Nordic Studies on Alcohol and Drugs最新文献

{"title":"\"My Advice is to not let him in\": How Support for Concerned Significant Others is Shaped by Professionals' Understandings of Alcohol and Other Drug Problems.","authors":"Hans Fagerström, Skogens Lisa, von Greiff Ninive","doi":"10.1177/14550725251388554","DOIUrl":"10.1177/14550725251388554","url":null,"abstract":"<p><strong>Aim: </strong>The study examines how Swedish welfare professionals linguistically construct and legitimize support for concerned significant others (CSOs) of individuals with alcohol and other drug (AOD) problems. This is studied through the professionals' understandings of AOD problems and how power relations embedded in their language shape the CSO role.</p><p><strong>Methods: </strong>Semi-structured interviews involving 10 AOD therapists and 10 family care consultants in Sweden were analyzed using Fairclough's critical discourse analysis.</p><p><strong>Results: </strong>The findings reveal three key logics, in which the CSOs are understood. First, professionals position themselves as educators, aiming to make CSOs understand AOD problems \"correctly\". Second, AOD problems are described as an evil force, making CSOs appear passive and reactive. Third, medical and resistance discourses dominate, portraying the AOD problem as an uncontrollable disease, legitimizing strategies such as boundary-setting and self-care. While use of these discourses is argued to reduce stigma and challenge traditional caregiving roles, it also pathologizes CSOs, reinforcing professional authority while limiting CSOs' perceived capacity for self-determined action and imposing an expectation of self-sufficiency.</p><p><strong>Conclusions: </strong>The study highlights how medicalization influences CSO support by describing caregiving as dysfunctional, which legitimizes professional intervention while limiting CSOs' agency. The findings highlight the need for an integrated approach balancing medical and resistance discourses with relational perspectives that emphasize social support.</p>","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"388-402"},"PeriodicalIF":2.2,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12571789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualifications and Competency Needs among Professionals in Outpatient Care for Young People with Co-occurring Problems.","authors":"Sabina Kapetanovic, Sabina Vlasman, Karin Boson, Peter Wennberg, Mats Anderberg, Mikael Dahlberg","doi":"10.1177/14550725251384006","DOIUrl":"10.1177/14550725251384006","url":null,"abstract":"<p><p>The study explores the qualifications and competency needs of professionals working at Swedish Maria clinics, specialized in treating youth with co-occurring substance use and mental health problems. A web-based survey was conducted among 87 professionals working at the clinics to assess their qualifications, competence in managing co-occurring problems and perceived needs for further training. Most professionals had high educational qualifications, with backgrounds in social work, nursing and psychology. Although health care and social services professionals had generally similar competencies, there were some notable differences in their professionalism and competency needs. Healthcare professionals were more likely to report competence in managing severe psychiatric conditions. In contrast, social services professionals more often reported using a broader range of treatment methods. Both groups identified a need for further education in managing severe psychiatric conditions, such as trauma, psychosis and eating disorders. Social services professionals more frequently emphasized the need for family-oriented approaches, while healthcare professionals more often identified a need for more in-depth knowledge related to substance use. While professionals at the clinics generally possess strong qualifications, there are differences in their confidence and expertise relating to managing complex mental health conditions. Tailored training initiatives that address specific needs based on professionals' educational backgrounds and organizational affiliations could enhance inter-professional collaboration and improve treatment outcomes for youth with co-occurring substance use and mental health problems.</p>","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"447-461"},"PeriodicalIF":2.2,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12558905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gambling Disorder and Increased Psychiatric Comorbidity: A Finnish Register-Based Study.","authors":"Anne H Salonen, Tiina A Latvala, Miika Vuori, Jonna Levola, Sari Castrén, Tanja Grönroos","doi":"10.1177/14550725251380172","DOIUrl":"10.1177/14550725251380172","url":null,"abstract":"<p><strong>Aim: </strong>This study investigates gender-specific standardized incidence ratios (SIRs) of comorbid psychiatric disorders among adults diagnosed with gambling disorder (GD) and also examines mortality rates and causes of death in this population.