions of young risky drinkers: event versus personal characteristics2017In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 112, no 8, p. 1369-1377Article in journal (Refereed)
    Abstract [en]

    Aims Risky single-occasion drinking (RSOD) by young people is a serious public health issue, yet little is known about the specific circumstances of risky drinking occasions. This study examined the independent effects of event- and individual-specific variables on RSOD. Design Longitudinal cohort study measuring self-reported RSOD and event- and individual-specific variables across two drinking occasions approximately 1 year apart. Setting Metropolitan Melbourne, Australia. Participants A sample of 710 young risky drinkers aged between 18 and 25years and defined as engaging in risky drinking practices (males: consumed alcohol in excess of 10 Australian Standard Drinks (ASD: 10g ethanol) in a single occasion in the previous year; females: consumed alcohol in excess of seven ASD for females in a single occasion in the previous year). Measurements Random digit-dial telephone landline survey of the most recent heavy drinking occasion and socio-demographic variables. The primary outcome was the log of the total drinks consumed in the most recent heavy drinking occasion. Event-specific (e.g. number of drinking locations) and time-varying (e.g. weekly income) and time-invariant (e.g. sex) individual-specific variables were examined as correlates of total drinks consumed. Findings Changes in event-specific characteristics including the length of the drinking occasion (Likelihood Ratio (2)(2)=24.4, P<0.001), the number of drinking locations (Wald (2)((1))=7.6, P=0.006) and the number of different drink types (Wald (2)((1))=13.6, P<0.001) were associated with increases in total drinks consumed, after adjustment for time-invariant and time-variant individual-specific variables such as gender, income level and weekly consumption. Few other effects were noted. Conclusions Event-specific characteristics are important predictors of the number of drinks consumed during risky single occasion drinking (RSOD) and illustrate the importance of event contexts when considering interventions targeting RSOD. The total number of drinks consumed in a RSOD session appears to rise independently with the duration of the drinking event, the number of drinking locations and the number of different types of beverage consumed.

  • 33.
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Alkoholen som katalysator2016In: Ikaros, ISSN 0782-6052, Vol. 13, no 1-2, p. 17-19Article in journal (Refereed)
  • 34.
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    An all-embracing problem description: the Swedish drug issue as a political catalyst 1982–20002013In: International journal on drug policy, ISSN 0955-3959, E-ISSN 1873-4758, Vol. 24, no 6, p. 558-565Article in journal (Refereed)
    Abstract [en]

    Background: This article examines the political formulation and ideological solution of the Swedish drugproblem in 1982–2000. How was the drug problem described in the Swedish parliament at the time? Howserious was the problem and what solutions were proposed? What were the ideological implications ofthe problem description, and how was the general political and ideological solution formulated?

    Methods: The empirical basis for the textual analysis consists of parliamentary bills, government bills andparliamentary records discussing the drug issue during the years 1982–2000.

    Results: In the prevailing spirit of consensus in the Swedish parliament at the time, both left-wing andright-wing parties portrayed drugs as a threat to the nation, people and the welfare state. Still, as theideological dimension kept growing stronger, the drug question functioned even better as an arena forpolitical discussions and ideological positions than in the 1970s.

    Conclusion: Compared to previous decades, the problem description broadened during the 1980s and1990s, and the drug problem could be used to support arguments on almost any topic. The drug problembecame a highly politicized issue about whom or what to change when the individual and the societyclashed, but also about what the individual and/or society should be changed into.

  • 35.
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Harm to others – rediscovered or eternal?2016In: Nordic Studies on Alcohol and Drugs, ISSN 1458-6126, Vol. 33, no 5-6, p. 479-482Article in journal (Refereed)
  • 36.
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Researchers should avoid conceptual banalization2016In: Nordic Studies on Alcohol and Drugs, ISSN 1458-6126, Vol. 33, no 2, p. 119-122Article in journal (Other academic)
  • 37.
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Transnational Nationalism and Idealistic Science: The Alcohol Question between the Wars2016In: Social history of medicine, ISSN 0951-631X, E-ISSN 1477-4666, Vol. 29, no 3, p. 590-610Article in journal (Refereed)
    Abstract [en]

    This article studies the interwar international conferences on the alcohol problem. How did they view the alcohol problem and its causes; what were the consequences for the individual and the society as a whole; and which solutions merited discussion? The first post-war conferences enjoyed an optimistic and internationalistic atmosphere, added to by American prohibition, which had given the temperance movement plenty to be hopeful about. But when the 1920s turned to the 1930s, the conferences were transformed into arenas for national solutions and into outright propaganda pieces. The responses to the alcohol problem debated in the interwar conferences built on a combination of scientifically masked ideological conviction and ideologically inspired passion for science. The apparently neutral ethics of such thinking was manifested in various radical measures to combat alcohol abuse.

