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  • 1.
    Abrahamson, Maria
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD).
    Moral norms in older Swedish women’s drinking narratives. Enduring patterns and successively new features2012Inngår i: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, Vol. 29, nr 4, s. 371-396Artikkel i tidsskrift (Fagfellevurdert)
    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.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Dahlberg, Lena
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Dalarna University, Sweden.
    Lennartsson, Carin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Social integration and alcohol consumption among older people: A four-year follow-up of a Swedish national sample2019Inngår i: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 196, s. 40-45Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Today's older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people's drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men.

    Methods: Longitudinal nationally representative data of older Swedish women and men aged over 65 - the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) - from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses.

    Results: Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group.

    Conclusions: Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.

  • 3.
    Agahi, Neda
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Kelfve, Susanne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Lennartsson, Carin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Kåreholt, Ingemar
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Jönköping University, Sweden.
    Alcohol consumption in very old age and its association with survival: A matter of health and physical function2016Inngår i: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 159, s. 240-245Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 4. Ahacic, Kozma
    et al.
    Kåreholt, Ingemar
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m 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 data2013Inngår i: Substance Abuse Treatment, Prevention, and Policy, E-ISSN 1747-597X, Vol. 8, s. 10-Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 5. Ahlner, Felicia
    et al.
    Erhag, Hanna Falk
    Johansson, Lena
    Fässberg, Madeleine Mellqvist
    Sterner, Therese Rydberg
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). University of Gothenburg, Sweden.
    Samuelsson, Jessica
    Zettergren, Anna
    Waern, Margda
    Skoog, Ingmar
    Patterns of Alcohol Consumption and Associated Factors in a Population-Based Sample of 70-Year-Olds: Data from the Gothenburg H70 Birth Cohort Study 2014–162022Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, nr 14, artikkel-id 8248Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Older adults of today consume more alcohol, yet knowledge about the factors associated with different consumption levels is limited in this age group. Based on the data from a population-based sample (n = 1156, 539 men and 617 women) in The Gothenburg H70 Birth Cohort Study 2014–16, we examined sociodemographic, social, and health-related factors associated with alcohol consumption levels in 70-year-olds, using logistic regression. Total weekly alcohol intake was calculated based on the self-reported amount of alcohol consumed. Alcohol consumption was categorized as lifetime abstention, former drinking, moderate consumption (≤98 g/week), and at-risk consumption (>98 g/week). At-risk consumption was further categorized into lower at-risk (98–196 g/week), medium at-risk (196–350 g/week), and higher at-risk (≥350 g/week). We found that among the 1156 participants, 3% were lifetime abstainers, 3% were former drinkers, 64% were moderate drinkers, and 30% were at-risk drinkers (20% lower, 8% medium, 2% higher). Among several factors, former drinking was associated with worse general self-rated health (OR 1.65, 95% CI 1.08–2.51) and lower health-related quality of life (measured by physical component score) (OR 0.94, 95% CI 0.91–0.97), higher illness burden (OR 1.16, 95% CI 1.07–1.27), and weaker grip strength (OR 0.96, 95% CI 0.94–0.98). Higher at-risk drinkers more often had liver disease (OR 11.41, 95% CI 3.48–37.37) and minor depression (OR 4.57, 95% CI 1.40–14.95), but less contacts with health care (OR 0.32, 95% CI 0.11–0.92). Our findings demonstrate the importance of classifications beyond abstinence and at-risk consumption, with implications for both the prevention and clinical management of unhealthy consumption patterns in older adults.

  • 6.
    Alm, Susanne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Kriminologiska institutionen.
    What happened to the Swedish problem drug users of the 1960's and 1970's?2015Inngår i: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 32, nr 2, s. 109-132Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 7.
    Almquist, Ylva B.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Östberg, Viveca
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Social relationships and subsequent health-related behaviours: linkages between adolescent peer status and levels of adult smoking in a Stockholm cohort2012Inngår i: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, nr 3, s. 629-637Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 8. Amundsen, Ellen J.
    et al.
    Bretteville-Jensen, Anne L.
    Kraus, Ludwig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (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 1985-20082016Inngår i: International journal on drug policy, ISSN 0955-3959, E-ISSN 1873-4758, Vol. 27, s. 36-42Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 9. Anderberg, Mats
    et al.
    Dahlberg, Mikael
    Wennberg, Peter
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap.
    Criminality among Young People With Substance Use Problems in Sweden: A One-Year Follow-Up Study2022Inngår i: Journal of Drug Issues, ISSN 0022-0426, E-ISSN 1945-1369, Vol. 52, nr 3, s. 406-420Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Swedish drug policy has a strong focus on minor drug violations. This longitudinal study analyses the association between criminality and substance use problems among young people who have received outpatient treatment and risk factors that predict continued problems with criminality. Research on this target group is under development in Sweden, but there are few follow-up studies. The study indicates that about one-quarters of the young people who begin outpatient treatment have been convicted of crimes at 1-year follow-up. Most of them who had been convicted with offences also have ongoing problems with substance use and three-quarters of the young people had been charged with a drug-related offence. More than five risk factors give an elevated risk of continued criminality. Interventions meeting the needs of young people, moving away from the current emphasis on penal law principles, may also contribute to reduced criminality in this target group. 

  • 10. Anderson, Peter
    et al.
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD).
    Addictions and European policy: Has the 'European project' stifled science-led policy?2011Inngår i: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 30, nr 2, s. 117-118Artikkel i tidsskrift (Fagfellevurdert)
  • 11. Andersson, Filip
    et al.
    Sundin, Erica
    Magnusson, Cecilia
    Ramstedt, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Karolinska Institutet, Sweden; The Swedish Council for Information on Alcohol and Other Drugs, Sweden.
    Galanti, Maria Rosaria
    Prevalence of cannabis use among young adults in Sweden comparing randomized response technique with a traditional survey2023Inngår i: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 118, nr 9, s. 1801-1810Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and Aims: The prevalence of cannabis use based on self-reports is likely to be underestimated in population surveys, especially in contexts where its use is a criminal offence. Indirect survey methods ask sensitive questions ensuring that answers cannot be identified with an individual respondent, therefore potentially resulting in more reliable estimates. We aimed to measure whether the indirect survey method ‘randomized response technique’ (RRT) increased response rate and/or increased disclosure of cannabis use among young adults compared with a traditional survey.

