title: Mortality among a national population sentenced to compulsory care for substance use disorders in Sweden: descriptive study.
abstract: 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) and 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.
authors.affiliation: Center for Addictions Research and Services, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA. Electronic address: tlhall@bu.edu.
authors.forename: Taylor
authors.initials: T
authors.lastname: Hall
authors.affiliation: Center for Addictions Research and Services, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Chassler
authors.affiliation: Department of Social Work, Umeå University, SE-901 87 Umeå, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Blom
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.
authors.forename: Marcus
authors.initials: M
authors.lastname: Blom-Nilsson
authors.affiliation: Boston University School of Public Health, Crosstown Center, 801 Massachusetts Avenue, Boston, MA 02118, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Sullivan
authors.affiliation: 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: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000401:mortality / Q000628:therapy; D002423:Cause of Death; D062787:Drug Overdose / Q000401:mortality; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D037141:Mandatory Programs / Q000706:statistics & numerical data; D008875:Middle Aged; D009026:Mortality; D009293:Opioid-Related Disorders / Q000401:mortality / Q000628:therapy; D012042:Registries; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000401:mortality / Q000628:therapy*; D013405:Suicide / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol; Mortality; Narcotics; Swedish compulsory care