</p><p><strong>Methods: </strong>The study included all individuals aged 18 years or older in Finland diagnosed with GD between 2011 and 2022 (<i>n</i> = 3,605), as defined by ICD-10 code F63.0 (International Classification of Diseases, 10th Revision). Data were drawn from nationwide social and healthcare registers, covering both primary and specialized care. The general population (<i>n</i> = 4,374,192) served as the reference group.</p><p><strong>Results: </strong>Among individuals with GD, 88.5% were diagnosed with at least one additional psychiatric disorder. After age standardization, the incidence of psychiatric comorbidities was significantly higher in the GD group compared to the general population. Mood and anxiety disorders were the most common disorders in both groups. However, personality disorders (PD), schizophrenia spectrum disorders (SSD) and substance use disorders (SUD) were significantly more common among individuals with GD. Some gender-specific patterns emerged: GD was particularly associated with PD and SUD among women, as well as with PD and SSD among men. Of the GD cohort, 3.6% had died, with suicide accounting for 22% of deaths.</p><p><strong>Conclusions: </strong>Diagnosed GD is associated with elevated rates of psychiatric disorders, particularly PD, SSD and SUD. These findings highlight the importance of comprehensive mental health assessment in individuals with GD. Frontline social and healthcare professionals should be attentive to the high occurrence of psychiatric comorbidities in this population to ensure timely and appropriate care.</p>","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"424-446"},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Strait or an Ocean? Exploring Risks and Resources among People who use Drugs in Denmark and Sweden.","authors":"Esben Houborg, Torkel Richert, Johan Nordgren, Kristian Relsted Fahnøe, Mette Kronbæk, Nanna Kappel, Katrine Schepelern Johansen","doi":"10.1177/14550725251380179","DOIUrl":"10.1177/14550725251380179","url":null,"abstract":"<p><strong>Background: </strong>Denmark and Sweden have similar welfare systems, but different drug policies. Denmark has historically a more liberal and more harm reduction-oriented drug policy than Sweden. On this background, we present a study of risks and use of formal and informal resources among structurally vulnerable people who use drugs in Copenhagen in Denmark and Malmö in Sweden.</p><p><strong>Methods: </strong>The study reports from research projects in each city that investigated the everyday lives and risks- and enabling environments of structurally vulnerable people who use drugs. Both projects involved the same survey. Participants were recruited at treatment and low-threshold services in Copenhagen (<i>n</i> = 243) and Malmö (<i>n</i> = 231).</p><p><strong>Results: </strong>The participants in the two cities used many different resources provided by the welfare system, but participants from Copenhagen made more use of available harm reduction services. The participants from Malmö used drugs in more risky settings and relied more on other people who use drugs for resources and had more concerns regarding overdoses and other drug-related harms and about being arrested by the police.</p><p><strong>Conclusions: </strong>In both cities, the Nordic welfare state plays a large role in providing resources, but drug policy can influence access to harm reduction resources and the experience of criminalization. These differences can play a role in shaping the local risk environments, although the patterns identified should be interpreted with caution given the exploratory nature of the study. More comparative research is needed to explore how drug policy shape risk environments.</p>","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"370-387"},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Related Deaths Among Young People in a Scottish Region: A Socio-Ecological Autopsy Approach to Understanding the Context of Drug Deaths.","authors":"Aileen O'Gorman, Stephanie Govenden, Frances Matthewson","doi":"10.1177/14550725251370436","DOIUrl":"10.1177/14550725251370436","url":null,"abstract":"<p><strong>Aims: </strong>Social, structural and systemic factors are critical to understanding drug-related deaths among adults. The relevance of these factors to young people is not known. This study explores the life experience, drug using histories and the interactions of a group of young people with agencies and services prior to their death. Our approach seeks to look beyond the immediate cause of death and identify broader contextual factors that may have contributed to a death through a \"whole-life view\".