How Much Treatment are Adolescents Receiving in Specialised Substance Use Healthcare in Sweden? Age and Cohort Trends.

Background: There is little systematic research on what adolescents are provided within specialised substance use treatment. This study explored trends in treatment received (number of outpatient treatment visits and inpatient treatment episodes) according to year and age at first contact among adolescents who were enrolled at Sweden's largest treatment provider, the Maria Ungdom Clinic in Stockholm, between 2011 and 2021.

Methods: The data were derived from electronic health records for all patients (n = 29 967) who were in contact with Maria Ungdom Stockholm between 2011 and 2021. Negative binomial regressions estimated the association between year cohort and age at first contact and number of outpatient visits respective number of inpatient episodes. We also tested whether trends according to year cohort and age at first contact were moderated by sex and treatment type.

Results: Patients in earlier cohorts and those who were younger at first contact had more outpatient visits. A similar association with age at first contact was observed for inpatient treatment, but was less evident for year cohort. Differences in outpatient visits according to year cohort and age at first contact were mainly observed in patients enrolled in both outpatient and inpatient treatment, and the same held true for differences in number of inpatient episodes according to age at first contact. Regression models that adjusted for potential different exposure time found a higher treatment rate among later cohorts and patients who were older at first contact.

Conclusion: Patients in the earlier year cohorts and who were at younger age at first contact with Maria Ungdom received most treatment. However, later cohorts and patients who were at an older age at first contact with Maria Ungdom had a higher treatment rate, suggesting that these groups were provided with a more intensive treatment.