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Lundgren, Lena
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Publications (10 of 37) Show all publications
Scarpa, S., Lundgren, L., Modeste-James, A. & John-Langba, J. (2024). Immigrant background, incarceration history and recidivism among adults assessed for illicit substance use severity: findings from a Swedish registry study. International journal of drug policy, 128, Article ID 104432.
Open this publication in new window or tab >>Immigrant background, incarceration history and recidivism among adults assessed for illicit substance use severity: findings from a Swedish registry study
2024 (English)In: International journal of drug policy, ISSN 0955-3959, E-ISSN 1873-4758, Vol. 128, article id 104432Article in journal (Refereed) Published
Abstract [en]

Background: In Sweden, as in other countries, individuals with immigrant backgrounds are disproportionately represented within the incarcerated population. This study examined the association between immigrant background and future incarceration for individuals assessed for illicit substance use severity, while considering their prior incarceration history.

Methods: Using data from Swedish Addiction Severity Index (ASI) assessments linked to register data from Statistics Sweden, we employed Zero-Inflated Negative Binomial (ZINB) regression models to analyse differences in incarceration histories within five years before and after ASI assessments based on immigrant backgrounds. Additionally, Cox proportional-hazard models were used to assess the likelihood of post-assessment incarceration among these groups.

Results: Immigrant background was positively associated with pre- and post-assessment incarceration. First- and second-generation immigrants from the Global South had longer periods of incarceration in the five years before assessments compared to native Swedes. Post-assessment, first-generation immigrants showed longer periods of incarceration. Survival analyses supported these findings, indicating a higher risk of prolonged post-assessment incarceration among all immigrant groups, particularly first-generation immigrants from the Global South.

Conclusion: Among individuals assessed for illicit drug use within Swedish municipalities, those with immigrant backgrounds faced higher incarceration risks, even after controlling for substance use severity and prior incarceration. Tailored interventions and support systems are vital to prevent re-entry into the criminal justice system. Timely actions can break re-offending cycles, redirecting paths away from reoffending and towards legal reintegration, thereby reducing incarceration and recidivism rates.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Illegal substance use, Immigrant background, Incarceration, Recidivism, Sweden
National Category
Social Work Public Health, Global Health, Social Medicine and Epidemiology Psychiatry
Research subject
Sociology; Social Medicine; Psychiatry
Identifiers
urn:nbn:se:umu:diva-223813 (URN)10.1016/j.drugpo.2024.104432 (DOI)38669771 (PubMedID)2-s2.0-85191009114 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016–07213
Available from: 2024-04-26 Created: 2024-04-26 Last updated: 2024-05-13Bibliographically approved
Lindner, S. R., Scarpa, S., McCarty, D. & Lundgren, L. (2023). Addiction severity and re-employment in Sweden among adults with risky alcohol and drug use. Journal of Substance Use and Addiction Treatment
Open this publication in new window or tab >>Addiction severity and re-employment in Sweden among adults with risky alcohol and drug use
2023 (English)In: Journal of Substance Use and Addiction Treatment, ISSN 2949-8767Article in journal (Refereed) In press
Abstract [en]

Background: The Addiction Severity Index (ASI) assesses respondents' biopsychosocial problems in seven addiction-related domains (mental health, family and social relations, employment, alcohol use, drug use, physical health, and legal problems). This study examined the association between the seven ASI composite scores and re-employment in a sample of Swedish adults screened for risky alcohol and drug use who were without employment at assessment.

Methods: We conducted a retrospective cohort analysis of employment outcomes among 6502 unemployed adults living in Sweden who completed an ASI assessment for risky alcohol and drug use. The study linked ASI scores to annual tax register data. The primary outcome was employment, defined as having earnings above an administrative threshold. We used Cox proportional hazard models to estimate the association between time to re-employment and ASI composite scores, controlling for demographic characteristics.

Results: Approximately three in ten individuals in the sample regained employment within five years. ASI composite scores suggested widespread biopsychosocial problems. Re-employment was associated with lower ASI composite scores for mental health (estimate: 0.775, 95 % confidence interval: 0.629–0.956), employment (estimate: 0.669, confidence interval: 0.532–0.841), drug use (estimate: 0.628, confidence interval: 0.428–0.924), and health (estimate: 0.798, confidence interval: 0.699–0.912).

