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  • 1.
    Blom Nilsson, Marcus
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Chassler, Deborah
    Center for Addictions Research and Services, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215 USA.
    Lundgren, Lena
    Umeå University, Faculty of Social Sciences, Department of Social Work. Center for Addictions Research and Services, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215 USA.
    Factors associated with work and taking prescribed methadone or buprenorphine among Swedish opiate addicts2015In: Evaluation and Program Planning, ISSN 0149-7189, E-ISSN 1873-7870, Vol. 49, p. 172-177Article in journal (Refereed)
    Abstract [en]

    Background/aims: Using national register data from 2002 to 2008, this exploratory study examines for opiate addicts (n = 2638) whether there is an association between predisposing, enabling and need factors and working and taking methadone or buprenorphine prescribed by a physician for a year or more.

    Methods: Chi-square analyses and One-way ANOVA were used to determine significant relationships between the independent variables and the dependent variable. A binomial logistic regression model, with variables entered as a single block, measured statistical associations between the independent variables and the dichotomous dependent variable.

    Results: Men and those with greater number of years of education (7%) and those with children were 7.08 times more likely to be working and taking prescription methadone or buprenorphine. Those who had more inpatient drug treatment episodes (5%), those who had been charged with crime 3.23 times, and those who had used psychiatric medications were 8.43 times more likely to be working and to have taken prescription methadone or buprenorphine one year or more.

    Conclusion: This study highlights that clients in treatment for opiate addiction who are working and have received methadone or buprenorphine treatment may have better treatment retention and be more integrated socially than their counterparts even though they have a higher level of problem severity and treatment needs.

  • 2.
    Blom-Nilsson, Marcus
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Padyab, Mojgan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Social Sciences, Department of Social Work.
    McCarty, Dennis
    OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, USA.
    Lundgren, Lena
    Umeå University, Faculty of Social Sciences, Department of Social Work. University of AQ2 Denver Graduate School of Social Work, Denver, USA.
    Sexual Abuse and Future Mental Health Hospitalization ina Swedish National Sample of Men Who Use Opioids2019In: Journal of addiction medicine, ISSN 1932-0620, E-ISSN 1935-3227Article in journal (Other academic)
    Abstract [en]

    Objective: Experiences of trauma, specifically sexual abuse, have been linked to both mental health and substance use disorders. This study used 14 years of Swedish health registry data to select a sample of adult men who reported frequent opioid use and assessed if those with a self-reported history of sexual abuse had a higher likelihood of hospitalization for a mental health disorder.

    Methods: A Swedish longitudinal (2003–2017) registry study linked Addiction Severity Index (ASI) assessments completed with individuals who sought treatment for substance use disorders with data on hospitalizations for mental health disorders, and assessed associations with self-reported histories of sexual abuse among men who reported sustained and frequent use of opioids (n¼1862). Cox regression methods tested associations and controlled for age, and the7 ASI composite scores: family and social relationships, employment, alcohol use, drug use, legal, physical health, and mental health.

    Results: The ASI composite score for mental health (hazard ratio[HR] 16.6, P<0.001) and a history of sexual abuse (HR 1.93,P<0.001) were associated with an elevated risk of future mental health hospitalization.

    Conclusion: Both the ASI composite scores for mental health andself-reported history of sexual abuse reflected complex needs amongmen who used opioids and increased risk for mental health hospitalization.Treatment providers should strive to provide integrated careand address the negative aspects of victimization.

  • 3.
    Hall, Taylor
    et al.
    Center for Addictions Research and Services, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA.
    Chassler, Deborah
    Center for Addictions Research and Services, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA.
    Blom, Björn
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Grahn, Robert
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Blom-Nilsson, Marcus
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Sullivan, Lisa
    Boston University School of Public Health, Crosstown Center, 801 Massachusetts Avenue, Boston, MA 02118, USA.
    Lundgren, Lena
    Center for Addictions Research and Services, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA.
    Mortality among a national population sentenced to compulsory care for substance use disorders in Sweden: Descriptive study2015In: Evaluation and Program Planning, ISSN 0149-7189, E-ISSN 1873-7870, Vol. 49, p. 153-162Article in journal (Refereed)
    Abstract [en]