    Design: We conducted two parallel nation-wide surveys during the spring and the summer of 2021. The first survey was a traditional questionnaire-based one (focusing on substance use and gambling). The second survey applied an indirect survey method known as ‘the cross-wise model’ to questions related to cannabis use. The two surveys employed identical procedures (e.g. invitations, reminders and wording of the questions)

    Setting and Participants: The participants were young adults (aged 18–29 years) living in Sweden. The traditional survey had 1200 respondents (56.9% women) and the indirect survey had 2951 respondents (53.6% women).

    Measurements: In both surveys, cannabis use was assessed according to three time-frames: life-time use; use during the past year; and use during the past 30 days.

    Findings: The estimated prevalence of cannabis use was two- to threefold higher on all measures when estimated using the indirect survey method compared with the traditional survey: use during life-time (43.2 versus 27.3%); during the past year (19.2 versus 10.4%); and during the past 30 days (13.2 versus 3.7%). The discrepancy was larger among males and individuals with an education shorter than 10 years, who were unemployed, and who were born in non-European countries.

    Conclusions: Indirect survey methods may provide more accurate estimates than traditional surveys on prevalence of self-reported cannabis use.

  • 12.
    Axelsson, Martin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    HR-medarbetares upplevelser kring spelprevention och policyimplementering på arbetsplatsen2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Skadligt bruk är ett brett begrepp som omfattar många olika former av bruk, till exempel av alkohol, droger eller spel om pengar vilket kan påverka arbetsprestationen negativt hos en arbetstagare. På uppdrag av Folkhälsomyndigheten ville man värdera verkningsgraden av genomförda utbildningsinsatser kopplat till problematiskt spelande. Syftet med den här studien är att kvalitativt utvärdera upplevelser av genomförda utbildningsinsatser som organisationen Alna genomfört kring skadligt bruk med fokus på spelproblem. Tematisk analys användes och datainsamling skedde genom semistrukturerade intervjuer med tio HR-medarbetare, vars fem organisationer ingick i utbildningsprojektet Spel och spelförebyggande insatser för arbetslivet. Resultatet visar att Alnas metoder och verktyg upplevs som effektiva och värdefulla av undersökningsdeltagarna. Vissa hinder för effektiv implementering av uppdaterade policys och riktlinjer identifierades och dessa kunde bestå av tidsbrist, underbemanning eller eftersatt prioritering av spelfrågan. Vidare framgår det att Alnas utbildningsinsatser främjat utformandet av policys och riktlinjer kring skadligt bruk med fokus på spel och spelproblem i organisationerna. 

    Fulltekst (pdf)
    HR-medarbetares upplevelser kring spelprevention och policyimplementering på arbetsplatsen
  • 13. Babor, Thomas F.
    et al.
    Casswell, Sally
    Graham, Kathryn
    Huckle, Taisia
    Livingston, Michael
    Rehm, Jürgen
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). La Trobe University, Australia.
    Rossow, Ingeborg
    Sornpaisarn, Bundit
    Alcohol: No Ordinary Commodity - a summary of the third edition2022Inngår i: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 117, nr 12, s. 3024-3036Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and Aims: This article summarizes the findings and conclusions of the third edition of Alcohol: No Ordinary Commodity. The latest revision of this book is part of a series of monographs designed to provide a critical review of the scientific evidence related to alcohol control policy from a public health perspective.

    Design: A narrative summary of the contents of the book according to five major issues.

    Findings: An extensive amount of epidemiological evidence shows that alcohol is a major contributor to the global burden of disease, disability and death in high-, middle- and low-income countries. Trends in alcohol products and marketing are described, indicating that a large part of the global industry has been consolidated into a small number of transnational corporations that are expanding their operations in Asia, Africa and Latin America. The main part of the book is devoted to a review of strategies and interventions designed to prevent or minimize alcohol-related harm. Overall, the most effective strategies to protect public health are taxation that decreases affordability and restrictions on the physical availability of alcohol. A total ban on alcohol marketing is also an effective strategy to reduce consumption. In addition, drink-driving counter-measures, brief interventions with at-risk drinkers and treatment of drinkers with alcohol dependence are effective in preventing harm in high-risk contexts and groups of hazardous drinkers.

    Conclusion: Alcohol policy is often the product of competing interests, values and ideologies, with the evidence suggesting that the conflicting interests between profit and health mean that working in partnership with the alcohol industry is likely to lead to ineffective policy. Opportunities for implementation of evidence-based alcohol policies that better serve the public good are clearer than ever before as a result of accumulating knowledge on which strategies work best.

  • 14. Babor, Thomas F.
    et al.
    Caulkins, Jonathan
    Fischer, Benedikt
    Foxcroft, David
    Medina-Mora, María Elena
    Obot, Isidore
    Rehm, Jürgen
    Reuter, Peter
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). La Trobe University, Australia.
    Rossow, Ingeborg
    Strang, John
    Drug Policy and the Public Good: a summary of the second edition2019Inngår i: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 114, nr 11, s. 1941-1950Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The second edition of Drug Policy and the Public Good presents up-to-date evidence relating to the development of drug policy at local, national and international levels. The book explores both illicit drug use and non-medical use of prescription medications from a public health perspective. The core of the book is a critical review of the scientific evidence in five areas of drug policy: (1) primary prevention programs in schools and other settings; (2) treatment interventions and harm reduction approaches; (3) attempts to control the supply of illicit drugs, including drug interdiction and law enforcement; (4) penal approaches, decriminalization and other alternatives; and (5) control of the legal market through prescription drug regimens. It also discusses the trend towards legalization of some psychoactive substances in some countries and the need for a new approach to drug policy that is evidence-based, realistic and coordinated. The accumulated evidence provides important information about effective and ineffective policies. Shifting the emphasis towards a public health approach should reduce the extent of illicit drug use, prevent the escalation of new epidemics and avoid the unintended consequences arising from the marginalization of drug users through severe criminal penalties.

