title: Repeated addiction treatment use in Sweden: a National Register Database study.
abstract: Sweden has a free, universal addiction treatment system, yet few studies exist examining utilization of treatment in this country. This study identified predisposing, enabling, and need factors associated with history of number of voluntary addiction treatment episodes for a national sample of 12,009 individuals assessed for an alcohol and/or drug use disorder in Sweden. On average, people reported 4.3 prior treatment episodes. Linear regression methods identified that predisposing factors such as older age and being male were associated with more voluntary addiction treatment episodes compared to younger and female clients; a higher Addiction Severity Index (ASI) employment score (an enabling factor) was associated with more voluntary addiction treatment episodes; and need factors including a history of inpatient mental health treatment, a higher ASI psychiatric score, a higher ASI alcohol score, higher levels of illicit drug use, more compulsory addiction treatment episodes, a lower ASI legal score, and a history of criminal justice involvement were all associated with more voluntary addiction treatment episodes compared to their counterparts.. There were no differences in the number of treatment episodes by education or immigrant status.
  
  
  CONCLUSIONS
  (1) Need is a key factor associated with more treatment use. (2) Further studies are needed to identify gender differences in access/use of treatment. (3) Given multiple treatment histories, Swedish addiction treatment policy should reflect a chronic care model rather than an acute care model.
authors: 1Social Work, Umea University, Umea, Sweden.
authors: Robert
authors: R
authors: Grahn
authors: Deborah
authors: D
authors: Chassler
authors: Lena
authors: L
authors: Lundgren
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D012008:Recurrence; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000628:therapy; D013548:Sweden / Q000453:epidemiology
keywords: Sweden; addiction treatment; chronic care model; compulsory treatment; substance use disorder; treatment repeaters