| 1. |
- Blomqvist, Jan, et al.
(författare)
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'More cure and less control' or 'more care and lower costs'? Recent changes in services for problem drug users in Stockholm and Sweden
- 2009
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Ingår i: Drugs. - : Informa UK Limited. - 0968-7637 .- 1465-3370. ; 16:6, s. 479-496
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Tidskriftsartikel (refereegranskat)abstract
- This article deals with the development of drug services in Stockholm, Sweden since the mid-1990s. Initially, data were collected as part of a European Union comparative study of the development of drug services in six major European cities. However, the present article uses these data to analyse to what extent the traditional 'Swedish model' of dealing with narcotic drugs can be said to have come to a crossroad. The article describes and analyses changes in drug use, and in the structure, organization and utilization of social services based, as well as healthcare-based drug services in Stockholm during the past decade. As pointed out in the article, the 'drug-free society' is still the ultimate goal of Swedish drug policy. However, as the Stockholm example hints, when it comes to the care and treatment of individual drug problems, there seems to be an on-going shift, from in-patient treatment towards measures such as substitution treatment, outpatient care and housing. The article discusses whether these changes signify a softening of Sweden's restrictive drug policy, or whether they rather point to a 're-medicalization' of drug services, and shift in focus from 'cure' and social re-integration towards a focus on 'care' and on attempts to avoid 'public nuisance'.
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| 2. |
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| 3. |
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| 4. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
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A study of service user involvement in practice in the Swedish substance abuse treatment system : Methods, participants, and outcomes
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Demands for service user involvement has a long history in the general health and welfare sectors in Sweden, but user involvement has been lagging behind as concerns substance abuse treatment. “The position of the service user in substance treatment: A study of user involvement in practice” therefore sought to analyze perceptions of user involvement and the extent to which alcohol and drug users in this treatment sector can influence the choice of intervention in their own case. The study included both the perspectives of the service users and their professional service providers. The relationship between user involvement, satisfaction, and outcomes were explored, as well as potential differences in perceptions and experiences between various service user groups and service providers. The study applied a qualitative research approach by interviewing 36 service users and 23 service providers (pairs of service users and providers), and following them up three months later.The primary goal of the present technical report was to provide a quantitative exploration of research participant characteristics, user involvement and treatment satisfaction by different groups, including outcomes. The report uses tabular formats as well as several summaries of interview accounts. The report also outlines our theoretical point of departure and detailed information concerning the research methods and methodological considerations.[A Swedish summary is available in the report]
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| 5. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
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Brukarinflytande på vårdmarknaden : en paradox i missbruks- och beroendevården?
- 2018
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Ingår i: Socialtjänstmarknaden. - Stockholm : Liber. - 9789147113019 ; , s. 85-115
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Kapitlet behandlar brukarinflytande inom missbruks- och beroendevården och diskuterar den potentiella konflikten mellan denna företeelse och New Public Management (NPM). Kapitlet diskuterar hur företeelser som ofta förknippas med NPM (t.ex. upphandling och ramavtal, valfrihet, prestationsbaserade ersättningssystem) inverkar på handlingsutrymme och vårdbeslut utifrån personalens och brukarnas utsagor, liksom hur klienter och patienter ser på sina möjligheter till inflytande i en NPM-inspirerad vård.
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| 6. |
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| 7. |
- Holmén, Elin, et al.
(författare)
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Take-Home Naloxone and risk management from the perspective of people who survived an opioid overdose in Stockholm — An analysis informed by drug, set and setting
- 2023
-
Ingår i: International journal of drug policy. - 0955-3959 .- 1873-4758. ; 115
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Take-Home Naloxone (THN) programs were introduced in Sweden in 2018 —a country with one of the highest rates of overdose mortality in the EU and a severe stigmatisation of people who inject drugs. This qualitative study builds on the international research that has expanded a previously narrow and medical focus on overdose deaths. It uses Zinberg’s framework to look beyond the role of the “drug ”to include the attitudes and personality of the person ( “set ”) and contextual factors ( “setting ”). This study explores the impacts of THN from the perspective of overdose survivors. Methods: Between November 2021 and May 2022 semi-structured interviews were conducted with 22 opioid overdose survivors, recruited among clients of the Stockholm needle and syringe program. All the participants had been treated with naloxone in an overdose situation. The interviews were processed through thematic analysis using deductive and inductive coding in accordance with the theoretical framework. Results: Interviewees included men and women who used different types of drugs. THN has impacted on “drug ”in terms of naloxone-induced withdrawal symptoms and peers having to deal with survivors’ emotions. Exploring “set ”revealed feelings of shame following naloxone revival for the person who overdosed. Despite such reactions, participants retained an overwhelmingly positive attitude towards THN. Participants integrated THN into their risk management practices ( “setting ”) and some acknowledged that THN provided a new way to treat overdoses without necessarily needing to interact with authorities, especially the police. Conclusion: The THN program has influenced “drug, set and setting ”for participants, providing increased safety at drug-intake and transferring overdose management and the burden of care to the community. The lived experi- ence of participants also exposes the limitations of THN indicating that there are additional unmet needs beyond THN programs, particularly in terms of “setting ”.
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| 8. |
- Klingemann, Harald, et al.
(författare)
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The Treatment Response : Systemic Features, Paradigms and Socio-Cultural Frameworks
- 2016
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Ingår i: The SAGE Handbook of Drug & Alcohol Studies. - London : Sage Publications. - 9781446298664 - 9781473921986 ; , s. 260-286
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Bokkapitel (refereegranskat)abstract
- Following some introductory notes on addiction treatment management as a specific case of societies’ response to deviant behaviours and social problems, an overview of the theoretical classifications and dimensions of addiction treatment systems is presented. The anti-thesis to these ideal-type system concepts is represented by the market New Public Management model oriented towards outcomes, regardless of the nature and organizational features of addiction interventions. As complementary to these general theoretical orientations, this serves as a review of specific issues concerning ‘a combined and integrated approach versus a specialized and segregated approach’, ‘the quest for the best treatment modalities’, ‘empirical and ethical aspects of coercion in treatment’ and ‘the relevance of user needs and orientation’. The empirical part begins by highlighting the ‘expert survey‘, ‘case study‘ and dynamic diffusion‘ approaches as treatment mapping strategies and informs on some key results, e.g. from the WHO Atlas –SU survey and the International Studies in the Development of Alcohol and Drug Treatment Systems. Results from an expert survey from fourteen countries conducted in 2014 illustrate the role of general political changes, efforts to control treatment systems, integration dynamics, the treatment gap and changing outcome criteria with concrete current examples. The conclusions point to the relative importance of professional addiction interventions drawing upon self-change research and the role of alternative lay help and outline factors in impeding system changes.
