title: The changing picture of substance abuse problems among Finnish prisoners.
abstract: OBJECTIVE
  Marginalized people are often absent from population surveys of substance use and from research based on care data. Special methods are needed to reach these small but very significant groups. This study analyses how patterns of intoxicant use have changed over time among one of the most marginalized group of people, the prisoners.
  
  
  METHODS
  Nationally representative samples of Finnish prisoners were examined: 903 prisoners in 1985, 325 prisoners in 1992, and 410 prisoners in 2006. Comprehensive field studies consisting of interviews and a clinical medical examination were used.
  
  
  RESULTS
  In 1985, a diagnosis for alcoholism was given to 41% of the men and 36% of the women prisoners. An increase over time was observed, and in 2006, 52% of men and 51% of women prisoners were alcohol dependent. Dependence on a drug was diagnosed in 6% of men and 3% of women in 1985; this prevalence had increased to 58% of men and 60% of women in 2006.
  
  
  CONCLUSIONS
  A dramatic change in prevalence of illegal drug use and drug addiction among prisoners has taken place in the past 20 years. Recognizing this shift from alcohol to other intoxicants is important since drugs are illegal substances and thus tend to lead to involvement with the judicial sector, thus stigmatizing and deepening the spiral of marginalization.
authors.affiliation: Finnish Foundation for Alcohol Studies, Helsinki, Finland. tomi.lintonen@uta.fi
authors.forename: Tomi
authors.initials: T
authors.lastname: Lintonen
authors.forename: Yaira
authors.initials: Y
authors.lastname: Obstbaum
authors.forename: Jorma
authors.initials: J
authors.lastname: Aarnio
authors.forename: Virpi
authors.initials: V
authors.lastname: von Gruenewaldt
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hakamäki
authors.forename: Juha
authors.initials: J
authors.lastname: Kääriäinen
authors.forename: Aino
authors.initials: A
authors.lastname: Mattila
authors.forename: Heikki
authors.initials: H
authors.lastname: Vartiainen
authors.forename: Päivi
authors.initials: P
authors.lastname: Viitanen
authors.forename: Terhi
authors.initials: T
authors.lastname: Wuolijoki
authors.forename: Matti
authors.initials: M
authors.lastname: Joukamaa
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D016739:Behavior, Addictive / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000706:statistics & numerical data / Q000639:trends; D015995:Prevalence; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D017678:Sex Distribution; D015813:Substance Abuse Detection / Q000706:statistics & numerical data / Q000639:trends; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*