Conclusions: This study suggests that several ASI domains may provide information on the complex factors (i.e., mental health, health, drug use) associated with long-term unemployment for people with risky substance use.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Addiction severity index, Substance use disorders, Unemployment
National Category
Public Health, Global Health, Social Medicine and Epidemiology Social Work Substance Abuse
Research subject
Sociology; Public health
Identifiers
urn:nbn:se:umu:diva-215253 (URN)10.1016/j.josat.2023.209178 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07213
Available from: 2023-10-12 Created: 2023-10-12 Last updated: 2023-10-19
Lundgren, L., Jemberie, W. B. & Sandlund, M. (2023). Biopsykosocialt perspektiv och implementeringsteori. In: Lena Lundgren (Ed.), Effektiv insatsplanering vid svår substansanvändning: (pp. 43-58). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Biopsykosocialt perspektiv och implementeringsteori
2023 (Swedish)In: Effektiv insatsplanering vid svår substansanvändning / [ed] Lena Lundgren, Lund: Studentlitteratur AB, 2023, p. 43-58Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2023
National Category
Social Work
Research subject
medical behavioral science; Psychiatry; Social Medicine
Identifiers
urn:nbn:se:umu:diva-212577 (URN)9789144155180 (ISBN)
Available from: 2023-08-06 Created: 2023-08-06 Last updated: 2023-10-20Bibliographically approved
Scarpa, S., Grahn, R. & Lundgren, L. (2023). Compulsory care of individuals with severe substance use disorders and alcohol- and drug-related mortality: a Swedish registry study. Frontiers in Psychiatry, 14, Article ID 1106509.
Open this publication in new window or tab >>Compulsory care of individuals with severe substance use disorders and alcohol- and drug-related mortality: a Swedish registry study
2023 (English)In: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 14, article id 1106509Article in journal (Refereed) Published
Abstract [en]

Aim: This study used 17 year of Swedish registry data (2003–2019) for 25,125 adults assessed for their severity of substance use to identify the baseline factors predicting the risk of being court-ordered into compulsory care and examine the association between admission to compulsory care and mortality risks due to alcohol- or drug-related causes.

Methods and materials: Addiction Severity Index (ASI) assessment data were linked to register data on demographic characteristics, compulsory care, and alcohol- and drug-related mortality. Cox regression models were used to identify baseline factors predictive of post-assessment admission to compulsory care in the 5 years post-substance use assessment. Discrete-time random-effect logistic regression models were used to examine the association between compulsory care duration and alcohol or drug-related mortality risks. Propensity score matching was used for validation.

Results: The first models identified that younger age, female gender, and ASI composite scores for drug use, mental health and employment were significantly associated with the risk of placement in compulsory care for drugs other than alcohol. Female gender and ASI composite scores for alcohol, drug use and employment were significantly associated with compulsory care treatment for alcohol use. The second models showed that older individuals and men were more likely to die due to alcohol-related causes, while younger individuals and men were more likely to die due to drug-related causes. Length of stay in compulsory care institutions significantly increased the likelihood of dying due to substance use-related causes. Propensity scores analyses confirmed the results.

Conclusion: In Sweden, a significant concern is the higher likelihood of women and young individuals to be court-ordered to compulsory care. Although compulsory care is often advocated as a life-saving intervention, our findings do not provide strong support for this claim. On the contrary, our findings show that admission to compulsory care is associated with a higher risk of substance use-related mortality. Factors such as compulsory care often not including any medical or psychological therapy, together with relapse and overdose after discharge, may be possible contributing factors to these findings.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023
Keywords
compulsory care, addiction treatment, alcohol-related mortality, drugs other than alcohol-related mortality, Addiction Severity Index
National Category
Substance Abuse Social Work
Identifiers
urn:nbn:se:umu:diva-203400 (URN)10.3389/fpsyt.2023.1106509 (DOI)000919995700001 ()36741106 (PubMedID)2-s2.0-85147213135 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016–07213
Available from: 2023-01-18 Created: 2023-01-18 Last updated: 2024-01-17Bibliographically approved
Scarpa, S., Grahn, R., Nyström, S., Sandlund, M. & Lundgren, L. (2023). Hur fungerade kursen Effektiv Planering av Insatser/EPI: Baslinje- och uppföljningsresultat. Socialmedicinsk Tidskrift, 100(5), 655-665
Open this publication in new window or tab >>Hur fungerade kursen Effektiv Planering av Insatser/EPI: Baslinje- och uppföljningsresultat
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2023 (Swedish)In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 100, no 5, p. 655-665Article in journal (Other (popular science, discussion, etc.)) Published
Abstract [sv]

Denna kvantitativa studie utvärderar kunskapsförändringar hos deltagare i EPI universitetskursen. Majoriteten av deltagarna var socialsekreterare inom miss-bruksområdet. Kursen resulterade i betydande förbättringar av deltagarnas kunskap, särskilt vad gäller insats- och vårdkontinuitetsmodeller samt använd-ning av motivationshöjande intervjutekniker. Kunskapen om äldre personer med beroendeproblem och fördelarna med ASI-uppföljningar för socialarbe-tare och klienter förbättrades också.