  • 38.
    Edman, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Berndt, Josefine
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    From boredom to dependence: The medicalisation of the Swedish gambling problem2016In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 33, no 1, p. 81-110Article in journal (Refereed)
    Abstract [en]

    AIMS - The aim of this study is to investigate the medicalising of gambling problems by comparing the political discussions on gambling in the Swedish Parliament in the early 1970s and the early 2010s. DESIGN - Against a theoretical background on medicalising processes in general, and medicalisation of gambling problems in particular, we have analysed discussion protocols and parliamentary bills in the Swedish Parliament from the years 1970-1975 and 2012-2013. RESULTS - The problem descriptions of the 1970s and 2010s are, in certain respects, strikingly similar, identifying proactive operators such as the gambling companies and highlighting an inadequate legal framework. But where the MPs of the 1970s put some effort into describing the drab society which fed the need for gambling, the elected representatives of the 2010s shortcut to individual dependence. CONCLUSIONS - EU membership and the development of the Internet have made effective control and regulation impossible in the early 2010s and the political handling of the Swedish gambling problem is therefore a clear example of how market liberalisation can pave the way for individualisation, medicalisation and depoliticisation of social problems.

  • 39.
    Edman, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Olsson, Börje
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    The Swedish drug problem: conceptual understandingand problem handling, 1839–20112014In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 31, no 5-6, p. 503-526Article in journal (Refereed)
    Abstract [en]

    AIM – To analyse the Swedish drug question by examining dominant concepts used to portray theproblem in the years 1839–2011. Theoretically, we understand these concepts as ideological toolsthat shape the political initiatives and administrative efforts to deal with the problem. The studyis based on two kinds of source material: articles in medical journals from the years 1839–1964and public reports on vagrancy, the alcohol problem, mental health and the drug problem fromthe years 1882–2011.

    FINDINGS – During the nineteenth century and the first part of the twentieth century the drugproblem remained an individual problem handled by doctors. When the Swedish drug problemwas established as a political question from the 1960s on, it also came to disengage itself from themedical frame of understanding. Medically oriented descriptions of “dependence” and “addiction”have appeared adequate or attractive when, for example, the socially motivated coercive treatmentsolution has been discredited (as in the 1970s), when there has been a desire to connect with aninternationally accepted terminology (as in the 1990s) or when a new organisational model with astronger professional support has been on the agenda (as in the 2010s). But otherwise the socialproblem description has called for concepts that have more or less explicitly dissociated themselvesfrom speculations in physiological or psychological predispositions for substance abuse.

  • 40.
    Edman, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Stenius, Kerstin
    Conceptual carpentry as problem handling: The case of drugs and coercive treatment in social democratic welfare regimes2014In: International journal on drug policy, ISSN 0955-3959, E-ISSN 1873-4758, Vol. 25, no 2, p. 320-328Article in journal (Refereed)
    Abstract [en]

    Background: The drug and alcohol fields are characterised by continuous contestations of key concepts and the competing uses of concepts by various actors, in different geographies and over time. This study investigates the political processes leading to legislation enabling coercive treatment of (non-psychotic) drug users in Finland and Sweden from the 1950s until the early 1980s. The drug treatment policies are analysed through conceptual changes and innovations. Methods: The article analyses conceptual discussions in public reports in Finland and Sweden, focusing on the work preceding the first legislations where both alcohol and drug treatment were included (in Finland 1961, in Sweden 1982). Theories from conceptual history are applied. Results: The Finnish and Swedish discussions carry arguments from two periods of the Nordic welfare state: in an early development stage and a fragile situation in Finland, and in a more mature and affluent time in Sweden. The paternalistic arguments vary over time and between countries. Still, in both countries and time periods, the view of the drug problem as a youth issue, as particularly enslaving and on society's obligation to protect drug using individuals from damaging their future give enough motivation for coercive treatment. The conceptual work included avoidance of certain terms but in other cases, a broadening of their meaning, to adopt them to the political goals. Conclusion: Close analyses of conceptual history can reveal new features of drug policy struggles and show how central concepts in drugs and alcohol field are continuously contested.