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| 9. |
- Lerkkanen, Tuulia, et al.
(författare)
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Debating the Drug Policy in Sweden : Stakeholders’ Moral Justifications in Media 2015–2021
- 2023
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Ingår i: Contemporary Drug Problems. - : SAGE Publications. - 0091-4509 .- 2163-1808. ; 50:2, s. 269-293
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Tidskriftsartikel (refereegranskat)abstract
- Drug-related harms continue to increase globally and governments struggle in search of effective and legitimate countermeasures. The choice between policy options is intertwined with the arguments that dominate drug policy discussions, which in turn are closely related to who has access to the policy debate. In this study, we examine stakeholders’ visibility and moral justifications of argumentation in the Swedish drug policy debate in the media (2015–2021). Justification analysis (JA) is used as a methodological and theoretical tool to illustrate the moral principles behind the claims by the stakeholders. The results show that the most visible stakeholders were politicians, government agencies and molders of public opinion. Furthermore, the stakeholders with successful active attempts to participate in the debate were molders of public opinion, NGOs, and politicians. The silent stakeholders in the media were people who use drugs and significant others. Stakeholders generally revolve around a dividing line regarding the restrictive features of Swedish drug policy, and were divided into proponents, opponents and neutral ones. All stakeholder groups included all three sides, hence reflecting the ingroup dissonance that may explain the continuing deadlock in Swedish drug policy. Justifications that value evidence-based policymaking (industrial worth) was used in the argumentation by the majority of the stakeholder groups, often combined with other moral justifications. This notion challenges the dichotomy of evidence and values in drug policy debates. Proponents relied more on the justifications that value paternalism (domestic worth), while opponents leaned toward the justifications valuing civil rights and social justice (civic worth). The development of Swedish drug policy may depend on the relative strength of these two value positions (domestic versus civic worth) in society and among stakeholders in power. This study continues the discussion of making contesting values explicit in the drug policy, serving a riveting case for international comparison.
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| 10. |
- Lerkkanen, Tuulia, et al.
(författare)
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Oenighet och olika värderingar i den svenska narkotikapolitiska debatten
- 2023
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Sammanfattning av den vetenskapliga artikeln Debating the drug policy in Sweden: Stakeholders’ moral justifications in media 2015–2021 (https://doi.org/10.1177/00914509231159394) i ett mer lättilgängligt format på svenska online.
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| 11. |
- Reissner, V., et al.
(författare)
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Differences in drug consumption, comorbidity and health service use of opioid addicts across six European urban regions (TREAT-project)
- 2012
-
Ingår i: European psychiatry. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 27:6, s. 455-462
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This comparative study investigated consumption patterns, comorbidity and treatment utilization of opioid addicts in six European cities (Athens, Essen, London, Padua, Stockholm, Zurich). Subjects and methods: Data were collected by structured face-to-face interviews. The representative sample comprises 599 addicts (100 patients per centre, 99 in London) at the start of a treatment episode. Results: Patients were dependent on opioids for about 10 years. Regional differences were significant regarding the patients' drug consumption pattern and their method of heroin administration (up to a fourth of the patients in Essen, London and Zurich usually smoke heroin). Concomitant use of benzodiazepines, cannabis and alcohol was common in all regions with the German and English samples showing the highest level of polydrug use. The prevalence of major depression was high in all regions (50%). Stockholm and London patients worry most about their physical health. Differences in the amount of needle sharing and especially in the use of public health service were prominent between the sites. Opioid addiction was a long-term disorder associated with a high burden of comorbidity and social problems in all cities. Conclusion: The results of the study show significant interregional differences of opioid addicts which might require different treatment strategies in European countries to handle the problem.
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| 12. |
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Samhället, alkoholen och drogerna : Politik, konstruktioner och dilemman
- 2012
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Antologi.Hur kan vi förstå alkoholens och drogernas roll i samhället? Hur definieras problemen, hur hanteras de och vilka konsekvenser får detta? Studier kring dessa frågor ger kunskap om moraliska och politiska dilemman, maktförhållanden, strukturer och förändringsprocesser. Frågorna öppnar upp för en diskussion kring gränsdragningar och spänningar i samhället. Boken har en samhällsvetenskaplig utgångspunkt och bidrar till ett kritiskt och reflekterande tänkande kring rusmedelsfrågan, en fråga som är alltför komplex för att endast kläs i medicinska termer, vilket ofta skapar en snäv problembild. Antologin behandlar bl.a. politik, sociala konstruktioner, genus, vård och välfärd. Den ger högskolestuderande en god ingång till och överblick över ämnet. Den riktar sig också till andra intressenter såsom yrkesverksamma inom välfärdssektorn, politiker, tjänstemän, journalister, föreningsaktiva, debattörer och den samhällsintresserade medborgaren.Tretton forskare vid Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD), Stockholms universitet, medverkar: Maria Abrahamson, Jan Blomqvist, Jenny Cisneros Örnberg, Hanna Enefalk, Evy Gunnarsson, Nina-Katri Gustafsson, Karin Heimdahl, Mona Livholts, Therese Reitan, Filip Roumeliotis, Jessica Storbjörk, Johan Svensson och Jukka Törrönen. Författarna har sin hemvist inom sociologi, socialt arbete, statsvetenskap, historia, psykologi och folkhälsovetenskap.Se http://www.suforlag.se/1100/1100.asp?id=4112
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| 13. |
- Stenius, Kerstin, 1951-, et al.
