Grahn R, Padyab M, Lundgren L. Associations between a risky psychosocial childhood and recurrent addiction compulsory care as adult.
NORDIC STUDIES ON ALCOHOL AND DRUGS 2020;
37:54-68. [PMID:
32934593 PMCID:
PMC7434189 DOI:
10.1177/1455072519882785]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/23/2019] [Indexed: 11/16/2022] Open
Abstract
Background:
Treatment for substance use disorder (SUD), results, in general, in
improvements in terms of both drug use and social functioning. However,
there are clients who are in need of repeated treatment. The aim of this
retrospective study was to identify, for adults in compulsory care for
severe SUD, the association between reporting having experienced a risky
psychosocial childhood and repeated entries into the Swedish compulsory care
system for SUD.
Method:
Hierarchical logistic regression and mediation analysis methods were used to
analyse data from the Swedish National Board of Institutional Care (SiS)
database. The sample included 2719 adults assessed at their compulsory care
intake. The study examined the association between history of institutional
care, family with SUD or psychiatric problem and repeated compulsory care
entries as an adult controlling for main drug, age and gender.
Results:
In the regression model the factor with the strongest association with
repeated compulsory care intakes for SUD, was as a child having been in
mandated institutional care (OR = 2.0 (1.60–2.51)). The
proportion of the total effect that is mediated through LVU (law (1990:52)
the care of young persons (special provisions) act) was 33% for SUD problems
in family during childhood, 44% for psychiatric problems in family during
childhood, and 38% for having been in foster care.
Conclusion:
Having been in mandated institutional care as a youth was strongly associated
with repeated compulsory care for SUD as an adult. This is concerning since
receipt of services as a child is supposed to mediate against the
consequences of risky childhood conditions. These adults, as a group, are in
need of a well-coordinated and integrated system of extensive aftercare
services to reduce the likelihood of re-entry into compulsory care for an
SUD.
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