  • 41.
    Ekendahl, Mats
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Danish heroin prescription in Swedish print media: exploring the silent agreements of harm reduction and zero tolerance2012In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 20, no 5, p. 423-434Article in journal (Refereed)
    Abstract [en]

    Sweden's response to drug problems has long been governed by zero tolerance, as manifested by the motto 'a drug-free society' and the criminalisation of drug use. In this context, the legitimacy of methadone maintenance treatment and other interventions often depicted as harm reduction has been questioned. This highlights that solutions to drug problems are circumscribed by culture-specific ideologies and definitions of reality that are articulated in different discourses. The study aims to elucidate how Denmark's decision in 2008 to launch heroin prescription (a controversial form of maintenance treatment) was addressed in Swedish print media, and identify how key concepts such as 'heroin users' and 'treatment' were attributed with meaning. In order for the analysis to go beyond apparent differences between the discourses of harm reduction and zero tolerance, specific interest was placed in constructions that were shared by protagonists on the issue of heroin prescription. The data encompasses 29 articles (news agency announcements plus daily press) that were analysed with focus on binary oppositions and then coded thematically. Four themes were identified: 'Users as passive victims'; 'Methadone as benchmark'; 'Treatment as necessity' and 'Swedish drug policy as unique'. These themes appear as presuppositions, or silent agreements, that precede different understandings of heroin prescription in Swedish press. It is concluded that the media representations reproduced traditional constructions of heroin users as victims in need of society's help. The relevance of characterising heroin prescription as a 'new way' of handling heroin dependence problems is discussed.

  • 42.
    Enefalk, Hanna
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Swedish alcohol consumption on the threshold of modernity: Legislation, attitudes, and national economy ca 1775-18552013In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 2, p. 265-274Article in journal (Refereed)
    Abstract [en]

    Aims: We aimed to map the context of the large increase in vodka consumption in Sweden during the transition from early modern to modern times (ca 1775-1855). What were the attitudes to alcohol among the groups that dominated society, and how did these attitudes relate to contemporary legislation and socio-economic change?

    Methods: Qualitative analysis of diaries and memoirs. Information was also collected from legislation, writings of the temperance movement, and previous research.

    Findings: During the period studied, attitudes to alcohol among the socio-economic elite were positive if the drinker was a person of standing, wereas drinking among the working population was scorned and, from the 1830s on, a cause for concern. Legislation was characterized by frequent and radical changes. Consumption levels are difficult to estimate: in the 1820s, agricultural overproduction, liberal legislation and improved distilling methods probably resulted in a major consumption increase. In 1846-53, permissive licensing laws and the industrialization of distilling similarly led to very high consumption levels.

    Conclusions: In Sweden in the late 18th and early 19th centuries the social elite appears to have used alcohol as a tool in their negotiations with the working population; but later, as the spread of wage labour and cheap vodka coincided with Sweden's largest ever population growth, the view that popular drinking must be checked gained support in leading circles.

  • 43. Frankl, My
    et al.
    Philips, Björn
    Wennberg, Peter
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Psychotherapy role expectations and experiences Discrepancy and therapeutic alliance among patients with substance use disorders2014In: Psychology and Psychotherapy: Theory, Research and Practice, ISSN 1476-0835, E-ISSN 2044-8341, Vol. 87, no 4, p. 411-424Article in journal (Refereed)
    Abstract [en]

    ObjectivesThe main aim of the study was to examine how the discrepancy between role expectations prior to psychotherapy and experiences of ongoing psychotherapy related to therapeutic alliance. We hypothesized that a similarity between patient role expectations and experiences would be associated with a stronger alliance. The study also examined whether different dimensions of psychotherapy role expectations predicted retention in psychotherapy. DesignA naturalistic study design was used with data collected prior to therapy and during the first 6months of therapy. MethodPatients with substance use disorders completed the Psychotherapy Expectation Questionnaire-short version (PEX-S) at the time of therapy assessment. A subsample of these patients (n=41; n=24 in individual therapy and n=17 in group therapy) provided data from therapy including psychotherapy experiences (also measured with PEX-S) and therapeutic alliance, measured with Working Alliance Questionnaire-short version. ResultsFor patients in group therapy, discrepancy between role expectations and experiences correlated negatively with alliance. Expectations prior to psychotherapy characterized by defensiveness correlated negatively with therapy retention. ConclusionThe finding that disconfirmation of patients' role expectations in group therapy were associated with weaker therapeutic alliance highlights the importance of discussing psychotherapy expectations at an early stage in treatment. Expectations characterized by defensiveness predicted worse retention in psychotherapy, which indicates that the PEX-S can be helpful in detecting patients at risk for dropout. Practitioner points <list list-type=bulleted> In targeting a patient's role expectancies prior to treatment, possible discrepancies between patient and therapist are made visible and possible to examine. Clarifying the patient's role expectations and the therapist's rationale might be a first step towards establishing a strong working alliance. Surveying the patient's defensiveness tendencies at the beginning of therapy offers a chance to discuss possible fears and other obstacles concerning therapy. Discrepancy between the patient's role expectations prior to treatment and their actual experiences of psychotherapy render valuable information that can be of use in the therapy process. <doi origin=wiley registered=yes>10.1111/(ISSN)2044-8341</doi

