title: Drop-out from the Swedish addiction compulsory care system.
abstract: Drop-out of addiction treatment is common, however, little is known about drop-out of compulsory care in Sweden. Data from two national register databases were merged to create a database of 4515 individuals sentenced to compulsory care 2001-2009. The study examined (1) characteristics associated with having dropped out from a first compulsory care episode, (2) the relationship between drop-out and returning to compulsory care through a new court sentence, and (3) the relationship between drop-out and mortality.
  
  
  METHODS
  Multivariable logistic regression analysis was used to address Aim 1 and Cox proportional hazards regression modeling was applied to respond to Aims 2 and 3.
  
  
  RESULTS
  Age and previous history of crime were significant predictors for drop-out. Clients who dropped out were 1.67 times more likely to return to compulsory care and the hazard of dying was 16% higher than for those who dropped-out.
  
  
  CONCLUSIONS
  This study finds that 59% of clients assigned to compulsory care drop-out. Younger individuals are significantly more likely to drop-out. Those who drop out are significantly more likely to experience negative outcomes (additional sentence to compulsory care and higher risk of mortality). Interventions need to be implemented that increase motivation of youth to remain in compulsory care.
authors.affiliation: Department of Social Work, Umeå University, SE-901 87 Umeå, Sweden. Electronic address: Mojgan.padyab@socw.umu.se.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Padyab
authors.affiliation: Department of Social Work, Umeå University, SE-901 87 Umeå, Sweden.
authors.forename: Robert
authors.initials: R
authors.lastname: Grahn
authors.affiliation: Department of Social Work, Umeå University, SE-901 87 Umeå, Sweden; Center for Addictions Research and Services, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA.
authors.forename: Lena
authors.initials: L
authors.lastname: Lundgren
mesh_terms: D000328:Adult; D000367:Age Factors; D003415:Crime / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D037141:Mandatory Programs / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Compulsory care; Drop-out; Mortality; Sweden