| 1. |
- Davstad, Ingrid, et al.
(författare)
-
An 18-Year Follow-Up of Patients Admitted to Methadone Treatment for the First Time
- 2009
-
Ingår i: Journal of Addictive Diseases. - : Informa UK Limited. - 1055-0887 .- 1545-0848. ; 28:1, s. 39-52
-
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.
|
|
| 2. |
|
|
| 3. |
- Davstad, Ingrid, et al.
(författare)
-
Self-reported drug use and mortality among a nationwide sample of Swedish conscripts - A 35-year follow-up
- 2011
-
Ingår i: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 118:2-3, s. 383-390
-
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.
|
|
| 4. |
- Karlsson, Gunilla, et al.
(författare)
-
Hospitalization and mortality succeeding drunk driving and risky driving
- 2003
-
Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 38:3, s. 281-286
-
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.
|
|
| 5. |
- Lindqvist, Per, et al.
(författare)
-
Mortality among homicide offenders : a retrospective population-based long-term follow-up.
- 2007
-
Ingår i: Criminal behaviour and mental health. - : Wiley. - 0957-9664 .- 1471-2857. ; 17:2, s. 107-12
-
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.
|
|
| 6. |
- Romelsjö, Anders, et al.
(författare)
-
Were the changes to Sweden's maintenance treatment policy 2000-06 related to changes in opiate-related mortality and morbidity?
- 2010
-
Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 105:9, s. 1625-1632
-
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.
|
|
| 7. |
- Stenbacka, Marlene, et al.
(författare)
-
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
-
Ingår i: Alcohol. - 0741-8329 .- 1873-6823. ; 28:1, s. 9-16
-
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.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Stenbacka, Marlene, et al.
(författare)
-
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
-
Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 22:1, s. 27-34
-
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.
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
- Jansson, B., et al.
(författare)
-
A small fraction of patients with repetitive injuries account for a large proportion of medical costs
- 2004
-
Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 14:2, s. 161-167
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The phenomenon of repetitive injuries has been judged to be of limited importance in the public health context. A study was therefore initiated in order to analyse all types of single and repetitive injuries using a longitudinal approach. METHODS: Hospital care, medical costs and risk factors were examined for single and repetitive severe injuries. A cross-sectional survey with a 12-year follow-up was performed. Questionnaire information from a survey of a random sample of the adult population 20-89 years old in 1984 in Stockholm County were linked to the Swedish national inpatient and cause-of-death register up to 1996, inclusive. RESULTS: During the study period 13% of males and 15% of females were hospitalized or deceased as a result of injuries. Persons with three or more injuries comprise 19% of the injuries, but account for 63% of the total number of days of hospital care and medical costs. Injuries related to falls were most common among patients requiring hospital care. Factors such as high age, living alone, stroke earlier, and use of hypnotics and sedatives were especially associated with repetitive injuries. The risk factors for single and repetitive injuries covariate, but the size of the risk is overrepresented for stroke, drugs, self-reported injuries and living alone for two or more injuries. CONCLUSION: These results indicate that subjects with repetitive injuries, and with the observed risk factors for such injuries, should be given extra attention, both in policy and prevention, but also in integrated treatment programmes.
|
|
| 15. |
- Johnsson, Kent, et al.
(författare)
-
College students' drinking patterns: trajectories of AUDIT scores during the first four years at university.
- 2008
-
Ingår i: European Addiction Research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 14:1, s. 11-18
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS: Changes in AUDIT score trajectories were examined in a student population during their first 4 years at a university, including high-risk consumers and a subsample of low-risk consumers. METHOD: 359 students were selected for the present study, comprising all high-risk consumers (the 27% with highest scores, i.e. 11 for males and 7 for females) and a randomized sample of low-risk consumers (n = 177 and 182, respectively). The Alcohol Use Disorder Identification Test (AUDIT) was used as screening instrument. Trajectory analyses were made using a semiparametric group-based model. RESULTS: In the low-AUDIT group, five distinct trajectories were identified: three stable non-risky consumption groups (83%) and two increasing groups (17%; from non-risky to risky). In the high-AUDIT group, three groups were identified: two stable high groups (58%) and one decreasing group (from risky to non-risky consumption; 41%). In the integrated model, stable risky consumption comprised 16% of the total sample, decreasing consumption 11%, increasing consumption comprised 13% and stable non-risky consumption 60% of the sample. Gender influenced the trajectories. CONCLUSION: The pattern of changes in risk consumption is similar to that found in corresponding US studies.
|
|
| 16. |
- Lundholm, Lena, et al.