  • 15.
    Barclay, Kieron
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. 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 Sweden2016Inngår i: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 167, s. 15-22Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 16. Been, Frederic
    et al.
    Bifisma, Lubertus
    Benaglia, Lisa
    Berset, Jean-Daniel
    Botero-Coy, Ana M.
    Castiglioni, Sara
    Kraus, Ludwig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (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 Switzerland2016Inngår i: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 161, s. 189-199Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 17.
    Bergmark, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    The role of psychopathology as motivator for drug dependency—some moderating remarks2013Inngår i: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, nr 4, s. 673-674Artikkel i tidsskrift (Annet vitenskapelig)
  • 18. Berman, Anne H.
    et al.
    Wennberg, Peter
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD).
    Sinadinovic, Kristina
    Changes in Mental and Physical Well-Being Among Problematic Alcohol and Drug Users in 12-Month Internet-Based Intervention Trials2015Inngår i: Psychology of Addictive Behaviors, ISSN 0893-164X, E-ISSN 1939-1501, Vol. 29, nr 1, s. 97-105Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 19. Bickl, Andreas M.
    et al.
    Kraus, Ludwig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). IFT Institut Für Therapieforschung, Germany; Eötvös Loránd University, Hungary.
    Loy, Johanna K.
    Kriwy, Peter
    Sleczka, Pawel
    Schwarzkopf, Larissa
    Development of Gambling Behaviour and Its Relationship with Perceived Social Support: A Longitudinal Study of Young Adult Male Gamblers2024Inngår i: Journal of Gambling Studies, ISSN 1050-5350, E-ISSN 1573-3602, Vol. 40, nr 1, s. 307-332Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Young adult men who gamble frequently face an elevated risk of developing gambling-related problems. So far, little is known about how changing levels of perceived social support interact with the course of gambling behaviour and gambling-related problems in this population. Using data from a prospective single-arm cohort study (Munich Leisure Time Study), we applied hierarchical linear models to investigate the longitudinal association of changes in perceived emotional and social support (hereafter PESS; operationalized as ENRICHD Social Support Instrument score) with gambling intensity, gambling frequency, and fulfilled criteria for gambling disorder. Pooling data from three time points (baseline, 12-month and 24-month follow-ups) to assess two 1-year intervals, these models disentangle the associations of (a) “level of PESS” (cross-sectional, between participants) and (b) “changes in individual PESS” (longitudinally, within-participants). Among the 169 study participants, higher levels of PESS were associated with fewer gambling-related problems (− 0.12 criteria met; p = 0.014). Furthermore, increasing individual PESS was associated with lower gambling frequency (− 0.25 gambling days; p = 0.060) and intensity (− 0.11 gambling hours; p = 0.006), and fewer gambling-related problems (− 0.19 problems; p < 0.001). The results suggest a mitigating influence of PESS on gambling behaviour and gambling-related problems. Increasing individual PESS appears more decisive for this pathway than high initial levels of PESS. Treatment and prevention strategies that activate and reinforce beneficial social resources in people with gambling-related problems are recommended and promising.

  • 20.
    Bishop, Lauren
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Max Planck Institute for Demographic Research, Germany; University of Helsinki, Finland.
    Högnäs, Robin S.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Role of hospitalisation for substance misuse in marital status transitions: a 47-year follow-up of a Swedish birth cohort2024Inngår i: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 78, nr 3, s. 153-159Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Substantial research suggests that the risk of substance misuse is higher among individuals who remain unmarried or experience marital dissolution, whereas marriage tends to be protective. However, few studies have considered the role of substance misuse for transitions between discrete marital status categories. The current study aims to estimate associations between substance misuse and marital status transitions from ages 20–66.

    Methods Our study population was a national Swedish cohort born in 1953 (n=71 901), followed from 1973 to 2019. Annual marital status and hospitalisation records for substance misuse were derived from the Total Population and National Patient registers, respectively. We used a five-state multistate model to estimate associations between substance misuse and marital status transitions—the state space included never married, married, divorced and widowed with death as the absorbing state. We further used fixed-effect models to estimate the effects of substance misuse on transitions out of marriage.

    Results Findings suggested that individuals’ substance misuse was associated with an increased risk of transitioning from married to divorced (HR=3.54, 95% CI 3.40 to 3.69) or widowed (HR=1.71, 95% CI 1.46 to 2.01), and transitioning to death from all states. Substance misuse was also negatively associated with transitioning from never married to married (HR=0.59, 95% CI 0.57 to 0.61), and into remarriage after divorce (HR=0.86, 95% CI 0.80 to 0.92). The fixed-effect results suggested that substance misuse increased the risk of transitioning to divorce and widowhood, net of sociodemographic characteristics.

    Conclusion Substance misuse is associated with an increased risk of marital dissolution and death when accounting for nearly 50 years of marital biographies.

  • 21. Bjerge, Bagga
    et al.
    Houborg, Esben
    Edman, Johan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD).
    Perälä, Riikka
    Concepts and policies directed at drug use i Denmark, Finland and Sweden2016Inngår i: Concepts of Addictive Behaviours across Time and Place / [ed] Matilda Hellman, Virginia Berridge, Karen Duke, Alex Mold, Oxford: Oxford University Press, 2016Kapittel i bok, del av antologi (Fagfellevurdert)
    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.