(författare)
-
Balancing welfare and market logics : Procurement regulations for social and health services in four Nordic welfare states
- 2020
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Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 37:1, s. 6-31
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Tidskriftsartikel (refereegranskat)abstract
- Aim: In increasingly market-oriented welfare regimes, public procurement is one of the most important instruments of influencing who produces which services. This article analyses recent procurement regulations in four Nordic countries from the point of view of addiction treatment. The implementation of public procurement in this field can be viewed as a domain struggle between the market logic and the welfare logic. By comparing the revision of the regulations after the 2014 EU directives in Denmark, Finland, Norway, and Sweden, we identify factors affecting the protection of a welfare logic in procurement. We discuss the possible effects of different procurement regulations for population welfare and health.Data and theoretical perspective: The study is based on the recently revised procurement laws in the four countries, and adherent guidelines. The analysis is inspired by institutional logics, looking at patterns of practices, interests, actors, and procurement as rules for practices.Results: Procurement regulations are today markedly different in the four countries. The protection of welfare and public health aspects in procurement – strongest in Norway – is not solely dependent on party political support. Existing service providers and established steering practices play a crucial role. Conclusion: In a situation where market steering has become an established practice and private providers are strongly present, it can be difficult to introduce strong requirements for protection of welfare and population health in procurement of social services.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
- Stenius, Kerstin, et al.
(författare)
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When the organization is a problem : An empirical study of social work with substance use problems in more or less NPM-influenced Swedish municipalities
- 2023
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Ingår i: Nordic Social Work Research. - 2156-857X .- 2156-8588. ; 13:1, s. 36-49
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Tidskriftsartikel (refereegranskat)abstract
- New Public Management (NPM) has added new aspects to the conflict between political-bureaucratic steering and professional autonomy in the search for a substance use treatment system (SUT) that is economic and characterized by high quality, accessibility, and professional discretion. This article analyses if and how organizational aspects of NPM imply additional challenges for professionals and SUT. The experiences of 29 social workers, in different positions in the services and administration of SUT, in six municipalities with different degrees of NPM and post-NPM, form the empirical data. Many quality problems were common across municipalities: frequent unevaluated reforms, lack of resources for SUT, and cooperation issues. Several problems were especially pronounced in statutory social work. NPM added challenges. Competition with private providers was viewed as initially (in the 1990s) having improved treatment, but the present market was regarded as creating quality problems without savings. Cooperation between providers was a special quality challenge in NPM municipalities, and NPM added to treatment continuity challenges. While accessibility for resourceful clients was linked to NPM models, treatment for less resourced users was obstructed by NPM. Workplace climate and trust issues were more problematic in the most NPM-permeated municipalities. Professional discretion was difficult to link to local NPM degree. Increased standardization and documentation were often accepted as improving quality. While a system based on competition ideology appeared destructive for treatment quality, post-NPM reforms with cooperation between needs-assessment, treatment, and economic support, conformed better with professionals’ perceptions of good treatment.
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| 18. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
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A conference on Nordic comparisons of addictive substances and behaviors – Time for the revival of the tradition of Nordic research exchange!
- 2023
-
Annan publikation (populärvet., debatt m.m.)abstract
- The Department of Public Health Sciences at Stockholm University and its Center for Social Research on Alcohol and Drugs (SoRAD) are announcing a conference on Nordic Comparative Research on Addictive Substances and Behaviors – Advancing by Comparing. It takes place in Stockholm, in April 2024. The three-day conference aims to revive the tradition of Nordic research collaboration by presenting the latest Nordic comparisons and sharing a platform for inspiring researchers to discuss possible comparisons in the future.
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| 19. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
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A prospective study of mortality up to eight years after starting treatment for alcohol and drug problems in Stockholm county : 2000-2008
- 2012
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Ingår i: Addiction Research and Theory. - : Informa UK Limited. - 1606-6359 .- 1476-7392. ; 20:5, s. 402-413
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Research indicates an association between substance use and premature death and that misuse of illicit drugs is more closely linked to mortality than alcohol misuse. Given that these studies often are based on homogeneous treatment populations, we sought to analyse long-term mortality among both alcohol and drug misusers in a representative treatment system sample by examining: (1) excess death ratios (SMR, standardised mortality ratio) in comparison with the general population and (2) risk factors for mortality within the sample. Method: Prospective study (N = 1659; 28% women) interviewed when starting treatment in Stockholm County, 2000-2002, and followed-up with regard to mortality up to 8 years after baseline. Analyses were based on death certificates and intake interview data (demographics, social situation/support, ICD-10 alcohol/drug dependence, treatment experiences). The strength of the study is the prospective design, that we have been able to link mortality to interview data, and to reach a heterogeneous treatment population. Results: (1) SMR was 5.7 (no sex difference). (2) Logistic regression showed that being older, male, retired and having reported living with a substance misuser were identified as risk factors for mortality within the sample. Housing organised by authorities and no dependence on alcohol/drugs were protective factors. The mortality risk did not differ between alcohol and drug-dependent cases. Neither was homelessness, living situation (3 years) nor education predictive of mortality. Conclusions: No difference regarding mortality risk between treated alcohol and drug-dependent patients in Sweden is found when controlling for age.
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| 20. |
- Storbjörk, Jessica, 1977-
(författare)
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A study of a Swedish treatment policy reform proposal
- 2013
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Ingår i: Snapshots of social drug research in Europe. - Lengerich : Pabst Science Publishers. - 9783899679113 ; , s. 57-59
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The chapter summarizes the rationale, aims, methods, results and conclusions of the study "A reformed substance abuse treatment system? Actors, arguments and power". The project studies a far-reaching reform proposal in which it was suggested that Swedish substance abuse treatment should be transferred from the municipal social services to the regional level health care system.Book Abstract: Globalisation influences not only legitimate economicsectors, but also affects developments onthe illicit drug market and the proportion of thosein treatment who are members of minority ethnicpopulations. In a rapidly changing world, theneed for information increases accordingly. Here,then, emerges an important task for science, especiallyin the light of the European endeavour forevidencebased drug policy. Recent years show analmost exponential increase in the use of onlinedata collection and analysis in social drug researchand, in some European countries fasterthan in others, research ethic committees havecome to play an important role in social drug research.The usual format of the European Society for SocialDrug Research’s annual book is 8-10 chapters,but this year the choice has been made to incorporatea greater number of short contributions,in the form of 21 ‘snapshots’, written by social scientistsworking in 11 European countries.
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| 21. |
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| 22. |
- Storbjörk, Jessica, 1977-
(författare)
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Commentary on Witkiewitz et al (2017) : Abstinence or moderation – a choice for whom and why?
- 2017
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 112:12, s. 2122-2123
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Analyses of low-risk drinking add legitimacy to moderation as an alcohol treatment goal, so increasing choice for some patient groups. Moderation also parallels a dominant model of opioid treatment, opioid maintenance treatment.
