| 1. |
- Davstad, Ingrid, et al.
(författare)
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An 18-Year Follow-Up of Patients Admitted to Methadone Treatment for the First Time
- 2009
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Ingår i: Journal of Addictive Diseases. - : Informa UK Limited. - 1055-0887 .- 1545-0848. ; 28:1, s. 39-52
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Tidskriftsartikel (refereegranskat)abstract
- An 18-year addiction career, 1985-2003, for 157 heroin dependent subjects (73% men; 49% human immunodeficiency virus seropositive) admitted for the first time to Stockholm's Methadone Maintenance Treatment program during 1989 to 1991 was analyzed with data from seven official registers and patient records. Regression analyses and incidence rates for various outcomes were calculated for subjects in first methadone maintenance treatment at the end of the observation period, discharged from first methadone maintenance treatment, in second methadone maintenance treatment, and discharged from second methadone maintenance treatment. Being human immunodeficiency virus positive (HR = 3.8), lodging (HR = 1.9) and prison sentence (HR = 1.7) predicted mortality for the 45% deceased. Approximately 70% of living subjects participated in methadone maintenance treatment at some period each year. Subjects in first or second methadone maintenance treatment had less criminality and had spent more time in methadone maintenance treatment (70% to 100%) than those discharged from first or from second methadone maintenance treatment (50%). Efforts and interventions should be intensified to increase time in treatment also for those with high problem severity.
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| 2. |
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| 3. |
- Davstad, Ingrid, et al.
(författare)
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Self-reported drug use and mortality among a nationwide sample of Swedish conscripts - A 35-year follow-up
- 2011
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Ingår i: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 118:2-3, s. 383-390
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Tidskriftsartikel (refereegranskat)abstract
- Background: Drug users in clinical samples have elevated mortality compared with the general population, but little is known about mortality among users of drugs within the general population. Aim: To determine whether self-reported use of illicit drugs and non-prescribed sedatives/hypnotics among young men in the general population is related to mortality. Methods: A 35-year follow-up of 48 024 Swedish men, born 1949-1951 and conscripted in 1969/1970, among whom drug use was reported by 8767 subjects. Cross-record linkage was effected between individual data from the Swedish conscription and other national registers. Deaths and causes of death/1000 person-years were calculated. Cox PH regression was used to estimate hazard ratios (HRs) for death with 95% confidence intervals (95% CIs). An HR was calculated for users of different dominant drugs at conscription compared with non-users by age interval, after adjusting for confounders and hospitalisation with a drug-related diagnosis. Results: Drug users showed elevated mortality (HR 1.61, p < 0.05) compared with non-users. After adjusting for risk factors, users of stimulants (HR 4.41, p < 0.05), cannabis (HR 4.27, p < 0.05), opioids (HR 2.83, p > 0.05), hallucinogens (HR 3.88, p < 0.05) and unspecified drugs (HR 4.62, p < 0.05) at conscription with a drug-related diagnosis during follow-up showed an HR approaching the standard mortality ratios in clinical samples. Among other drug users (95.5%), only stimulant users showed statistically significantly increased mortality (HR 1.96, p < 0.05). Conclusions: In a life-time perspective, drug use among young men in the general population was a marker of premature death, even a long time after exposure.
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| 4. |
- Karlsson, Gunilla, et al.
(författare)
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Hospitalization and mortality succeeding drunk driving and risky driving
- 2003
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Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 38:3, s. 281-286
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Tidskriftsartikel (refereegranskat)abstract
- AIMS:The association between drunk driving (DD) and/or risky driving (RD) offences and subsequent hospitalization and mortality was studied during a 25-year period.METHODS:Information about drinking habits and psychosocial factors for the 8122 conscripts from Stockholm County in 1969-1970 was linked to register data on hospitalization, mortality, DD and RD.RESULTS:Analyses comparing background characteristics of DD and RD groups showed that the prevalence of problem behaviour and drug use was highest in the RD group. The relative risk (RR) for hospitalization after DD and/or RD was significantly elevated in multivariate logistic regression analysis for all the studied diagnostic categories (alcohol diagnoses, narcotic diagnoses, suicide attempts, psychoses, E-codes, all diagnoses), and was especially high for alcohol (RR = 7.2) and diagnosis of drug misuse (RR = 9.2). The RR of all hospitalization was 1.5 for the DD group, 1.8 for the RD group, and 1.9 for those who had been sentenced both for drunk driving and risky driving (DRD), all of which were significantly increased. The RR of death was significantly elevated in all three groups.CONCLUSIONS:The results show a significantly increased risk of hospitalization and mortality both in the DD and the RD group. From a public health and traffic safety perspective, this implies a need for developing and implementing better prevention strategies.
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| 5. |
- Lindqvist, Per, et al.
(författare)
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Mortality among homicide offenders : a retrospective population-based long-term follow-up.