  • 22. Bjerkeli, Pernilla J.
    et al.
    Vicente, Raquel Perez
    Mulinari, Shai
    Johnell, Kristina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Merlo, Juan
    Overuse of methylphenidate: an analysis of Swedish pharmacy dispensing data2018Inngår i: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 10, s. 1657-1665Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To identify overuse of methylphenidate and to investigate patterns of overuse in relation to sociodemographic and clinical characteristics.

    Patients and methods: Swedish national, pharmacy dispensing data were analyzed for all 56,922 individuals aged 6-79 years, who filled a methylphenidate prescription between 2010 and 2011. Overuse was defined as having above 150% days covered by the dispensed amount during 365 days from the first prescription fill, assuming use at the maximum recommended daily dose.

    Results: In total, 4,304 individuals (7.6% of the methylphenidate users) were categorized as overusers. The risk of overuse increased with age (OR for 46-65 years vs 6-12 years 17.5, 95% CI 14.3-21.3), and was higher in men (OR 1.4, 95% CI 1.3-1.5) and individuals with low income (OR 1.1, 95% CI 1.0-1.2), as well as in individuals with an attention deficit hyperactivity disorder (ADHD) diagnosis (OR 1.4, 95% CI 1.3-1.6), health care visits (OR 1.3, 95% CI 1.2-1.4), previous ADHD medication use (OR 2.6, 95% CI 2.4-2.8), and previous diagnosis of mental and behavioral disorders due to psychoactive substance use (OR 2.1 95% CI 2.0-2.3).

    Conclusion: Among individuals using methylphenidate in Sweden, 7.6% receive amounts that are larger than what they should have a medical need for, assuming that they were using the maximum recommended daily dose 365 days per year. Notably, the prevalence of overuse was associated with previous diagnosis of alcohol and drug misuse. The prevalence was also positively associated with higher age and previous use of ADHD medication. These findings may point toward a link between exposure time and overuse. However, future studies with long-term data are needed to investigate this.

  • 23. Blindow, Katrina J.
    et al.
    Thern, Emelie
    Hernando-Rodriguez, Julio C.
    Nyberg, Anna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Sweden; Uppsala University, Sweden.
    Magnusson Hanson, Linda L.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Gender-based harassment in Swedish workplaces and alcohol-related morbidity and mortality: A prospective cohort study2023Inngår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 49, nr 6, s. 395-404Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The study investigated experiences of different types of work-related gender-based harassment (GBH), specifically sexual and gender harassment, as risk factors for alcohol-related morbidity and mortality (ARMM).

    Methods: Information about experiences of (i) sexual harassment (SH-I) and (ii) gender harassment (GH-I) from inside the organization and (iii) sexual harassment from a person external to the organization (SH-E) were obtained from the Swedish Work Environment Survey 1995–2013, a biannual cross-sectional survey, administered to a representative sample of the Swedish working population. The survey responses from 86 033 individuals were connected to multiple registers containing information about alcohol-related diagnoses, treatment, or cause of death. Cox proportional hazard models were fitted to assess hazard ratios (HR) of incident ARMM during a mean follow-up of eight (SH-I and GH-I) and ten (SH-E) years.

    Results: A higher prospective risk estimate of ARMM was found among participants who reported experiences of SH-E [HR 2.01, 95% confidence interval (CI) 1.61–2.52], GH-I (HR 1.33, CI 1.03–1.70), or SH-I (HR 2.37, CI 1.42–3.00). Additional analyses, distinguishing one-time from reoccurring harassment experiences, indicated a dose–response relationship for all three harassment types. Gender did not modify the associations. Under the assumption of causality, 9.3% (95% CI 5.4–13.1) of the risk of ARMM among Swedish women and 2.1% (95% CI 0.6–3.6) among Swedish men would be attributable to any of the three types of GBH included in this study.

    Conclusions: Experiences of GBH in the work context may be a highly relevant factor in the etiology of ARMM.

  • 24. Bloomfield, Kim
    et al.
    Grittner, Ulrike
    Kraus, Ludwig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (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?2017Inngår i: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 34, nr 4, s. 342-352Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 25.
    Bogren, Alexandra
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD).
    Alcohol short-circuits important part of the brain': Swedish newspaper representations of biomedical alcohol research2017Inngår i: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 25, nr 3, s. 177-187Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 26.
    Bornscheuer, Lisa
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Karolinska University Hospital, Sweden.
    Lundin, Andreas
    Forsell, Yvonne
    Lavebratt, Catharina
    Melas, Philippe A.
    The cannabinoid receptor-1 gene interacts with stressful life events to increase the risk for problematic alcohol use2022Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 12, artikkel-id 4963Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Problematic alcohol use is a major contributor to the global burden of death and disabilities, and it represents a public health concern that has grown substantially following the COVID-19 pandemic. The available treatment options remain limited and to develop better pharmacotherapies for alcohol misuse we need to identify suitable biological targets. Previous research has implicated the brain’s endocannabinoid system (ECS) in psychiatric and stress-related outcomes, including substance use and habituation to repeated stress. Moreover, genetic variants in the cannabinoid-1 receptor gene (CNR1; CB1R) have been associated with personality traits, which are in turn predictors of substance use disorders. To date, however, no human genome-wide association study has provided evidence for an involvement of the ECS in substance use outcomes. One reason for this ECS-related “missing heritability” may be unexamined gene-environment interactions. To explore this possibility, we conducted cross-sectional analyses using DNA samples and stress-exposure data from a longitudinal Swedish population-based study (N = 2,915). Specifically, we genotyped rs2023239, a functional C/T single nucleotide polymorphism in CNR1, previously reported to be associated with CNR1 binding in the brain, subjective reward following alcohol intake, and alcohol cue-elicited brain activation. Our two outcomes of interest were (i) problematic alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT), and (ii) personality trait scores based on the Five Factor Model. We found no baseline association between rs2023239 and problematic alcohol use or personality traits. However, there was a clear trend for interaction between rs2023239’s risk allele (C) and stressful life events (SLEs) in both childhood and adulthood, which predicted problematic alcohol use. Although not significant, there was also some indication that the risk allele interacted with child SLEs to increase scores on neuroticism. Our study supports the notion that the ECS can affect alcohol intake behaviors by interacting with life adversities and is—to the best of our knowledge—the first to focus on the interaction between CNR1 and stressors in both childhood and adulthood in humans. Further studies are warranted to confirm these findings.