  • 44. Friedrichs, Anke
    et al.
    Silkens, Anna
    Reimer, Jens
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institute for Therapeutic Research Munich, Germany.
    Scherbaum, Norbert
    Piontek, Daniela
    Röhrig, Jeanette
    Hempleman, Jochen
    Härter, Martin
    Buchholz, Angela
    Role preferences of patients with alcohol use disorders2018In: Addictive Behaviours, ISSN 0306-4603, E-ISSN 1873-6327, Vol. 84, p. 248-254Article in journal (Refereed)
    Abstract [en]

    Aims

    Shared decision making (SDM) is increasingly demanded in medical decision making. SDM acknowledges patients' role preferences in decision making processes. There has been limited research on SDM and role preferences in substance use disorders; results are promising. Aim of this study was to investigate role preferences of patients with alcohol use disorders (AUD), and to identify predictors of these preferences.

    Method

    Cross-sectional data collected from June 2013 to May 2014 in four detoxification wards in Germany during a randomised controlled trial (RCT, Registration Code O1GY1114) was analysed. Of the 250 patients with AUD who were included in the RCT, data from 242 patients [65% male; mean age = 45.2 years (sd = 10.3)] were analysed. Participants' role preferences were assessed with the Control Preference Scale. Potential correlates were drawn from instruments used in the RCT; multinomial logistic regression was used.

    Results

    90% (n = 217) of the AUD patients preferred an active or shared role in decision-making, 10% (n = 25) preferred a passive role. Patients' desire for help was associated with their role preference (OR = 3.087, p = .05). The model's goodness of fit was Nagelkerke's R-2 = 0.153 [chi(2) (24) = 25.206, p = .395].

    Conclusions

    Patients' preference for an active role in decision-making underscores the importance of involving patients in their treatment planning. Patients' desire for help seems to be an important determinant of paternalistic decision making. However, further research is needed to determine whether patients' role preferences are related to their behavior during their treatment referral and recovery.

  • 45.
    Gauffin, Karl
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Björkenstam, Emma
    Childhood Household Dysfunction, Social Inequality and Alcohol Related Illness in Young Adulthood. A Swedish National Cohort Study2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 3, article id e0151755Article in journal (Refereed)
    Abstract [en]

    The aim of this paper is to estimate the cumulative effect of childhood household dysfunction (CHD) on alcohol related illness and death later in life and to test the interaction between CHD and socioeconomic background. The study utilised Swedish national registers including data of a Swedish national cohort born 1973-82 (n = 872 912), which was followed from age 18 to 29-40 years. Cox regression analyses were used to calculate hazard ratios (HR) for alcohol related illness or death in young adulthood. The CHD measure consisted of seven indicators: parental alcohol/drug misuse, mental health problems, criminality, death, divorce, social assistance, and child welfare interventions. Childhood socioeconomic position (SEP) was indicated by parental occupational status. Outcomes were alcohol related inpatient hospital care, specialised outpatient care or deaths. Using the highest socioeconomic group without CHD experience as a reference, those in the same socioeconomic group with one indicator of CHD had HRs of 2.1 [95% CI: 1.7-2.5], two CHD indicators 5.6 [4.4-7.1], three or more indicators 9.4 [7.1-12.4] for retrieving inpatient care. Socioeconomic disadvantage further increased the risks-those with low socioeconomic background and three CHD indicators or more had a HR of 12.5 [10.9-14.3]. Testing for interaction suggests that the combined HRs deviates from additivity [Synergy index: 1.6, 95% CI: 1.4-1.9]. The results for outpatient care were similar, but not as pronounced. In conclusion, this Swedish national cohort study shows that childhood household dysfunction is strongly and cumulatively associated to alcohol related illness later in life and that it interacts with socioeconomic disadvantage.