    Sweden's compulsory addiction system treats individuals with severe alcohol and narcotics use disorders. Merging data from three national level register databases of those sentenced to compulsory care from 2001 to 2009 (n = 4515), the aims of this study were to: (1) compute mortality rates to compare to the general Swedish population; (2) identify leading cause of mortality by alcohol or narcotics use; and (3) identify individual level characteristics associated with mortality among alcohol and narcotics users. In this population, 24% were deceased by 2011. The most common cause of death for alcohol users was physical ailments linked to alcohol use, while narcotics users commonly died of drug poisoning or suicide. Average age of death differed significantly between alcohol users (55.0) and narcotics users (32.5). Multivariable logistic regression analysis identified the same three factors predicting mortality: older age (alcohol users OR = 1.28, narcotic users OR = 1.16), gender [males were nearly 3 times more likely to die among narcotics users (p < .000) acid 1.6 times more likely to die among alcohol users (p < .01)] and reporting serious health problems (for alcohol users p < .000, for narcotics users p < .05). Enhanced program and government efforts are needed to implement overdose-prevention efforts and different treatment modalities for both narcotic and alcohol users. (C) 2014 Elsevier Ltd. All rights reserved.

  • 4.
    Lundgren, Lena
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work. Butler Institute of Families, Graduate School of Social Work, University of Denver, Denver, CO.
    Padyab, Mojgan
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Lucero, Nancy M.
    Butler Institute of Families, Graduate School of Social Work, University of Denver, Denver, CO.
    Blom-Nilsson, Marcus
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Nyström, Siv
    National Board of Health and Welfare, Stockholm, Sweden.
    Carver-Roberts, Tabitha
    Butler Institute of Families, Graduate School of Social Work, University of Denver, Denver, CO.
    Sandlund, Mikael
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Immigration Status and Substance Use Disorder-related Mortality in Sweden: A National Longitudinal Registry Study2019In: Journal of addiction medicine, ISSN 1932-0620, E-ISSN 1935-3227, Vol. 13, no 6, p. 483-492Article in journal (Refereed)
    Abstract [en]

    Objectives: First-generation immigrants, in many countries, are healthier than their native counterparts. This study examined the association between first- and second-generation immigrant status and alcohol- or drugs other than alcohol-related (primarily opioids) mortality for those with risky substance use.

    Methods: A Swedish longitudinal, 2003 to 2017, registry study combined Addiction Severity Index (ASI) assessment data with mortality data (n = 15 601). Due to missing data, the analysis sample for this study was 15 012. Multivariate models tested the relationship between immigration status and drugs other than alcohol or alcohol-related mortality, controlling for demographics and the 7 ASI composite scores (CS).

    Results: Age, a higher ASI CS for alcohol, a lower ASI CS family and social relationship, a lower ASI CS for drug use and a higher ASI CS for health significantly predicted mortality because of alcohol-related causes. Higher ASI CS for drugs other than alcohol, employment, and health, age, male sex, and immigration status predicted drugs other than alcohol, related mortality. Individuals born in Nordic countries, excluding Sweden, were 1.76 times more likely to die of drugs other than alcohol compared with their Swedish counterparts. Individuals born outside a Nordic country (most common countries: Iran, Somalia, Iraq, Chile) were 61% less likely to die of drugs other than alcohol compared with their Swedish counterparts. Those with parents born outside Nordic countries were 54% less likely to die of drugs other than alcohol.

    Discussion: Research is needed on why people with risky substance use from Nordic countries (not Sweden) residing in Sweden, have higher mortality rates because of drugs other than alcohol (primarily opioids drugs other than alcohol compared with the other population groups in our study). Findings indicate that ASI CSs are strong predictors of future health problems including mortality due to alcohol and other drug-related causes.

  • 5.
    Nilsson Blom, Marcus
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Opioidberoende: en studie om beroendevården och det sociala sammanhangets betydelse2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Opioid dependence is highly associated with health problems relating to physical health (infectious diseases) as well as mental health (depression, anxiety, antisocial behavior). In addition, research has found an association between use of opioids and increased risk of premature death as a consequence of overdose or other circumstances, such as suicide. Furthermore, opioid dependent individuals experience a high level of social exclusion and problems with relationships, housing, income and livelihood. Overall, there is a connection between opioid dependence and physical, psychological and social vulnerability as well as premature death.