Abstract [en]

This quantitative study assesses knowledge improvement among partici-pants of the EPI university course. The majority were social workers in sub-stance abuse. The course led to significant enhancements in participants’ knowledge, particularly concerning intervention and care continuity and the use of motivational interview techniques. Knowledge about older individuals with substance dependencies and benefits of ASI follow-up interviews for social workers and clients also improved.

Keywords
Pre-post design, Educational intervention, Social work, Addiction
National Category
Social Work
Research subject
Social Medicine
Identifiers
urn:nbn:se:umu:diva-217749 (URN)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-01453
Available from: 2023-12-12 Created: 2023-12-12 Last updated: 2023-12-12Bibliographically approved
Sandlund, M. & Lundgren, L. (2023). Missbruk och missbruksvård. In: Lena Lundgren (Ed.), Effektiv insatsplanering: vid svår substansanvändning (pp. 29-41). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Missbruk och missbruksvård
2023 (Swedish)In: Effektiv insatsplanering: vid svår substansanvändning / [ed] Lena Lundgren, Lund: Studentlitteratur AB, 2023, p. 29-41Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2023
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-222833 (URN)9789144155180 (ISBN)
Available from: 2024-03-28 Created: 2024-03-28 Last updated: 2024-03-28Bibliographically approved
Blom-Nilsson, M., Padyab, M. & Lundgren, L. (2023). Samsjuklighet, substansanvädning och psykisk ohälsa. In: Lena Lundgren (Ed.), Effektiv insatsplanering vid svår substansanvändning: (pp. 121-132). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Samsjuklighet, substansanvädning och psykisk ohälsa
2023 (Swedish)In: Effektiv insatsplanering vid svår substansanvändning / [ed] Lena Lundgren, Lund: Studentlitteratur AB, 2023, p. 121-132Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2023
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-212671 (URN)9789144155180 (ISBN)
Available from: 2023-08-07 Created: 2023-08-07 Last updated: 2023-10-20Bibliographically approved
Lundgren, L., Padyab, M., Sandlund, M. & McCarty, D. (2022). Frequency and recency of non-medical opioid use and death due tooverdose or suicide among individuals assessed for risky substance use: Anational registry study in Sweden. Journal of Substance Abuse Treatment, Article ID 108567.
Open this publication in new window or tab >>Frequency and recency of non-medical opioid use and death due tooverdose or suicide among individuals assessed for risky substance use: Anational registry study in Sweden
2022 (English)In: Journal of Substance Abuse Treatment, ISSN 0740-5472, E-ISSN 1873-6483, article id 108567Article in journal (Refereed) Published
Abstract [en]

Sweden and many other countries have experienced increases in suicide and accidental overdose deaths. Ananalysis examined the associations between recency of non-medical opioid misuse and frequency of use of nonmedicalopioids with death due to either suicide or accidental overdose within a sample of 15,000 Swedish adultswho completed an Addiction Severity Index (ASI) assessment for risky substance use or a substance use disorder.Methods and materials: Suicide (n = 136) and death due to overdose (n = 405) were identified in the official Causeof Death Registry from the Swedish National Board of Health and Welfare. Control variables included demographiccharacteristics and risks associated with either overdose or suicide. Cox regression analyses controlledfor variables statistically significantly at the bivariate level.Results: At the multivariable level: a) a higher (modified) ASI Composite Score for mental health; b) history ofsuicide attempt; c) having used non-medical opioids for 1–2 times per week for at least a year; d) history ofinjection drug use; and, e) early onset of drug use, were all significantly and positively associated with death dueto suicide. At the multivariable level: a) a higher the revised ASI Composite Score for mental health; b) recency ofuse of non-medical opioids; c) frequency of non-medical opioid use; d) being a male; and e) being of ages 18–24years compared to ages 43–51 years were all positively and significantly associated with death due to accidentaloverdose.Conclusion: These findings underscore the need to integrate mental health and substance use disorder treatmentand provide suicide and overdose prevention interventions for individuals with an opioid use disorder. Recencyand frequency of non-medical opioids were only associated with death due to overdose and not suicide. However,other drug use related variables (using opioids 1–2 times per week for at least a year, early onset of drug use anddrug injection) were significantly associated with death due to suicide.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Overdose, Suicide, Mortality, Opioid use, Sweden
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-190495 (URN)10.1016/j.jsat.2021.108567 (DOI)000789151900009 ()34340844 (PubMedID)2-s2.0-85111594396 (Scopus ID)
Projects
STANCE-programmet: Studier av socialtjänstens interventioner för alkohol- och narkotikaproblem och hälsoeffekter, ett kollaboralt longitudinellt forskningsprogram
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07213
Available from: 2021-12-16 Created: 2021-12-16 Last updated: 2023-09-05Bibliographically approved
Jemberie, W. B., Padyab, M., McCarty, D. & Lundgren, L. M. (2022). Hospital admission rate, cumulative hospitalized days, and time to admission among older persons with substance use and psychiatric conditions. Frontiers in Psychiatry, 13, Article ID 882542.
Open this publication in new window or tab >>Hospital admission rate, cumulative hospitalized days, and time to admission among older persons with substance use and psychiatric conditions
2022 (English)In: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 13, article id 882542Article in journal (Refereed) Published
Abstract [en]