(författare)
-
Acute influence of alcohol, THC or central stimulants on violent suicide : a Swedish Population study
- 2014
-
Ingår i: Journal of Forensic Sciences. - : Wiley. - 0022-1198 .- 1556-4029. ; 59:2, s. 436-440
-
Tidskriftsartikel (refereegranskat)abstract
- Alcohol and substance abuse in general is a risk factor for suicide, but very little is known about the acute effect in relation to suicide method. Based on information from 18,894 medico-legal death investigations, including toxicological findings and manner of death, did the present study investigate whether acute influence of alcohol, tetrahydrocannabinol (THC) or central stimulants (amphetamine and cocaine) was related to the use of a violent suicide method, in comparison with the non-violent method self-poisoning and alcohol/illicit drugs negative suicide decedents. Multivariate analysis was conducted and the results revealed that acute influence of THC was related to using the violent suicide method; jumping from a height (RR 1.62; 95%CI 1.01-2.41). Alcohol intoxication was not related to any violent method, while the central stimulants positive suicide decedent had a higher, albeit not significant, risk for several violent methods. The study contributes with elucidating suicide methods in relation to acute intoxication.
|
|
| 17. |
- Romelsjö, Anders, et al.
(författare)
-
Abstention, alcohol use and risk of myocardial infarction in men and women considering social anchorage and working conditions : the SHEEP case control study
- 2003
-
Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 98:10, s. 1453-1462
-
Tidskriftsartikel (refereegranskat)abstract
- Aims Very few studies indicating that low–moderate alcohol consumption protects from myocardial infarction (MI) controlled for social support and working conditions, which could confound the findings. Therefore, a first aim was to study the risk of non-fatal and total MI in relation to volume of alcohol consumption and measures of social support and working conditions. A second aim was to analyse the impact of the volume of earlier alcohol use in abstainers.Design Data came from a case–control study, the Stockholm Heart Epidemiology Program (SHEEP), including first MI among Swedish citizens 45–70 years old.Setting Stockholm County 1992–94.Participants There were 1095 cases of MI in men and 471 in women (928 and 372 were non-fatal), and 2339 living controls from the general population.Measurement Information about alcohol use at different periods in life and job strain, social anchorage and life control besides pre-existing health problems, smoking, physical activity, socio-economic status and marital status was obtained by a questionnaire from the cases and the controls.Findings In multivariate logistic regression analyses, the relative risk for MI (especially non-fatal) was reduced among alcohol consumers. RR for non-fatal MI was 0.52 (95% confidence intervals 0.32, 0.85) in men with a consumption of 50–69.9 g 100% ethanol/day and 0.21 (95% confidence interval 0.06, 0.77) in women with a consumption of 30 g or more per day (reference category 0.1–5 g 100% ethanol/day). Men who were abstainers during the previous 1–10 years and with an earlier average consumption of 5–30 g 100% ethanol/day had a significantly lower relative risk compared to such abstainers with an earlier higher consumption. Earlier consumption among abstainers may also have an impact on gender differences in MI. Analyses showed positive interaction between abstention and low life-control in women, but only 4% of the female cases were due to this interaction. There were no other interactions between measures of alcohol use and social anchorage, life control and working situations.Conclusion Alcohol use had a protective impact on MI, with little impact of job strain, social anchorage and life control, giving increased support for a protective impact of low-moderate alcohol use. The level of previous alcohol consumption among male 1–10-year-long abstainers influenced the risk of MI.
|
|
| 18. |
|
|
| 19. |
- Ståhlbrandt, Henriettae, et al.
(författare)
-
Alcohol trajectories over three years in a Swedish residence hall student population.
- 2010
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 7:4, s. 1432-1447
-
Tidskriftsartikel (refereegranskat)abstract
- Although it is known that college students have a high alcohol consumption, less is known about the long-term drinking trajectories amongst college students and, in particular, students living in residence halls, known to be high-risk drinkers. Over four consecutive years, the drinking habits of 556 Swedish residence hall students were analyzed. The main instruments for measuring outcome were AUDIT (Alcohol Use Identification Disorders Test), SIP (Short Index of Problems) and eBAC (estimated Blood Alcohol Concentration). The drinking trajectories among Swedish residence hall students showed stable and decreasing drinking patterns, with age and gender being predictors of group membership.
|
|