  • 27. Boson, Karin
    et al.
    Anderberg, Mats
    Melander Hagborg, Johan
    Wennberg, Peter
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Karolinska Institute, Sweden.
    Dahlberg, Mikael
    Adolescents with substance use problems in outpatient treatment: a one-year prospective follow-up study focusing on mental health and gender differences2022Inngår i: Substance Abuse Treatment, Prevention, and Policy, E-ISSN 1747-597X, Vol. 17, nr 1, artikkel-id 53Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Although several studies have found a high incidence of coexisting mental health problems among adolescents with substance use problems, follow-up studies addressing how these conditions change over time are rare. The study will describe and analyze indications of mental health problems and how various risk factors predict outcomes 1 year after initial treatment contact. In addition, gender-specific risk factors are explored.

    Methods: A clinical sample of 455 adolescents (29% girls, median age 17 years) answered a structural interview at baseline and were followed up using official records 1 year after initiated treatment. Bivariate associations and logistic regressions were conducted to analyse the links between risk factors at the individual, social, and structural levels as well as links between various mental illness symptoms at treatment start and indications of mental health problems 1 year later were analysed.

    Results: The results show that mental health problems among adolescents largely persisted 1 year after start of outpatient care for substance use problems. Forty-two per cent of the sample displayed indications of mental health problems at follow-up, and registrations for both outpatient treatment and psychiatric medication were more common among the girls. Girls also reported more mental illness symptoms at treatment start than boys did, especially anxiety. Depression and suicidal thoughts had predictive values regarding indications of mental health problems and small cumulative effects were found for 6-10 co-occurring risk factors.

    Conclusions: Adolescents with depression and suicidal thoughts at treatment start should yield attention among clinicians as these general risk factors could predict indication of mental health problems at 1 year follow-up effectively. Also, patients with more than six co-occurring risk factors seem more vulnerable for continued mental health problems. Generally, girls displayed a greater mental health and psychosocial burden at treatment initiation and were more likely to show indication of mental health problems at follow-up. These results suggests that girls are more likely to get psychiatric out-treatment parallel to, or after, substance abuse treatment. We recommend further investigation of gender differences and gender-specific needs in substance use treatment.

  • 28. Bowden, Jacqueline A.
    et al.
    Delfabbro, Paul
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). La Trobe University, Australia.
    Miller, Caroline L.
    Wilson, Carlene
    Levels of Parental Drinking in the Presence of Children: An Exploration of Attitudinal Correlates2021Inngår i: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 57, nr 4, s. 460-469, artikkel-id agab071Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims

    This study aimed to examine perceived social norms, the effect of parental drinking on these norms, alcohol use in front of children, and how norms and consumption vary based on child age and gender of the parent.

    Methods

    A cross-sectional online panel survey was undertaken with n = 1000 Australian adults (including 670 parents) aged 18-59 years. The survey assessed: alcohol consumption in front of children; normative attitudes towards drinking in the presence of children; and perceived social norms.

    Results

    Overall, 33.9% of parents reported drinking a glass of alcohol each day or a couple of times a week, 18.2% reported getting slightly drunk and 7.8% indicated getting visibly drunk each day or a couple of times a week with their children present. In total, 37.5% reported drinking in front of their children at least weekly. Fathers were more likely to drink in front of children than mothers. Most parents deemed drinking small amounts of alcohol in front of children as acceptable but did not accept drunkenness. Respondents were less concerned about a father drinking one or two drinks in front of their children than a mother. Social expectations were not related to child age, but norms related to others' perceived behaviour were.

    Conclusions

    Many parents, particularly fathers consume alcohol in front of their children. There is a need to target health promotion strategies to adults and parents consuming in excess of health guidelines, and to the many parents who are consuming alcohol at higher levels in front of their children.

  • 29. Bowden, Jacqueline A.
    et al.
    Delfabbro, Paul
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (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 analysis2017Inngår i: BMC Public Health, E-ISSN 1471-2458, Vol. 17, artikkel-id 549Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 30. Bowden, Jacqueline A.
    et al.
    Delfabbro, Paul
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). La Trobe University, Australia.
    Miller, Caroline
    Wilson, Carlene
    Parental drinking in Australia: Does the age of children in the home matter?2019Inngår i: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 38, nr 3, s. 306-315Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction and Aims Parental role modelling of alcohol use is known to influence alcohol consumption in adolescence and in later life. This study aimed to assess relationships between parental status, child age and alcohol consumption, which have not been well documented. Design and Methods Data were sourced from the 2013 Australian National Drug Strategy Household Survey. Analyses were conducted for 25-55 year olds (n = 11 591) by parental status, gender and age of youngest child in the household, controlling for socio-demographic factors. Results Parents were less likely than non-parents to exceed the alcohol guideline for increased lifetime risk (18.2% vs. 24.2%) and short-term risk: at least weekly (14.2% vs. 21.2%); and at least monthly (27.5% vs. 35.9%). Fathers were just as likely to exceed the guidelines for lifetime risk as other men, but those with children aged 0-2, were less likely to exceed the guideline for short-term risk. Women were least likely to exceed the guideline for lifetime risk if they had children aged 0-2, 6-11 or 15 years and over, or the guideline for short-term risk, if they had children aged 0-2, or 15 years and over in the household. Parents were more likely to report drinking in the home. Discussion and Conclusions Parents were less likely to exceed alcohol guidelines than non-parents, especially mothers whose youngest child was an infant or in high school or older. Consistent with population rates in men, fathers were more likely to exceed alcohol guidelines than mothers, and this excess consumption warrants public health attention.