- 2007
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Ingår i: Criminal behaviour and mental health. - : Wiley. - 0957-9664 .- 1471-2857. ; 17:2, s. 107-12
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Tidskriftsartikel (refereegranskat)abstract
- Background Empirical data on homicide and homicide offenders are needed in the ongoing discussion on violence and crime prevention. One issue, insufficiently investigated, is the post-trial life course of homicide offenders.Aim To examine whether the mortality rate, as well as cause and manner of death, of homicide offenders is different from the general population.Method An incidence cohort of Swedish homicide offenders from 1970 to 1980 (n = 153) was re-examined by computerized record linkage with the National Cause-of-Death Register for the period between trial and 1 October 2002, i.e. 22-32 years after the offence. Death certificates were analysed, and standard procedures for calculating Standard Mortality Rate (SMR) and survival analysis were employed.Results Half of the study subjects had died by 2002. The overall mortality rate was about three times higher than that of the general population. In particular, the risk of suicide was salient.Implications It can be argued that offenders' self-neglect and self-contempt merge with public and professional views, predisposing to an increased risk of premature death. Copyright (c) 2007 John Wiley & Sons, Ltd.
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| 6. |
- Romelsjö, Anders, et al.
(författare)
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Were the changes to Sweden's maintenance treatment policy 2000-06 related to changes in opiate-related mortality and morbidity?
- 2010
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 105:9, s. 1625-1632
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Tidskriftsartikel (refereegranskat)abstract
- Aims To analyse whether changes in maintenance treatment of opiate-dependent subjects in Sweden were related to changes in opiate-related mortality and inpatient care from 1998 to 2006. Design We collected data from surveys of methadone maintenance treatment units, of buprenorphine and methadone sales, and of mortality and inpatient care in Sweden. Setting Sweden. Participants Patients in maintenance treatment. Measurements Survey data of treatment policy to all units in 2003 and 2005. Trend tests and correlation analyses of data on sales, mortality, inpatient care and forensic investigations. Findings The surveys showed a marked change to a less restrictive policy, with increased use of 'take-away doses' and a reduction of discharges due to side misuse. The one-year retention rate stayed high. Sales of buprenorphine and methadone and the number of patients in treatment increased more than threefold from 2000 to 2006, with the greatest increase for buprenoprphine, introduced in year 2000. There was a significant 20-30% reduction in opiate-related mortality and inpatient care between 2000-2002 and 2004-2006 but not of other drug-related mortality and inpatient care. This decline was larger in Stockholm County, which had a less restricted treatment policy. However, a significant increase in buprenorphine- and methadone-related mortality occurred. For the study period 1998-2006, statistically significant declines occurred only in Stockholm County. Conclusions The liberalization of Sweden's drug policy correlated with an increase in maintenance treatment, a decrease in opiate-related mortality and inpatient care and an increase in deaths with methadone and buprenorphine in the tissues.
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| 7. |
- Stenbacka, Marlene, et al.
(författare)
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Association between use of sedatives or hypnotics, alcohol consumption, or other risk factors and a single injurious fall or multiple falls : a longitudinal general population study
- 2002
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Ingår i: Alcohol. - 0741-8329 .- 1873-6823. ; 28:1, s. 9-16
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we investigated the association between risk factors, including use of sedatives or hypnotics or alcohol consumption, and injurious falls leading to hospitalization or death among 4023 subjects (1828 men and 2195 women) aged 20-89 years in Stockholm County, Sweden. Questionnaire data obtained from the 1984-1985 Stockholm Health of the Population Study (SHPS) were linked to official data registers on hospitalization and mortality. Of the 4023 subjects, 330 (121 men and 209 women) had been treated for or died of injurious falls during the 12-year follow-up period. High age was significantly associated with injurious falls among both men and women. Multivariate analyses showed that women who had used sedatives or hypnotics during the 2 weeks before an injurious fall were at increased risk [relative risk of 1.83 (95% confidence interval, 1.10-3.06)] for two or more injurious falls, but not for a single fall accident. High alcohol consumption and earlier self-reported injurious falls were significantly associated with injurious falls for women younger than 60 years of age and with earlier self-reported falls and living alone for men in the same age category. Among older women (>60 years of age), high alcohol consumption and use of sedatives or hypnotics were significantly associated with injurious falls, whereas living alone and earlier self-reported accidents were significant predictors for men in the same age category. These results support a cautious prescribing policy for sedatives and hypnotics, as well as an awareness of high alcohol consumption and its association with injurious falls.
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| 9. |
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| 10. |
- Stenbacka, Marlene, et al.
(författare)
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The impact of methadone treatment on registered convictions and arrests in HIV-positive and HIV-negative men and women with one or more treatment periods
- 2003
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 22:1, s. 27-34
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates criminality among 331 opiate abusers admitted to Stockholm's methadone maintenance programme (SMMP) between 1988 and 1992, and a comparison group of 1483 untreated opiate abusers. Information on arrests, criminal convictions, and intravenous drug abuse was obtained from official records. For both genders the annual rate of convictions decreased from 2.2 convictions per year during the 4 years prior to the first treatment, to 0.5 convictions during treatment, compared to 2.0 convictions for the comparison group. There was an even greater decrease in the rate of arrests for patients on methadone treatment. The decline was observed for both genders and in both HIV-positive and HIV-negative patients. Rates of convictions among patients who had more than one treatment period were clearly reduced during each treatment period, and while the rate increased after they were expelled from treatment it remained at a lower level than during the 4 years prior to treatment. Thus, the methadone treatment is shown to have a profound positive effect on arrests and convictions, not only for patients remaining in treatment but also for those patients who were expelled from treatment involuntarily.
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