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| 23. |
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| 24. |
- Storbjörk, Jessica, 1977-
(författare)
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Drug Users as Social Change Agents : Increasing but Limited Possibilities in Sweden
- 2012
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Ingår i: Substance Use & Misuse. - : Informa UK Limited. - 1082-6084 .- 1532-2491. ; 47:5, s. 606-609
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This commentary discusses some prerequisites for and potential changes in drug user participation in treatment, decision-making, and policy in Sweden. What possibilities and obstacles are there for drug users to serve as social change agents? To what extent are drug users able to bring about change in social organizations and institutions—changes that are beneficial from their point of view?
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| 25. |
- Storbjörk, Jessica, 1977-
(författare)
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Events as precipitators to treatment : Important for both well-integrated and marginalized alcohol and drug users of a Swedish treatment system
- 2009
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Ingår i: Contemporary Drug Problems. - : SAGE Publications. - 0091-4509 .- 2163-1808. ; 36:1/2, s. 345-373
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Tidskriftsartikel (refereegranskat)abstract
- "Women and Men in Swedish Alcohol and Drug Treatment" studies how people with alcohol and drug problems come to treatment. The focus is on different alcohol- and drug-related life events in the year prior to treatment and whether or not these events contributed to treatment entry. The importance of these events is also studied in relation to level of marginalization. The representative crosssectional sample includes 1865 clients (71% men) interviewed inperson when entering inpatient and outpatient treatment facilities. Most respondents reported events in the year prior to treatment and these were also perceived as contributors to treatment. Events related to significant others and health workers seem to be of greatest importance for treatment entry. These events happen to a lot of the problematic alcohol and drug users and are viewed as strong contributing factors by the respondents. More marginalized people and misusers with more severe addiction problems experience more events. A curvilinear relationship (somewhat Ushaped) was found between level of marginalization and events as contributors to treatment: the least marginalized people are most likely to report events as contributors, people in between are the least likely and the most marginalized people are likely to report events as contributors to treatment, given that they have experienced the event.
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| 26. |
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| 27. |
- Storbjörk, Jessica, 1977-
(författare)
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Frivillig vård är ofta ofrivillig
- 2007
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Ingår i: Socionomen. - 0283-1929. ; :2, s. 12-15
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 28. |
- Storbjörk, Jessica, 1977-
(författare)
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Från idé via osäkerhet till nypremiär − tjugo år med forskningscentret SoRAD
- 2021
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Annan publikation (populärvet., debatt m.m.)abstract
- Behovet av samhällsvetenskaplig forskning om alkohol och andra droger är stort. Det kan dock vara svårt att hitta former för att säkra kontinuitet och avancemang, vilket SoRAD:s tjugoåriga historia visar. Samhällsvetenskaplig alkohol- och drogforskning har nu landat vid en nybildad undervisningsinstitution vid Stockholms universitet. Det ger en stabil grund men även nya utmaningar.
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| 29. |
- Storbjörk, Jessica, 1977-
(författare)
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Gender differences in substance use, problems, social situation and treatment experiences among clients entering addiction treatment in Stockholm
- 2011
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Ingår i: Nordic Studies on Alcohol and Drugs. - Warsaw : Versita. - 1455-0725 .- 1458-6126. ; 28:3, s. 185-209
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Tidskriftsartikel (refereegranskat)abstract
- AIM - While gender differences in substance use/problems have been found to be smaller in more gender-equal countries such as Sweden, gender-specific norms still prevail, and women's (mis)use continues to be more condemned than men's. This article analyses and discusses similarities and differences between the sexes in alcohol and drug treatment in terms of men's and women's treatment experiences, consumption/problems, social situation, and life-domain problems. METHOD - 1865 respondents were interviewed (structured interview) at the beginning of a new treatment episode in 2000-2002 in Stockholm County (sample representative of those starting a new treatment episode for alcohol or drug problems in Stockholm County). Responses are cross-tabulated by sex and multivariate logistic regression is used to predict whether men or women have more severe problems in various life domains of the Addiction Severity Index (ASI composite scores). RESULTS - Bivariate analyses showed that women and men differ significantly in their treatment experiences. Women are more likely to have contact with mental health services, whereas men tend to deal more with the criminal justice system. The sexes do not differ in alcohol and drug problem severity, but women are more likely to have problems with pharmaceuticals. In contrast to the hypothesis, it turned out that men, not women, are more marginalised as concerns housing, income, family situation, lack of friends. Women report more problems related to family, social life and mental/physical health, while men report higher criminality and financial problems. CONCLUSIONS - There are no gender differences among the clients in the treatment system when it comes to substance problem severity but differences occur concerning the clients' social situation and different life-domain problems. As men are more socially exposed a focus on women may obscure problems among men.
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| 30. |
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| 31. |
- Storbjörk, Jessica, 1977-
(författare)
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How Substance Use Treatment Professionals Manage Organisational Tensions : A Web Survey and an Interview Study
- 2020
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Ingår i: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 66:2, s. 93-103
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The study examined how substance use treatment professionals managed problems and tensions in their work, and explored if the strategies varied by organisational features related to New Public Management (NPM). Methods: A total of 69 semi-structured interviews(2017–2018) with treatment staff in nine sampled local/regional areas formed the basis for constructing a web survey administered to staff across Sweden in 2019 (n=606). The means showed how often the different strategies were used. Regression analyses examined organisationaldifferences, and central strategies were illustrated by the interview study. Results: Treatment professionals in general reported satisfactory freedom in their work. Staff in more NPM-like organisations were less likely to report autonomy and more inclined to report conflicting demands.When conflicts emerged, the staff used both passive strategies indicating adaptation or resignation, and active strategies including boundary spanning, protest, and liberty-taking. Some challenging strategies such as looking for other jobs or reporting one thing but doing anotherwere more common in more NPM-like organisations. The opposite was found for customer orientation. Conclusions: While NPM features on customer orientation and steering methods appeared to create fewer problems, more NPM-like organisations appeared to be less favourableoverall and should be applied with caution.