</p><p><strong>Methods: </strong>The study developed a socio-ecological autopsy approach informed by social autopsy methods and social ecology and risk environment frameworks. Health, social work, police and post-mortem records of the young people were collated and analysed. Summary narratives, chronologies and descriptive statistics were produced using Excel and NVivo.</p><p><strong>Findings: </strong>Twenty-one deaths were identified; almost all were due to multi-drug toxicity, mainly heroin mixed with other substances. Almost all the young people had reported mental health issues such as anxiety, depression and self-harm, and had experinced at least one recorded overdose before they died. Most grew up in precarity and poverty in deprived areas. In their short lives, most of this cohort of young people experienced multiple adversities in childhood and as young adults, particularly in the year preceding their death.</p><p><strong>Conclusions: </strong>Complex and fragmented services struggled to respond holistically to early signs of difficulties and to the young people's cumulative experience of trauma and adversity, mental ill-health and drug-related harms in the context of prohibition. There is a need for a radical rethink of systems to enable integrated youth-centred approaches that meet the needs of those at risk of drug-related deaths and to address the broader social and structural contexts of drug deaths.</p>","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"499-513"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charting recovery pathways in Sweden: The role of time, gender and meaningful activities.","authors":"Mulka Nisic, David Best, Linda Nilsson, Peter Moilanen","doi":"10.1177/14550725251357221","DOIUrl":"10.1177/14550725251357221","url":null,"abstract":"<p><p><b>Aim:</b> To explore the influence of gender and time in addiction recovery on engagement in meaningful activities and the reduction of harmful behaviours among the recovery population in Sweden. <b>Methods:</b> Participants were recruited through social media, recovery and treatment services, and snowballing, resulting in a sample of 110 individuals who consider themselves in addiction recovery for more than 3 months. Bivariate analyses were used to explore gender differences in relation to personal characteristics and current utilization of recovery support. The relationship with time in recovery was examined for three recovery stages (early (5 years)) in relation to meaningful engagement and detrimental activities. The Strengths and Barriers Recovery Scale (SABRS) was used to calculate changes in recovery-related well being. Specifically, we assessed the overall difference between reported strengths and barriers - referred to as the \"SABRS change score\" - and compared these by gender and stage of recovery. <b>Results:</b> The data indicate variations in recovery experiences across genders and stages of recovery, with women reporting more strengths in recovery and a greater change in recovery strengths from active addiction to recovery. The findings affirm the progressive character of recovery, illustrating how prolonged periods in recovery correlate with decreased negative activities (barriers) and increased meaningful activities (recovery strengths). <b>Conclusions:</b> These findings provide significant insights into recovery pathways in Sweden. As well as providing empirical support for defining addiction recovery as a process over time that is associated with enhanced well being and increased (community) engagement and citizenship, recovery support services that sustain recovery in the long-term will result in reduced harmful behaviours and increases in meaningful activities.</p>","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"403-423"},"PeriodicalIF":2.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the quality criteria for qualitative research.","authors":"Matilda Hellman","doi":"10.1177/14550725251358087","DOIUrl":"10.1177/14550725251358087","url":null,"abstract":"","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"277-288"},"PeriodicalIF":2.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment satisfaction among patients in opioid agonist treatment in Norway: A multicenter cohort study.","authors":"Linda Nesse, Thomas Clausen","doi":"10.1177/14550725251351711","DOIUrl":"10.1177/14550725251351711","url":null,"abstract":"<p><p><b>Background:</b> Treatment satisfaction is an important indicator of patients' perceptions of opioid agonist treatment (OAT) for opioid dependence. In addition, treatment satisfaction may have implications for treatment outcomes. The present study aimed to explore treatment satisfaction among OAT patients one year after enrollment, as well as the role of different psychosocial and treatment characteristics in treatment satisfaction. <b>Methods:</b> The study was based on data from the NorComt project (2012-2016), which used a multicenter cohort design with structured questionnaire-based interviews. The sample consisted of 175 OAT patients in Norway who rated their treatment satisfaction (high, mixed, low) one year after enrollment in a new treatment episode in OAT. Treatment satisfaction (high versus mixed or low) was used as a dependent variable in logistic regression models, with demographic characteristics, well-being, substance use, and treatment characteristics as independent variables. <b>Results:</b> Overall, 54.9% of the participants reported high satisfaction with OAT one year after enrollment, while 25.7% reported mixed satisfaction and 19.4% low satisfaction. Of the 175 participants who reported on treatment satisfaction, 161 remained in treatment at follow-up. Reporting an active occupational status and an individual treatment plan in OAT was associated with increased odds for reporting treatment satisfaction, while reporting ongoing substance use was associated with decreased odds for reporting treatment satisfaction. <b>Conclusions:</b> Psychosocial, situational factors, as well as coordinated, integrated support, may play a role in OAT patients' treatment satisfaction. To identify facilitators and barriers in OAT, it is vital to address relevant needs and goals for treatment from the perspectives of patients.</p>","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"353-364"},"PeriodicalIF":2.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Policy to Politics: Is there a Nordic Model for the regulation of alcohol and gambling?","authors":"Virve Marionneau, Mikaela Lindeman, Jenny Cisneros Örnberg, Thomas Karlsson","doi":"10.1177/14550725251350445","DOIUrl":"10.1177/14550725251350445","url":null,"abstract":"<p><p><b>Aim:</b> Control policies in the fields of alcohol and gambling show similarities across Nordic countries. The so-called Nordic model has consisted of strong state intervention and, in many cases, monopolistic provision. However, internal and external pressures pose challenges to the model. This article provides a comparative review of current policies on alcohol and gambling in the Nordic region. <b>Methods:</b> We analyse framings, implementation and outcomes of current alcohol and gambling policies in Denmark, Finland, Iceland, Norway and Sweden. We produce a review of legal documents and grey literature. We also analyse on-going and recent policy changes (2021-2024). Our focus is on policies related to World Health Organisation's evidence-based \"best buys\": physical availability, taxation and marketing. While these best buys are designed for alcohol, we also apply these to gambling. <b>Results:</b> Control policies in the region take place on a spectrum from more restrictive to more market-oriented. Overall, alcohol policy is more restrictive than gambling policy. In comparison with gambling policy, alcohol policy was characterised by a stricter public health framing and consistent implementation based on the best buys. In terms of policy outcomes, more stringent alcohol regulations translated, to some extent, to lower consumption and prevalence, but not systematically. Recent policy developments suggest that alcohol policy may be heading towards increased de-regulation, whereas gambling policies are becoming stricter. <b>Conclusions:</b> The Nordic model continues to be visible particularly in alcohol control. However, the model is challenged by politics. To persist, the Nordic model needs political will and increased cross-country and cross-sectoral collaboration.</p>","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"299-320"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workplace interventions for Finnish nurses: a retrospective document analysis of disciplinary decisions related to substance use.","authors":"Katrimaija Luurila, Mari Kangasniemi, Marja Hult, Arja Häggman-Laitila","doi":"10.1177/14550725251351702","DOIUrl":"10.1177/14550725251351702","url":null,"abstract":"<p><p><b>Aim:</b> The study aimed to describe the workplace interventions for registered nurses (RNs) with substance use disorder (SUD) related violations leading to disciplinary actions. <b>Methods:</b> A retrospective document analysis of disciplinary decisions related to RNs with SUD (N = 171) from a Finnish regulatory authority. The data were analyzed using descriptive statistics and qualitative methods. <b>Results:</b> Substance abuse at the workplace involved intervention actions by a nurse leader and employer with work ability assessment and measures, legislation-based measures for hearing the worker, investigation and handling. Substance abuse services and occupational health services were involved in more than half of incidents. In most of the cases, the RN's contract terminated. <b>Conclusions:</b> Further research about the interventions and supervision of healthcare workers with SUD could help clarify protocols and develop measures for the early detection at work places.</p>","PeriodicalId":46180,"journal":{"name":"Nordic Studies on Alcohol and Drugs","volume":" ","pages":"337-352"},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}