    The importance of social cohesion has rarely been the focus in research on opioid dependence. Therefore, there is a need to further explore whether differences in outcomes (medication assisted treatment, mortality and co-morbidity) in addition to individual characteristics, can be derived from social aspects of the opioid dependent individual’s life.

    The overall aim of the dissertation is to examine individual and social factors among individuals who are dependent on opioids and how they are associated with outcomes relating to: a) medication assisted treatment; and b) mortality and co-morbidity.

    This dissertation is based on data from four different registers. The first and second sub-studies use ASI data. The third uses DOK data from the National Board of Institutions (SiS) and the Death Registry (National Board of Health and Welfare). The fourth study is based on both DOKdata and data from the national patient registry (National Board of Health and Welfare).

    Overall, this dissertation confirms the understanding of opioid dependence as associated with a high level of vulnerability. This dissertation shows that opioid dependence is characterized by extensive care efforts, low levels of employment, and a high level of mental health and comorbidity.

    This dissertation shows that the characteristics related to the social network (parenting, work and education) are of significance for being in treatment, but also remaining in care (medication assisted treatment), which in turn promotes the individual's health and long-term health development. In that, this dissertation shows that for individuals dependent on opioids, there is an association between being part of a social network and favorable health development.

  • 6.
    Nilsson Blom, Marcus
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Lundgren, Lena
    Center for Addictions Research and Services Boston University School of Social Work.
    Chassler, Deborah
    Center for Addictions Research and Services Boston University School of Social Work.
    Predisposing, enabling, and need factors of heroin addict's using prescribed methadone or buprenorphine for a year or longer: an exploratory study of drug treatment for heroin addicts in the Swedish welfare system2014In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 31, no 2, p. 175-188Article in journal (Refereed)
    Abstract [en]

    AIM

    - This exploratory study draws on national register data for 2,638 opioid users from 2004- 2008 to examine whether or not certain predisposing, enabling and need factors are associated with taking methadone or buprenorphine continuously on doctor’s orders for one year or more.

    DESIGN

    - Chi-square analysis, one-way Anova and logistic regression methods were used to explore the association between self-reported demographic characteristics, alcohol/drug use severity, substance use disorder treatment history, criminal justice history, level of mental health symptomatology, mental health treatment history, and whether or not adult opioid users had taken methadone or buprenorphine continuously on doctor’s orders for one year or longer.

    RESULTS

    - Having a job and having had more voluntary treatment episodes were significantly associated with using methadone or buprenorphine. Those opioid users who had a job were 19 times more likely to be on methadone or buprenorphine than opiate users who did not have a job.

    CONCLUSIONS

    - In our study, individuals who were working were significantly more likely to medicate against their opioid abuse. This suggests that they may be more socially integrated than their non-medicating counterparts

  • 7.
    Nilsson Blom, Marcus
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Lundgren, Lena
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Deborah, Chassler
    Arbete som bakgrundsfaktor i underhållsbehandling2014In: popnad.comArticle in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Sannolikheten för individer som arbetar och har ett opiatberoende att medicinera sitt missbruk med ordinerat metadon eller buprenorfin är 19 gånger större än för de utan arbete. Marcus Blom Nilsson, Lena M. Lundgren och Deborah Chassler skriver om bakgrundsfaktorers betydelse i behandling av opiatberoende.

  • 8.
    Nilsson Blom, Marcus
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Padyab, M.
    Lundgren, L. M.
    Cause of death: Factors associated with opioid related mortality among opioid users in the Swedish compulsory care treatment systemManuscript (preprint) (Other academic)
  • 9.
    Nilsson Blom, Marcus
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Padyab, M.
    Lundgren, L. M.
    Factors associated with experience of hospitalization for mental health disorders among opioid users in a compulsory care settingManuscript (preprint) (Other academic)
1 - 9 of 9
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