  • 31. Braun, Barbara
    et al.
    Ludwig, Monika
    Sleczka, Pawel
    Buehringer, Gerhard
    Kraus, Ludwig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). IFT Institut für Therapieforschung, Germany.
    Gamblers seeking treatment: Who does and who doesn't?2014Inngår i: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 3, nr 3, s. 189-198Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 32. Bronner, Kerstin Birgitta Thelin
    et al.
    Wennberg, Peter
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (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 population2012Inngår i: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 35, nr 2, s. 130-137Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 33. Buchholz, Angela
    et al.
    Dams, Judith
    Rosahl, Anke
    Hempleman, Jochen
    Koenig, Hans-Helmut
    Konnopka, Alexander
    Kraus, Ludwig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. IFT Institut für Therapieforschung, Germany; Eötvös Loránd University, Hungary .
    Kriston, Levente
    Piontek, Daniela
    Reimer, Jens
    Roehrig, Jeanette
    Scherbaum, Norbert
    Silkens, Anna
    Berner, Michael
    Patient-Centered Placement Matching of Alcohol-Dependent Patients Based on a Standardized Intake Assessment: Primary Outcomes of an Exploratory Randomized Controlled Trial2020Inngår i: European Addiction Research, ISSN 1022-6877, E-ISSN 1421-9891, Vol. 26, nr 3, s. 109-121Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Placement matching guidelines are promising means to optimize patient-centered care and to match patients' treatment needs. Despite considerable research regarding placement matching approaches to optimize alcohol abuse treatment, findings are inconclusive. Objectives: To investigate whether the use of patient-centered placement matching (PCPM) guidelines is more effective in reducing heavy drinking and costs 6 months after discharge from an inpatient alcohol withdrawal treatment compared to usual referral to aftercare. Secondary aims were to investigate whether age, gender, trial site or level of care (LOC) are moderators of efficacy and whether patients who were actually referred to the recommended LOC had better treatment outcomes compared to patients who were treated under- or overmatched. Methods: Design. Exploratory randomized controlled trial with measurements during withdrawal treatment and 6 months after initial assessment. Setting. Four German psychiatric clinics offering a 7-21 day inpatient qualified withdrawal program for patients suffering from alcohol dependence. Participants. From 1,927 patients who had a primary diagnosis of alcohol dependence and did not have organized aftercare when entering withdrawal treatment, 299 were invited to participate. Of those, 250 were randomized to the intervention group (IG, n = 123) or the control group (CG, n = 127). Intervention. The PCPM were applied to patients of the IG by feeding back a recommendation to a LOC for aftercare that was calculated from the Measurements in the Addictions for Triage and Evaluation (MATE) and discussed with the staff of the treatment unit. Patients of the CG received a general feedback regarding their MATE interview on request. Measurements. The MATE, the Client Socio-Demographic and Service Receipt Inventory--European Version and the MATE-Outcomes were administered. Data were analyzed using generalized linear models. Results: In the intention-to-treat analysis, there were no significant differences between IG and CG regarding days of heavy drinking (incident risk ratio [IRR] 1.09; p = 0.640), direct (IRR 1.06; p = 0.779), indirect (IRR 0.77; p = 0.392) and total costs (IRR 0.89; p = 0.496). Furthermore, none of the investigated moderator variables affected statistically significant drinking or cost-related primary outcomes. Regardless of group allocation, patients who received matched aftercare reported significantly fewer days of heavy drinking than undermatched patients (IRR 2.09; p = 0.004). For patients who were overmatched, direct costs were significantly higher (IRR 1.79; p = 0.024), but with no additional effects on alcohol consumption compared to matched patients. Conclusions: While the use of PCPM failed to affect the actual referral to aftercare, our findings suggest that treating patients on the recommended LOC may have the potential to reduce days of heavy drinking compared to undertreatment and costs compared to overtreatment.

  • 34. Callina, Sarah
    et al.
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Centre for Alcohol Policy Research, Australia; Monash University, Australia.
    Harm, tangible or feared: Young Victorians' adverse experiences from others' drinking or drug use2014Inngår i: International journal on drug policy, ISSN 0955-3959, E-ISSN 1873-4758, Vol. 25, nr 3, s. 401-406Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 35. Callinan, S.
    et al.
    Rankin, G.
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). La Trobe University, Australia.
    Stanesby, O.
    Rao, G.
    Waleewong, O.
    Greenfield, T. K.
    Hope, A.
    Laslett, A-M.
    Harms from a partner's drinking: an international study on adverse effects and reduced quality of life for women2019Inngår i: American journal of drug and alcohol abuse, ISSN 0095-2990, E-ISSN 1097-9891, Vol. 45, nr 2, s. 170-178Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Partners of heavy drinking individuals can be detrimentally affected as a result of their partner's drinking.

    Objectives: The aim of this study was to identify the proportion of heterosexual intimate partner relationships with a heavy drinking male that resulted in reported alcohol-related harm and to investigate the impact of this on well-being in 9 countries.

    Methods: This study used survey data from the Gender and Alcohol's Harm to Others (GENAHTO) Project on Alcohol's Harm to Others in 9 countries (10,613 female respondents, 7,091 with intimate live-in partners). Respondents were asked if their partners drinking had negatively affected them as well as questions on depression, anxiety, and satisfaction with life.