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| 32. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
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Implications of Eligibility Criteria on the Generalizability of Alcohol and Drug Treatment Outcome Research : A Study of Real-World Treatment Seekers in Sweden and in Australia
- 2017
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Ingår i: Substance Use & Misuse. - : Informa UK Limited. - 1082-6084 .- 1532-2491. ; 52:4, s. 439-450
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clinical studies of alcohol and drug treatment outcomes frequently apply participant eligibility criteria (EC), which may exclude real-world treatment seekers, impairing the representativeness of studied samples. Some research exists on the impact of EC on alcohol treatment seekers. Little is known about drug treatment and country differences. Objectives: We tested and compared the degree to which commonly used EC exclude real-world treatment seekers with problem alcohol and drug use in Sweden and Australia, and compared the impact of EC on outcomes. Methods: Two large naturalistic and comparative service user samples were used. Respondents were recruited in Stockholm County (n = 1,865; data collection 2000–2002), and Victoria and Western Australia (n = 796; in 2012–2013). Follow-up interviews were conducted after 1 year. Cross-tabulations, Chi-square (χ2) tests and logistic regressions were used. Results: Percentages of the samples excluded by individual EC ranged from 5% (lack of education/literacy) to 70% (social instability) among Swedish alcohol cases and from 2% (low alcohol problem severity) to 69% (psychiatric medication) among Australian counterparts; and from 2% (age 60+ years) to 82% (social instability) among Swedish drug cases and from 1% (age 60+ years) to 67% (psychiatric medication) among Australian counterparts. Country differences and differences across substances appeared independent of country effect. Co-morbid psychiatric medication, noncompliance, poly drug use, and low education EC caused positive 1-year outcome bias; whereas female sex and old age introduced negative outcome bias. Conclusions/Importance: Commonly used EC exclude large proportions of treatment seekers. This may impair generalizability of clinical research, and the effects of many EC differ by country and drug type.
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| 33. |
- Storbjörk, Jessica, 1977-
(författare)
-
Implications of enrolment eligibility criteria in alcohol treatment outcome research : generalisability and potential bias in 1- and 6-year outcomes
- 2014
-
Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 33:6, s. 604-611
-
Tidskriftsartikel (refereegranskat)abstract
- It has been acknowledged that participants in clinical trials differ from real-world service users,primarily due to the extensive use of research eligibility criteria (EC). Generalisability and outcome bias become pressing issueswhen evidence-based treatment guidelines, crystallised from outcome research, influence treatment provision.This study reportson the effects of EC on generalisability and short- and long-term outcomes among real-world treatment-seekers.Ten of the most commonly used EC were operationalised and applied to a large representative service user sample(n = 1125) from Stockholm County, Sweden, to determine the percentage of real-world problem alcohol users that would havebeen excluded by each EC and the extent to which EC bias the 1 and 6-year alcohol outcomes.Individual EC excluded between 5% and 80% of real-world service users and 96% would have been excluded by at least one EC. Most of the EC introduced a positive/upwards bias in 1- and 6-year outcomes. Most notably, the removal of the unmotivated/non-compliantservice users caused an upwards bias that would considerably boost estimates of treatment effectiveness. Other bias effects weresmaller. Six-year effects were generally higher than for 1 year.Outcome studies that excludecomplex and non-compliant cases are not representative of real-world service users, and thus effectiveness estimates from clinicaltrials are biased by several commonly used EC.EC should be used judiciously and be taken into account in practice guidelines.This burgeoning research area should be further developed. [Storbjörk J. Implications of enrolment eligibility criteria inalcohol treatment outcome research: Generalisability and potential bias in 1- and 6-year outcomes.
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| 34. |
- Storbjörk, Jessica, 1977-
(författare)
-
Inledning
- 2012
-
Ingår i: Samhället, alkoholen och drogerna. - Stockholm : Stockholms universitets förlag. - 9789176566817 ; , s. 9-13
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Inledning till en antologi: Hur kan vi förstå alkoholens och drogernas roll i samhället? Hur definieras problemen, hur hanteras de och vilka konsekvenser får detta? Studier kring dessa frågor ger kunskap om moraliska och politiska dilemman, maktförhållanden, strukturer och förändringsprocesser. Frågorna öppnar upp för en diskussion kring gränsdragningar och spänningar i samhället.Boken har en samhällsvetenskaplig utgångspunkt och bidrar till ett kritiskt och reflekterande tänkande kring rusmedelsfrågan, en fråga som är alltför komplex för att endast kläs i medicinska termer, vilket ofta skapar en snäv problembild. Antologin behandlar bl.a. politik, sociala konstruktioner, genus, vård och välfärd. Den ger högskolestuderande en god ingång till och överblick över ämnet. Den riktar sig också till andra intressenter såsom yrkesverksamma inom välfärdssektorn, politiker, tjänstemän, journalister, föreningsaktiva, debattörer och den samhällsintresserade medborgaren.Tretton forskare vid Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD), Stockholms universitet, medverkar: Maria Abrahamson, Jan Blomqvist, Jenny Cisneros Örnberg, Hanna Enefalk, Evy Gunnarsson, Nina-Katri Gustafsson, Karin Heimdahl, Mona Livholts, Therese Reitan, Filip Roumeliotis, Jessica Storbjörk, Johan Svensson och Jukka Törrönen. Författarna har sin hemvist inom sociologi, socialt arbete, statsvetenskap, historia, psykologi och folkhälsovetenskap.
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| 35. |
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| 36. |
- Storbjörk, Jessica, 1977-
(författare)
-
Missbruk av genus
- 2013
-
Ingår i: Social Qrage. - 1404-997X. ; :4, s. 33-33
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Fokus på kvinnors specifika problem och vårdbehov i missbruks- och beroendevården kan bidra till att traditionella könsroller cementeras och att såväl kvinnor som män blir utan viktiga hjälpinsatser.
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| 37. |
- Storbjörk, Jessica, 1977-
(författare)
-
Märkbar tilltro till missbrukarvårdens potential
- 2007
-
Ingår i: Medicinsk access. - 1652-9782. ; :7, s. 68-71
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Forskningen visar att missbrukarvården ger relativt dåliga resultat (20-40 procent av dem som vårdas är alkoholfria ett år efter behandling) och har inte förbättrats nämnvärt över tid. Trots de smått nedslående resultaten fortsätter jakten på bättre behandlingsmetoder. Jessica Storbjörk, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD), Stockholms universitet, menar i denna artikel att det är viktigt att ta ett steg tillbaka och fundera på om inriktningen – jakten på evidensbaserade metoder – är den ultimata lösningen.
