Aims: In the article at hand we intend to discuss to what extent hitherto efforts towards standardization and quality assurance have been able to achieve stability concerning the production of evidence, and whether an actual evidence-based practice for psychosocial interventions for alcohol and drug problems is anywhere truly in the making. Methods: To explain several methodological inadequacies we make use of a perspective commonly referred to as the actor-network theory (ANT). This is characterized by a strong interest in detailed analysis of how an innovation or an idea is transformed due to interaction with its situated and specific conditions.The empirical material is taken from four earlier studies of our own hands. Results: We have given examples of how an unsystematic handling of different control group designs can lead to serious misinterpretations of intervention effects. The same goes for researcher allegiance, the use of different types of criteria in order to rank different types of evidence, unmotivated restrictions on the inclusion of evidence in a given systematic review, or as in the case of several US clearinghouses. to use extremely weak criteria when discriminating between what is evidence-based and what is not. Conclusions: We suggest that all of these shortcomings are directly or indirectly related to translations, modifications or neglect to adhere to methodological rules intended to produce a reduction of biases and increase standardization

Background: Differing results on gender specific factors related to mortality risks among substance misusers highlights the need for further research. The present article is based on a 30-year follow-up study on substance misusers treated in residential care for drug problems in Sweden in 1982-1983 aiming to identify and compare gender differences in predictors of mortality.

Method: Original data consists of personal interviews with 1163 substance misusers treated in inpatient units in Sweden during 1982-1983. The outcome variable is death retrieved from the National Cause of Death Register held by the National Board of Health and Welfare. Gender differences and similarities regarding predictors of mortality was estimated in univariate and multivariate models, using Cox proportional hazards models.

Results: School failure, imprisonment and being a parent without custody of the child seem to constitute risk factors for mortality among women, but not among men. A social network of friends seemed to be more important for men. Treatment-dropout was a significant risk factor for premature death among men, but not among women. Both gender reporting alcohol as their self-reported most dominant substance misuse showed higher mortality risks compared with those with stimulants as dominant substance misuse.

Conclusions: Imprisonment was highly predictive of mortality for the women, suggesting that this group is important to pay particular attention to. Suggested differences in the importance of social factors need to be investigated more thoroughly. The substantial hazard revealed for women with polydrug misuse including alcohol calls for attention to this in treatment for substance misuse.

Background: This article presents a 30-year follow-up study of a cohort of 1163 substance misusers who were in inpatient treatment in the early 1980s. Data was originally collected in the Swedish Drug Addict Treatment Evaluation (SWEDATE). Objectives: The aim is to examine the overall mortality and identify causes of death in different groups based on self-reported most dominant substance misuse among those who have died during January 1984-December 2013. Methods: SWEDATE-data was linked to the National Cause of Death Register. Five mutually exclusive study groups were created based on self-reported most dominant substance misuse for the last 12 months before intake to treatment: Alcohol, Cannabis, Stimulants, Opiates, and Other. The Standardized Mortality Ratio (SMR) was calculated. Results: During the follow-up, 40% died. SMR is 10.3 for women and 11.7 for men. The study groups differed regarding SMR; 13.1 in the Alcohol group, 9.2 in the Cannabis group, 9.6 in the Stimulants group, 16.7 in the Opiates group and 10.8 in the Other group. Drug related death was the most common cause of death (28% only underlying, 19% both underlying and contributing) followed by alcohol related reasons (17% vs. 9%). Conclusions: Alcohol misuse among substance abusers might have a negative impact on mortality rates. Methodological changes in how drug related deaths is registered affects the interpretation of the statistics of cause of death. Further analysis on the relation between drug related cause of death and drug misuse related death is needed.

Research indicates that a number of psychosocial interventions are effective for reducing behavioural problems in youth. These interventions are now often included on best practice lists aiming to facilitate informed treatment choices among practitioners. However, analyses in neighbouring research areas have highlighted serious shortcomings in how primary studies are analysed and how studies are synthesised in research reviews. This study took a closer look at the evidence of efficacy for psychosocial interventions that aim to reduce behavioural problems in youth, as shown in systematic research reviews by the Cochrane and the Campbell Collaborations (n = 8). The findings suggest a bias towards overemphasising the efficacy of the interventions in several reviews, an over-confidence in the validity of the findings in some reviews and, overall, a somewhat uncertain evidence base for the efficacy of the interventions. Systematic reviews are crucial for summarising research but more attention to methodological issues may be needed in this area.

The body of Internet addiction research articles has grown rapidly during the last years. Critics claim that the bulk of this research is more confirmatory than scrutinizing, in spite of weak evidence for the label of addiction. A study on excessive Internet use in Sweden has been cited repeatedly in Internet addiction studies. The present study takes a closer look at these citations and combines the presentation with a systematic review of methods and theoretical approaches in Internet addiction studies, published between January 2000 and July 2013.

Background and Aims

A crucial, but under-appreciated, aspect in experimental research on psychosocial treatments of substance use disorders concerns what kinds of control groups are used. This paper examines how the distinction between different control group designs has been handled by the Cochrane and the Campbell Collaborations in their systematic reviews of psychosocial treatments of substance abuse disorders.

Methods

We assessed Cochrane and Campbell reviews (n = 8) that were devoted to psychosocial treatments of substance use disorders. We noted what control groups were considered and analysed the extent to which the reviews provided a rationale for chosen comparison conditions. We also analysed whether type of control group in the primary studies influenced how the reviews framed the effects discussed and whether this was related to conclusions drawn.

Results

The reviews covered studies involving widely different control conditions. Overall, little attention was paid to the use of different control groups (e.g. head-to-head comparisons vs. untreated controls) and what this implies when interpreting effect sizes. Seven of eight reviews did not provide a rationale for the choice of comparison conditions.

Conclusions

Cochrane- and Campbell reviews of the efficacy of psychosocial interventions with substance use disorders seem to underappreciate that use of different control group types yields different effect estimates. Most reviews have not distinguished between different control group designs and therefore have provided a confused picture regarding absolute and relative treatment efficacy. A systematic approach to treating different control group designs in research reviews is necessary for meaningful estimates of treatment efficacy.