  • 46.
    Gauffin, Karl
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Fridell, Mats
    Hesse, Morten
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Childhood socio-economic status, school failure and drug abuse: a Swedish national cohort study2013In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 8, p. 1441-1449Article in journal (Refereed)
    Abstract [en]

    Aim To investigate whether socio-economic status (SES) in childhood and school failure at 15 years of age predict illicit drug abuse in youth and young adulthood. Design setting and participantsRegister study in a Swedish national cohort born 1973-88 (n=1405763), followed from age 16 to 20-35 years. Cox regression analyses were used to calculate hazard ratios (HR) for any indication of drug abuse. Measurements Our outcomes were hospital admissions, death and criminality associated with illicit drug abuse. Data on socio-demographics, school grades and parental psychosocial problems were collected from censuses (1985 and 1990) and national registers. School failure was defined as having mean school grades from the final year in primary school lower than -1standard deviation and/or no grades in core subjects. Findings School failure was a strong predictor of illicit drug abuse with an HR of 5.87 (95% CI: 5.76-5.99) after adjustment for age and sex. Childhood SES was associated with illicit drug abuse later in life in a stepwise manner. The lowest stratum had a HR of 2.28 (95% CI: 2.20-2.37) compared with the highest stratum as the reference, when adjusted for other socio-demographic variables. In the fully adjusted model, the effect of SES was greatly attenuated to an HR of 1.23 (95% CI: 1.19-1.28) in the lowest SES category, while the effect of school failure remained high with an HR of 4.22 (95% CI: 4.13-4.31). Conclusions School failure and childhood socio-economic status predict illicit drug abuse independently in youth and young adults in Sweden.

  • 47. Gomes de Matos, Elena
    et al.
    Atzendorf, Josefine
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Piontek, Daniela
    Substanzkonsum in der Allgemeinbevölkerung in Deutschland. Ergebnisse des Epidemiologischen Suchtsurveys 20152016In: SUCHT, ISSN 0939-5911, E-ISSN 1664-2856, Vol. 62, no 5, p. 271-281Article in journal (Refereed)
    Abstract [en]

    Aims: We assess the extent of substance use among the adult general population in Germany. Method: Data come from the 2015 Epidemiological Survey of Substance Abuse, a national survey conducted among the resident population aged 18 to 64 years. With a response rate of 52.2 %, the sample size was n = 9,204. Participants were asked about their use of alcohol, tobacco, pharmaceuticals, and illicit drugs. Results: Of all respondents, 28.7 % had used tobacco products in the past 30 days, and 72.8 % had drunk alcohol. Indications of clinically relevant use within 12 months prior to the survey were found for 28.3 % of men and 9.6 % of women. Regarding illicit drugs, the 12-month prevalence was 6.1 % for cannabis and at most 1 % for all other substances. Analgesics were the class of pharmaceuticals with the highest prevalence of use (47.1 %), but the lowest prevalence of daily use among consumers of a given pharmaceutical (8.6 %). Conclusions: Results demonstrate that the use of psychoactive substances is still highly prevalent in the general population. Prevalence of use as well as indications for clinically problematic use were highest for licit substances that are highly available. Potentially clinically relevant illicit drug use affects considerably fewer individuals. However, because they comprise a specific risk population, it should be ensured that they are reached by appropriate prevention measures.

  • 48. Gomes de Matos, Elena
    et al.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institute for Therapeutic Research, Germany.
    Hannemann, Tessa-Virginia
    Soellner, Renate
    Piontek, Daniela
    Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use2017In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 36, no 6, p. 797-804Article in journal (Refereed)
    Abstract [en]