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| 38. |
- Storbjörk, Jessica, 1977-
(författare)
-
On the significance of social control : Treatment-entry pressures, self-choice and alcohol and drug dependence criteria one year after treatment
- 2012
-
Ingår i: International Journal of Social Welfare. - : Wiley. - 1369-6866 .- 1468-2397. ; 21:2, s. 160-173
-
Tidskriftsartikel (refereegranskat)abstract
- This article explores howself-choice and treatment-entry pressuresare associated with one-year treatment outcome (dependencesymptoms, 0–6, 12 months) among alcohol and drugmisusers, respectively. Informal pressures (from family andfriends), formal pressures (related to work, healthcare, socialservices, social allowances, child custody) and legal pressures(related to the police, criminal justice system, compulsorytreatment) were analysed.A sample (N = 1,210) representativeof the addiction treatment system of Stockholm County wasinterviewed when starting a new treatment episode and afterone year. Regression analyses indicated that self-choice andpressures are associated with outcome among alcohol misusersbut not among drug misusers when controlling for backgroundfactors and severity. Self-choice (without pressures) correlatedwith a good outcome (a lower number of dependence criteria).Pressures were generally associated with poorer outcome.Alcohol misusers who had experienced threats regarding childcustody did better in comparison with those not experiencingsuch pressure. The difference in results by drug type andimplications were discussed.
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| 39. |
- Storbjörk, Jessica, 1977-
(författare)
-
One model to rule them all? Governing images in the shadow of the disease model of addiction
- 2018
-
Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 37:6, s. 726-728
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Treatment providers demonstrate a quite strong support for a disease model of addiction, particularly so in the United States. However, conceptions vary and the problems may be perceived as primarily a disease, moral or social problems, or a combination of these (Barnett et al. in press). This commentary discusses the ongoing and dynamic process of defining addiction problems and notes that non-medical perspectives often appear in the shadow of and tend to oppose the disease model that stands quite inviolable – i.e., like the One Ring to rule them all by citing The Lord of the Rings. Recent changes in the Swedish Addiction treatment system, well known for its social perspective on the nature and handling of addiction problems, are highlighted to demonstrate that the world may be changing, or not. It is argued that there cannot be just one model.
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| 40. |
- Storbjörk, Jessica, 1977-
(författare)
-
Oraker till att inte söka vård : En studie i Stockholms läns beroendevård
- 2003
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Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 20:2-3, s. 113-127
-
Tidskriftsartikel (refereegranskat)abstract
- This article is part of a larger treatment system study entitled Women and Men in Swedish Alcohol and Drug Treatment carried out in Stockholm County. The goal is to analyse and describe the reasons people have for not entering the healthbased addiction treatment system in Stockholm County. The following questions were raised: What reasons for not seeking treatment did the patients have prior to treatment entry? What are the differences between females and males and alcohol and drug abusers with regard to reasons for not seeking help? The material analysed consists of 942 face-toface interviews with patients entering alcohol and drug treatment units. The analysis is based on nine items about various things that might get in the way of people getting help for an alcohol or drug problem. The majority of the patients (90 %) endorsed at least one of the statements. The three most prevalent reasons for not entering treatment among the patients were that they did not want to stop drinking or using drugs; they were concerned about what others would think; and thought they could handle their problem themselves. Approximately half of the respondents agreed with each of these items. Forty-four per cent did not think their problem was that serious, and therefore had not sought treatment earlier. Treatment scepticism constituted a barrier for 36 per cent of the respondents that did not think treatment would help them. Responsibilities at work are not considered an important barrier to entering treatment as only 22 per cent agreed with this statement. However, when focusing on those who had a job nearly 45 per cent of the respondents agreed with the statement. Thirty-one per cent of the respondents did not enter treatment since they felt they had too many responsibilities at home. Only 7 per cent indicated the reason for not seeking treatment as there was nobody to take care of their children (among those who had children). A present threat to abusers with children seems to be fear of losing custody of their children. Nearly 30 per cent considered this a reason for not entering treatment. The females support five out of nine statements to a significantly greater extent than the men do and also support three of the four remaining statements to a greater extent than the males, although not to a significant degree. There is no doubt that women experience more home- and childrelated barriers to entering treatment. The only difference between alcohol and drug abusers was that alcohol abusers reported unwillingness to stop usage more frequently as a reason for not entering treatment than the drug abusers.
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| 41. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
-
Restructured welfare service provision : For‑profit and non-profit providers in residential substance use treatment in Denmark, Finland, Norway and Sweden
- 2021
-
Ingår i: Nordisk välfärdsforskning | Nordic Welfare Research. - : Scandinavian University Press / Universitetsforlaget AS. - 1799-4691 .- 2464-4161. ; 6:3, s. 142-159
-
Tidskriftsartikel (refereegranskat)abstract
- The welfare state has been found to be highly resilient and protected from retrenchment by institutional and popular support. However, marketization with restructuration of publicly funded health and welfare services is changing the composition of service providers in the Nordic welfare model, heavily relying upon public provision. Sweden has been the Nordic country most favourable for the establishment of for-profit private welfare providers. The present article uses the case of residential substance use treatment (SUT) to outline and elaborate upon the mix of public, for-profit and non-profit private providers in Denmark, Finland, Norway and Sweden in 2019–2020. The comparison takes its point of departure in Sweden, which, as expected, presented the biggest and most profit-oriented SUT market. The other countries presented smaller markets, measured by the number of units. Denmark and Norway had the highest presence of NGOs, while Norway stood out with a high share of public provision and few for-profit units. The article identified the market-friendly Sweden, ambivalent Finland, stable, market-regulating Denmark and stable, welfare-corporatist Norway, and investigated the country-specific factors potentially influencing the different developments. Implications for the future development of SUT within the Nordic welfare state were discussed.