    Results: The proportion of partnered respondents that reported having a harmful heavy drinking partner varied across countries, from 4% in Nigeria and the US to 33% in Vietnam. The most consistent correlate of experiencing harm was being oneself a heavy episodic drinker, most likely as a proxy measure for the acceptability of alcohol consumption in social circles. Women with a harmful heavy drinking partner reported significantly lower mean satisfaction with life than those with a partner that did not drink heavily.

    Conclusions: Harms to women from heavy drinking intimate partners appear across a range of subgroups and impact on a wide range of women, at least demographically speaking. Women living with a heavy drinking spouse experience higher levels of anxiety and depression symptoms and lower satisfaction with life.

  • 36. Callinan, Sarah
    et al.
    Laslett, Anne-Marie
    Rekve, Dag
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (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 project2016Inngår i: The international journal of alcohol and drug research, ISSN 1925-7066, Vol. 5, nr 2, s. 25-32Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 37. Callinan, Sarah
    et al.
    Livingston, Michael
    Dietze, Paul
    Gmel, Gerhard
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). La Trobe University, Australia.
    Age-based differences in quantity and frequency of consumption when screening for harmful alcohol use2022Inngår i: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 117, nr 9, s. 2431-2437Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and aims: Survey questions on usual quantity and frequency of alcohol consumption are regularly used in screening tools to identify drinkers requiring intervention. The aim of this study was to measure age-based differences in quantity and frequency of alcohol consumption on the Alcohol Use Disorders Identification Test (AUDIT) and how this relates to the prediction of harmful or dependent drinking.

    Design: Cross-sectional survey.

    Setting: Australia.

    Participants: Data were taken from 17 399 respondents who reported any alcohol consumption in the last year and were aged 18 and over from the 2016 National Drug Strategy Household Survey, a broadly representative cross-sectional survey on substance use.

    Measurement: Respondents were asked about their frequency of consumption, usual quantity per occasion and the other items of the AUDIT.

    Findings: In older drinkers, quantity per occasion [β = 0.53, 95% confidence interval (CI) = 0.43, 0.64 in 43–47-year-olds as an example] was a stronger predictor of dependence than frequency per occasion (β = 0.24, 95% CI = 0.17, 0.31). In younger drinkers the reverse was true, with frequency a stronger predictor (β = 0.54, 95% CI = 0.39, 0.69 in 23–27-year-olds) than quantity (β = 0.26, 95% CI = 0.18, 0.34 in 23–27-year-olds). Frequency of consumption was not a significant predictor of dependence in respondents aged 73 years and over (β = −0.03, 95% CI = −0.08, 0.02). Similar patterns were found when predicting harmful drinking. Despite this, as frequency of consumption increased steadily with age, the question on frequency was responsible for at least 65% of AUDIT scores in drinkers aged 53 years and over.

    Conclusions: In younger drinkers, frequent drinking is more strongly linked to dependence and harmful drinking subscale scores on the Alcohol Use Disorders Identification Test (AUDIT) than quantity per occasion, yet quantity per occasion has a stronger influence on the overall AUDIT score in this group. In older drinkers, frequency of consumption is not always a significant predictor of the AUDIT dependence subscale and is a weak predictor of the harmful drinking subscale.

  • 38. Callinan, Sarah
    et al.
    Livingston, Michael
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (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?2016Inngår i: Journal of Studies on Alcohol and Drugs, ISSN 1937-1888, E-ISSN 1938-4114, Vol. 77, nr 4, s. 612-619Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 39. Callinan, Sarah
    et al.
    Livingston, Michael
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (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?2018Inngår i: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 37, nr 1, s. 42-47Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 40. Callinan, Sarah
    et al.
    Mojica-Perez, Yvette
    Wright, Cassandra J. C.
    Livingston, Michael
    Kuntsche, Sandra
    Laslett, Anne-Marie
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). La Trobe University, Australia.
    Kuntsche, Emmanuel
    Purchasing, consumption, demographic and socioeconomic variables associated with shifts in alcohol consumption during the COVID-19 pandemic2021Inngår i: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 40, nr 2, s. 183-191Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction and Aims: Restrictions introduced to reduce the spread of COVID-19 have had major impacts on the living circumstances of Australians. This paper aims to provide insight into shifts in alcohol consumption and associated factors during the epidemic. Design and Methods: A cross-sectional convenience sample of 2307 Australians aged 18 and over who drank at least monthly was recruited through social media. Respondents were asked about their alcohol consumption and purchasing in 2019 prior to the epidemic plus similar questions about their experiences in the month prior to being surveyed between 29 April and 16 May 2020. Results: Reports of average consumption before (3.53 drinks per day [3.36, 3.71 95% confidence interval]) and during (3.52 [3.34, 3.69]) the pandemic were stable. However, young men and those who drank more outside the home in 2019 reported decreased consumption during the pandemic, and people with high levels of stress and those who bulk-bought alcohol when restrictions were announced reported an increase in consumption relative to those who did not. Discussion and Conclusions: A reported increase in consumption among those experiencing more stress suggests that some people may have been drinking to cope during the epidemic. Conversely, the reported decrease in consumption among those who drank more outside of their home in 2019 suggests that closing all on-trade sales did not result in complete substitution of on-premise drinking with home drinking in this group. Monitoring of relevant subgroups to assess long-term changes in consumption in the aftermath of the epidemic is recommended.