    Introduction and Aims. This study estimates cross-country variation in socioeconomic disparities in adolescent alcohol use and identifies country-level characteristics associated with these disparities. Design and Methods. The association between socioeconomic status (family wealth and parental education) and alcohol use (lifetime use and episodic heavy drinking) of 15- to 16-year-olds from 32 European countries was investigated. Country-level characteristics were national income, income inequality and per capita alcohol consumption. Multilevel modelling was applied. Results. Across countries, lifetime use was lower in wealthy than in less wealthy families (odds ratio [OR]((girls))=0.95, OR(boys)=0.94). The risk of episodic heavy drinking, in contrast, was higher for children from wealthier families (OR(girls)=1.04, OR(boys)=1.08) and lower when parents were highly educated (ORs=0.95-0.98). Socioeconomic disparities varied substantially between countries. National wealth and income inequality were associated with cross-country variation of disparities in lifetime use in few comparisons, such that among girls, the (negative) effect of family wealth was greatest in countries with unequally distributed income (OR=0.86). Among boys, the (negative) effect of family wealth was greatest in low-income countries (OR=1.00), and the (positive) effect of mothers' education was greatest in countries with high income inequality (OR=1.11). Discussion and Conclusions. Socioeconomic disparities in adolescent alcohol use vary across European countries. Broad country-level indicators can explain this variation only to a limited extent, but results point towards slightly greater socioeconomic disparities in drinking in countries of low national income and countries with a high income inequality. [Gomes de Matos E, Kraus L, Hannemann T-V, Soellner R, Piontek D. Cross-cultural variation in the association between family's socioeconomic status and adolescent alcohol use.

  • 49. Grittner, Ulrike
    et al.
    Gustafsson, Nina-Katri
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Huhtanen, Petri
    Svensson, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Stockholm Prevents Alcohol and Drug Problems (STAD), Centre for Dependency Disorders, Stockholm County Council.
    Nordlund, Sturla
    Bloomfield, Kim
    Who are the private alcohol importers in the Nordic countries?2014In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 31, no 2, p. 125-139Article in journal (Refereed)
    Abstract [en]

    Aims – The high price of alcohol in the Nordic countries has been a long-standing policy to curb consumption, which has led consumers to importing alcohol from countries with lower prices. This paper seeks to develop a profile of alcohol importers in four Nordic countries. Methods – Cross-sectional data from general population surveys in Denmark (2003–2006), Norway (2004), Sweden (2003–2006) and Finland (2005–2006) were analysed by multiple logistic and linear regression. Independent variables included region, socio-demographics, drinking indicators and alcohol-related problems. Outcome variables were importer status and amount of imported alcohol.  Results – People living in regions close to countries with lower alcohol prices were more often importers and imported higher amounts than people living in other regions. Higher educated persons were more likely to be importers, but the amounts imported were smaller than those by people with lower education. Persons with higher incomes were also more likely to be importers and they also imported larger amounts than people with lower incomes. In Sweden and Denmark regional differences of importer rates were more pronounced for persons of lower incomes. Age, risky single-occasion drinking, risky drinking and alcohol problems were positively related to the amounts of imported alcohol. Conclusions – Private importers in the Nordic countries are an integrated yet heavy drinking segment of society and do not appear to be located on the fringes of society.

  • 50. Gross, Cornelius
    et al.
    Reis, Olaf
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Piontek, Daniela
    Zimmermann, Ulrich S.
    Long-term outcomes after adolescent in-patient treatment due to alcohol intoxication: A control group study2016In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 162, p. 116-123Article in journal (Refereed)
    Abstract [en]

    Background: The long-term psychosocial development of adolescents admitted to in-patient treatment with alcohol intoxication (AIA) is largely unknown. Methods: We invited all 1603 AIAs and 641 age- and sex-matched controls, who had been hospitalized in one of five pediatric departments between 2000 and 2007, to participate in a telephone interview. 277 cases of AIA and 116 controls (mean age 24.2 years (SD 2.2); 46% female) could be studied 5-13 years (mean 8.3, SD 2.3) after the event. The control group consisted of subjects who were admitted due to conditions other than alcohol intoxication. Blood alcohol concentration on admission was systematically measured in the AIA but, owing to the retrospective study design, not in the control group. Subtle alcohol intoxication could therefore not be entirely ruled out in the control group. Long-term outcome measures included current DSM-5 alcohol use disorders (AUD), drinking patterns, illicit substance use, regular smoking, general life satisfaction, use of mental health treatment, and delinquency. Results: AIA had a significantly elevated risk to engage in problematic habitual alcohol use, to exhibit delinquent behaviors, and to use illicit substances in young adulthood compared to the control group. Severe AUD also occurred considerably more often in the AIA than the control group. Conclusions: In the majority of AIAs, further development until their mid-twenties appears to be unremarkable. However, their risk to develop severe AUD and other problematic outcomes is significantly increased. This finding calls for a diagnostic instrument distinguishing between high- and low-risk AIAs already in the emergency room.

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