Background: Substance use among older persons occurs with medical and psychiatric comorbidities. This study examined the associations of substance use disorder (SUD), psychiatric, and dual diagnoses with 12-month cumulative hospitalized days, hospital admission rate and number of days to first hospitalization.

Methods: The cohort of 3,624 individuals (28.2% women) aged 50 years or older was assessed for substance use severity in 65 Swedish municipalities during March 2003–May 2017. Addiction Severity Index data were linked to hospital discharge records and crime statistics. The outcomes were (a) 12-month cumulative hospitalized days; (b) Hospital admission rate, and (c) days to first hospitalization. Generalized linear regression techniques investigated associations between outcomes and SUD, psychiatric and dual diagnoses at admission.

Results: During 2003–2017, 73.5% of the participants were hospitalized. Twelve-month hospitalized days were positively associated with SUD (Incidence rate ratio (IRR) = 1.41, 95%CI: 1.26–1.58), dual diagnosis (IRR = 2.03, 95%CI: 1.74–2.36), and psychiatric diagnoses (IRR = 2.51, 95%CI: 2.09–3.01). Hospital admission rate was positively associated with SUD (IRR = 4.67, 95%CI: 4.28–5.08), dual diagnosis (IRR = 1.83, 95%CI: 1.64–2.04), and psychiatric diagnoses (IRR = 1.73, 95%CI: 1.55–1.92). Days to first hospitalization were negatively associated with SUD (IRR = 0.52, 95%CI: 0.47–0.58), dual diagnosis (IRR = 0.57, 95%CI: 0.50–0.65), and psychiatric diagnoses (IRR = 0.83, 95%CI: 0.73–0.93). The marginal effects of SUD and/or mental disorders increased with age for all outcomes, except for days to first hospitalization.

Conclusion: Three of four older persons assessed for substance use severity were later hospitalized. Substance use disorders, dual diagnoses and other mental disorders were the primary reasons for hospitalization and were associated with longer stays, earlier hospitalization, and repeated admissions. Sensitizing service providers to old age substance use and sharing data across the care continuum could provide multiple points of contact to reduce the risk of hospitalizations among older persons with problematic substance use.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
Keywords
aged, repeated hospitalizations, length of stay (D007902), older adult, dual diagnosis, substance use disorder, mental health disorders, comorbidities
National Category
Psychiatry Social Work Geriatrics
Research subject
Social Medicine
Identifiers
urn:nbn:se:umu:diva-194017 (URN)10.3389/fpsyt.2022.882542 (DOI)000876149900001 ()35530023 (PubMedID)2-s2.0-85129652326 (Scopus ID)
Projects
STANCE
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07213The Royal Swedish Academy of SciencesThe Kempe Foundations
Available from: 2022-04-22 Created: 2022-04-22 Last updated: 2024-01-17Bibliographically approved
Lundgren, L., Jemberie, W. B. & McCarty, D. (2022). Introduction to a Special Issue: Care and treatment for substance use disorders: Studies from around the world. Journal of Substance Abuse Treatment, 134, Article ID 108620.
Open this publication in new window or tab >>Introduction to a Special Issue: Care and treatment for substance use disorders: Studies from around the world
2022 (English)In: Journal of Substance Abuse Treatment, ISSN 0740-5472, E-ISSN 1873-6483, Vol. 134, article id 108620Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2022
National Category
Substance Abuse
Identifiers
urn:nbn:se:umu:diva-187748 (URN)10.1016/j.jsat.2021.108620 (DOI)2-s2.0-85120674671 (Scopus ID)
Available from: 2021-09-20 Created: 2021-09-20 Last updated: 2022-03-01Bibliographically approved
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