  • 41. Callinan, Sarah
    et al.
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). University of Melbourne, Australia; Turning Point Alcohol & Drug Centre, Australia.
    Livingston, Michael
    Changes in Australian attitudes to alcohol policy: 1995–20102014Inngår i: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 33, nr 3, s. 227-234Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction and Aims

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

    Design and Methods

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

    Results

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

    Discussion and Conclusions

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

  • 42. Callinan, Sarah
    et al.
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Centre for Alcohol Policy Research, Turning Point, Australia; University of Melbourne, Australia.
    Livingston, Michael
    Jiang, Heng
    Who Purchases Low-Cost Alcohol in Australia?2015Inngår i: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 50, nr 6, s. 647-653Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 43. Caluzzi, Gabriel
    et al.
    Fenton, Laura
    Holmes, John
    MacLean, Sarah
    Pennay, Amy
    Fairbrother, Hannah
    Törrönen, Jukka
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap.
    ‘90 per cent of the time when I have had a drink in my hand I’m on my phone as well’: A cross-national analysis of communications technologies and drinking practices among young people2023Inngår i: New Media and Society, ISSN 1461-4448, E-ISSN 1461-7315Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 44. Coomber, Kerri
    et al.
    Zahnow, Renee
    Ferris, Jason
    Droste, Nicolas
    Mayshak, Richelle
    Curtis, Ashlee
    Kypri, Kypros
    de Andrade, Dominique
    Grant, Kristy
    Chikritzhs, Tanya
    Room, Robin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). La Trobe University, Australia.
    Jiang, Heng
    Taylor, Nicholas
    Najman, Jake
    Miller, Peter
    Short-term changes in nightlife attendance and patron intoxication following alcohol restrictions in Queensland, Australia2018Inngår i: BMC Public Health, E-ISSN 1471-2458, Vol. 18, artikkel-id 1185Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: This study aims to explore short-term changes following the introduction of alcohol restrictions (most notably 2am to 3am last drinks). We examined patterns of nightlife attendance, intoxication, and alcohol use among patrons shortly before and after restrictions were introduced in Fortitude Valley, Brisbane: the largest night-time entertainment precinct of Queensland.

    Methods: Street-intercept patron interviews were conducted in Fortitude Valley in June (n=497) and July (n=562) 2016. A pre-post design was used to assess changes in time spent out drinking/partying prior to the interview, time of arrival in the precinct, pre-drinking, and blood alcohol concentration (BAC).

    Results: Regression models indicated that after the policy introduction, the proportion of people arriving at Fortitude Valley before 10:00pm increased (OR=1.38; 95% CI=1.04, 1.82). Participants reported going out, on average, one hour earlier after the intervention (=-0.17; 95% CI=0.11, 0.22). There was a decrease (RRR=0.58; 95% CI=0.43, 0.79) in the proportion of participants who had a high level of intoxication (BAC 0.10g/dL) post-intervention. No other significant differences were found.

    Conclusions: Earlier cessation of alcohol sales and stopping the sale of rapid intoxication drinks after midnight was associated with people arriving in Fortitude Valley earlier. Though legislative loopholes allowed some venues to continue trading to 5am, the proportion of people in the precinct who were highly intoxicated decreased after the restriction. Further measurement will be required to determine whether the reduction has persisted.

  • 45. Cunningham, John A.
    et al.
    Blomqvist, Jan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD).
    Koski-Jannes, Anja
    Raitasalo, Kirsimarja
    Societal images of Cannabis use: comparing three countries2012Inngår i: Harm Reduction Journal, E-ISSN 1477-7517, Vol. 9, s. 21-Artikkel i tidsskrift (Fagfellevurdert)
    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.

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  • 46. Dahlberg, Mikael
    et al.
    Anderberg, Mats
    Wennberg, Peter
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Karolinska Institutet, Sweden.
    Psychometric properties of the UngDOK: A structured interview for adolescents with substance-use problems2017Inngår i: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, Vol. 34, nr 2, s. 160-172Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 47. Danielsson, Anna-Karin
    et al.
    Agardh, Emilie
    Hemmingsson, Tomas
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Karolinska Institutet, Sweden.
    Allebeck, Peter
    Falkstedt, Daniel
    Cannabis use in adolescence and risk of future disability pension: A 39-year longitudinal cohort study2014Inngår i: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 143, s. 239-243Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 48. Danielsson, Anna-Karin
    et al.
    Falkstedt, Daniel
    Hemmingsson, Tomas
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (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 study2015Inngår i: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 110, nr 11, s. 1794-1802Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 49. Danielsson, Anna-Karin
    et al.
    Wennberg, Peter
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Karolinska institutet, Sweden; Stockholm County Council, Sweden.
    Hibell, Björn
    Romelsjö, Anders
    Alcohol use, heavy episodic drinking and subsequent problems among adolescents in 23 European countries: does the prevention paradox apply?2012Inngår i: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 107, nr 1, s. 71-80Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 50. Dauber, Hanna
    et al.
    Pogarell, Oliver
    Kraus, Ludwig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. IFT Institut für Therapieforschung, Germany; ELTE Eötvös-Loránd-University, Hungary.
    Braun, Barbara
    Older adults in treatment for alcohol use disorders: service utilisation, patient characteristics and treatment outcomes2018Inngår i: Substance Abuse Treatment, Prevention, and Policy, E-ISSN 1747-597X, Vol. 13, artikkel-id 40Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background In western countries demographic changes are leading to an ageing society. Consequently, the number of older adults with alcohol use disorders (AUDs) will rise and the demand of treatment is likely to increase. However, thus far not many older adults with an AUD are seeking treatment and little is known about the efficacy of treatment for older adults. The present study aimed at determining the proportion of older adults with an AUD in addiction treatment, particular characteristics and treatment outcomes of this clientele.

    Methods Using data of 10,860 patients with an AUD aged 60 and over that are documented within the national German addiction care system we conducted exploratory analyses with regard to prevalence, sociodemographic, disorder- and treatment-related variables.

    Results Overall, we found a low proportion of older patients in treatment due to AUDs, but highly positive treatment outcomes. With regard to sociodemographic and disorder-related characteristics, older females and late-onset patients in particular constitute a unique clientele.

    Conclusions The low service utilisation on the one hand but good treatment prognosis on the other emphasise the need to promote treatment seeking among older adults with AUDs. In this context, the special characteristics we found among older patients may contribute to better reach this population and to improve provisions of targeted treatment approaches.

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