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| 42. |
- Storbjörk, Jessica, 1977-
(författare)
-
Skyldigheterna bakom rättigheterna i svensk välfärdslagstiftning
- 2012
-
Ingår i: Samhället, alkoholen och drogerna. - Stockholm : Stockholms universitets förlag. - 9789176566817 ; , s. 184-215
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- I det här kapitlet diskuterar jag de lagstiftade rättigheter vi medborgare har inom välfärdsområdet. Ur dessa kan vi utläsa vilka skyldigheter vi också har och vad som därigenom karaktäriserar de ”normala” liv vi förväntas eftersträva.Kapitlet berättar om Lasse, en så kallad ”tung missbrukare”. Jag presenterarcentrala delar av den välfärdslagstiftning som människor i Lasses situation ofta berörs av. Vilka rättigheter har Lasse? Vilka villkor och krav på motprestationer kan välfärdsinstitutionerna, enligt gällande lagar och förordningar,ställa på honom? Och vad säger det om vad som förväntas av oss alla i Sverige? Välfärdslagarna utgör ett spänningsfält mellan statens och den enskildes intressen och kan sägas ange den överenskomna och normerande gränsen mellan de beteenden och livsval som av lagstiftaren betraktas som eftersträvansvärda och de som inte gör det. Kapitlet visar att lagarna uppmanaross att ta ansvar, göra rätt för oss, vara skötsamma, aktiva, motiverade att göra något åt våra problem och att solidariskt ta hand om varandra. Välfärdslagarnahar utöver en hjälpande funktion (individskydd) också en disciplinerandefunktion (samhällsskydd). Vi kontrolleras i det här fallet inte genom straffrätten utan genom begränsade och villkorade rättigheter.
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| 43. |
- Storbjörk, Jessica, 1977-
(författare)
-
Stakeholders’ arguments for and against moving Swedish substance abuse treatment to the health care system : How a fat reform proposal became a thin government bill
- 2014
-
Ingår i: Nordic Studies on Alcohol and Drugs. - 1458-6126. ; 31:1, s. 81-110
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND - Far-reaching changes in the Swedish substance abuse treatment system (SAT) were proposed by a state-commissioned inquiry in 2011. The proposal implied a break with the social tradition of SAT. It was suggested that the treatment responsibility should be transferred from the municipal social services to the regional-level health care system; and that compulsory treatment in its present form (assessed by/paid for by social services, run by the state) should be abolished and become incorporated into coercive psychiatric care provided by health care. A lively debate arose, and the vast majority of stakeholders sought to articulate their arguments. AIM - The study analysed the development of Swedish SAT by examining the policy process from reform proposal to government bill in 2013. METHOD - Content analysis was used to analyse written comments on the proposal submitted to the Ministry of Health and Social Affairs by close to 200 stakeholders. The goal was to empirically chart and examine the arguments for and against as well as advocates and opponents of the reform. With the government bill at hand, we retrospectively sorted out the winning arguments in the now highly contested SAT field and which actors were able to influence the process. CONCLUSIONS - The article discloses that the mixed response and rather critical voices in most groups, including social/medical professions and government bureaucracy, helped block the responsibility shifts, and that reformations of subsystems like SAT are difficult to carry out as freestanding projects within larger systems of social and health care.
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| 44. |
- Storbjörk, Jessica, 1977-
(författare)
-
The interplay between perceived self-choice and reported informal, formal and legal pressures in treatment entry
- 2006
-
Ingår i: Contemporary Drug Problems. - : SAGE Publications. - 0091-4509 .- 2163-1808. ; 33:4, s. 611-643
-
Tidskriftsartikel (refereegranskat)abstract
- This article focuses on the interplay between reported informal, formal and legal pressure and self-choice in treatment entry. The representative sample of those entering treatment for alcohol or drugs problems in Stockholm County, Sweden includes 1865 clients (71% men). Most respondents reported that it was their own idea to come to treatment (81%). It was also common to report reasons for entering treatment indicating different forms of perceived pressures, especially informal pressures (75%), but also formal and legal pressures. Informal pressure from someone close was a particularly important reason for treatment entry. Informal pressure was found to be positively associated with the feeling of self-choice in treatment entry, whereas perceptions of formal pressure (and particularly legal pressure) mainly were negatively related to self-choice. Most of those reporting self-choice in treatment entry also reported informal, formal, or legal pressure as reasons for coming to treatment.
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| 45. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
-
The new suit of the Centre for Social Research on Alcohol and Drugs (SoRAD) : A well-tailored costume for tackling research and challenges ahead
- 2020
-
Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 37:6, s. 592-608
-
Tidskriftsartikel (refereegranskat)abstract
- This overview reviews the establishment and evolution of the Centre for Social Research on Alcohol and Drugs (SoRAD). It outlines its current organization and updated research direction, and discusses SoRAD’s future challenges and opportunities. SoRAD was established at Stockholm University to strengthen and support Swedish social science research on alcohol and drugs. It became active in 1999, and quickly grew in research efforts and reputation, while experiencing setbacks around 2006 and 2017. In 2018 SoRAD merged with the Centre for Health Equity Studies (CHESS), to form a new Department of Public Health Sciences. In its new suit, SoRAD acts as a research centre within the teaching department. The research activities on alcohol and other drugs and gambling behaviour and problems may be categorized into four main areas: Social epidemiology; Subcultures and social worlds of use and heavy use; Policy formation, implementation and societal responses; and Societal and other collective definitions of problems and solutions. The new arrangements, with an increased staff pool and close interplay with higher education, provides a more stable and long-term platform for achieving the main mission of promoting and developing social science research on addictive substances and behaviours and related problems.
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| 46. |
- Storbjörk, Jessica, 1977-
(författare)
-
The social ecology of alcohol and drug treatment : Client experiences in context
- 2006
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this thesis is to study how individuals with alcohol and drug problems come to treatment – who is in treatment and who is not? It further studies the goal and role of treatment according to different groups – clients, staff and politicians. How can we understand clients’ experiences in a context?The main data is from the Women and men in Swedish alcohol and drug treatment-study, with a representative sample of clients as well as complementary data on the views of staff and the general population.The thesis comprises four related papers: (1) explores who is in treatment and who is not by analysing the client and the general population samples; (2) studies reasons for coming to treatment among clients by focussing on self-choice in relation to informal, formal, and legal social pressures to seek treatment; (3) investigates alcohol and drug related events among misusers and the role of these events in treatment entry, and in relation to level of marginalization of the clients; (4) analyses motives for and conflicts surrounding changes in the treatment system on an organizational level.The thesis reveals that clients in treatment are marginalized (regarding housing, work, family, etc.). At treatment entry, clients report self-choice as well as a range of pressures to seek treatment as reasons for coming. The events are influential in treatment seeking, especially events and pressures in relation to significant others. In addition, it is shown that changes in the treatment system are not only driven with the interests of the clients in mind. Professional struggles, economic cuts, and coincidences are of importance. It is shown that different actors have competing as well as compatible and matching views on the goals of treatment. Finally, some notable changes in the treatment system are discussed.
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| 47. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
-
The social perspective and the BDMA's entry into the non-medical stronghold in Sweden and other Nordic countries
- 2022
-
Ingår i: Evaluating the Brain Disease Model of Addiction. - London, UK : Taylor & Francis Group. - 9781003032762 ; , s. 416-430
-
Bokkapitel (refereegranskat)abstract
- Sweden and the other Nordic countries have held an alternative way to many other countries of understanding and responding to substance use and addiction. The non-medical approach grew particularly strong in the 1960s, but this social perspective has, since the 1990s, become increasingly challenged. This chapter outlines the social understanding and the developments within substance use treatment (SUT), policy, and everyday society in Sweden. A renewed medicalization began at the turn of the millennium, and has accelerated in more recent years, increasingly so due to an underlying brain disease model of addiction (BDMA) and sometimes also by outspoken BDMA arguments. Some explanations for the BDMA’s entry into the Nordic non-medical stronghold are: the medical perspective embedded in both evidence-based practices (EBP) and New Public Management (NPM), and the related fragmentation of the treatment system and demands for cost-effectiveness, communication and public outreach. Explanations are also found in worldwide trends, e.g., a mainstreaming of diagnoses; the public health movement; drug-related deaths and a push towards medical harm reduction measures; and, most recently, by a BDMA rhetoric emerging in public and policy debate and SUT. Understood from processes of ‘copresence’ and ‘vaguification’, the BDMA is in line with these forces driving towards a biomedical understanding of substance use problems.
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| 48. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
-
The Swedish Addiction Treatment System : Government, Steering and Organisation. Technical Report
- 2019
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Welfare systems in Sweden and internationally have gone through major changes regarding modes of operation and means of government in New Public Management (NPM) reforms, which have sought to balance autonomy and control. There is a lively debate about NPM, but research is scarce. NPM indicates improved performances but also unintended consequences and inconsistencies concerning ideas, demands on the services and performance incentives – such as tensions between medical and social professional autonomy and knowledge on the one hand and administrative control, auditing and a growing bureaucracy (e.g., procurement, inspections, documentation) on the other. The research project used addiction treatment with different organisations and professions as a case for studying the impact of NPM on the daily work in regional health care and municipal social services organisations.We charted the broad steering and organisation of addiction treatment. We analysed the extent to which tendencies of NPM have conveyed advantages or created conflicting logics by comparing addiction treatment in three regions and six municipalities with varying degrees of NPM. The study used official statistics, documents, interviews and a web survey. A total of 85 interviews were made with 93 individual state, regional and local policy-makers and officials (including the previously unstudied procurers) and public and private care providers (managers and treatment professionals) in 2017–2018. The interviews formed the basis for a web survey among professionals in Sweden in 2019. Purchasing addiction services was further examined by observing a large procurement process, by organising a workshop with Nordic procurement experts, and by interviewing civil servants in Finland, Denmark and Norway.The study shows how addiction treatment is governed and organised, highlighting developments over time with special emphasis on various NPM features. The interviews addressed advantages and tensions in the daily work and if and how professionals seek to adapt to new, perhaps inconsistent, demands. The web survey allows for comparisons across organisations and professional groups. This technical report presents the background and aims of the study and describes in detail the Swedish study setting, and the study design, methods and data sources used.
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| 49. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
-
The two worlds of alcohol problems : Who is in treatment and who is not?
- 2008
-
Ingår i: Addiction Research and Theory. - : Informa UK Limited. - 1606-6359 .- 1476-7392. ; 16:1, s. 67-84
-
Tidskriftsartikel (refereegranskat)abstract
- In the study “Women and Men in Swedish Alcohol and Drug Treatment,” it is possible to compare alcohol consumption and problems among respondents in the general population with those in clients entering alcohol treatment. The differences between these groups have led researchers to talk about the “two worlds” of alcohol problems-in general and in clinical populations. The aim of this article is to study the relative strength of factors in predicting entering and the clinical population. The studied factors are demographics and marginalization; volume and frequency of drinking; alcohol dependence; social response to drinking (suggestions to cut down or seek treatment by informal actors, e.g. family and friends, and formal actors such as employer, the social services or judicial system); and treatment history. The client sample includes 1202 clients (71% men) interviewed face-to-face when entering inpatient and outpatient treatment facilities in Stockholm. In the general population survey, 3557 persons aged 18-75 years were interviewed. The two samples differ significantly. As expected, clients were older, more marginalized and reported more severe alcohol problems, and many reported previous treatment experiences and social responses. Logistic regression analyses show that previous treatment, unemployment/institutionalization and having an unstable living situation are the strongest predictors of who is in treatment, followed by age, alcohol dependence and frequency of drinking. Formal pressures to cut down or seek treatment are also important and males are more likely to be in treatment. The results support a notion of the treatment system as a place for handling marginalized people, beyond and beside their extent of drinking.
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| 50. |
- Storbjörk, Jessica, 1977-
(författare)
-
Vem tvångsvårdas? : Utmärkande drag för tvångsvårdade respektive frivilligt vårdade personer med alkohol- och narkotikaporlbem
- 2010
-
Ingår i: Nordisk Alkohol- og narkotikatidsskrift (NAT). - Helsinki : Nordic Welfare Centre / The Finnish National Institute for Health and Welfare (THL). - 1455-0725 .- 1458-6126. ; 27:1, s. 19-46
-
Tidskriftsartikel (refereegranskat)abstract
- The article studies what characterized thosecommitted to compulsory treatment (CT)according to the Care of Alcoholics, Drugabusers and Abusers of Volatile Solvents(Special Provision) Act as compared to thosein voluntary treatment in Stockholm County2001–2002. The aim is to analyze who is inCT by studying which client characteristics(sex, age, drug of choice, consumption, routeof administration, social situation, physicalhealth, incl. municipality) are associatedwith CT. Responses from 361 CT-clients whowere interviewed with DOK (Documentationof Clients) are compared to comparableresponses from 1772 clients in voluntarytreatment from the study Women and Menin Swedish Alcohol and Drug Treatment.Bivariate and multivariate analyses showthat the two groups differ significantly inmany respects. Clients in CT are younger,report more frequent consumption of theirmain drug of choice and an inferior socialsituation (housing, livelihood). An analysisof interaction terms shows that old alcoholmisusers are less likely to be in CT thanyoung drug misusers. Women are not morelikely to be in CT than men. However, CT wasmore often used for women, but not for men,with children under the age of 18 or whowere living with another misuser.
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