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Objective This study sought to assess the overall risk of death among cannabis users compared with non-users; and assess mortality among persons with psychotic disorders and find out to what extent cannabis use affects the excess mortality. Methods A study …

The commentary of Segrot et al on the Swedish Strengthening Families Program (SFP) trial is important. The spread of evidence-based practice has resulted in an increased interest in empirically supported interventions (ESIs) and a growing number of controlled trials of imported and culturally adapted interventions. Evidence from selected case examples of replication trials of family-based US Blueprints model and promising programs appears mixed.1 We are beginning to learn from these successes and failures that features of both ESIs and the research designs used to test them may contribute to outcomes, that is, whether transport from one cultural context to another is successful in terms of program implementation and observed outcomes. To understand the contradictory results from studies of imported ESIs, at least four explanations are available. The first has …

Objective To determinate whether schizophrenia patients with a history of cannabis use have a different prognosis, with re-admission to relapse and hospital duration, compared to those without a history of cannabis use. Method A cohort study of 50 087 Swedish men with data on cannabis use at ages 18–20. A total of 357 cases of schizophrenia were …

Background: A number of factors have been identified that protect adolescents or, alternatively, put them at risk for drug use and other high-risk behaviours. These factors concern different personal and environmental factors, e.g. the community, the school setting, family, peer group and individual characteristics.The aim of the present study was to examine the associations between risk and protective factors and adolescents' use of alcohol and drugs. Methods: In both May 2003 and 2004, random samples of 4800 adolescents (a total of 9600) in Sweden were contacted and asked to fill out a questionnaire.It concerned use of alcohol and illicit drugs and a large number of adolescent risk and protective factors. A total of 5445 (57%) adolescents agreed to participate. Results: About 44% of the adolescents in grade 9 (15-16 years of age) had been drunk on at least one occasion and nearly 80% of those in grade 11 (17-18 years of age). Almost 15% in grade 9 and 40% in grade 11 had been drinking heavily during the previous month, and 4% in grade 9 and 12% in grade 11 had used cannabis. Strong associations were found between elevated individual, family, school and community risk factors and use of alcohol and drugs. Conversely, protective factors were negatively related to the use of alcohol and drugs. Conclusions: This study confirms the importance of risk and protective factors within different domains in explaining alcohol and drug use among adolescents. The results support efforts targeting multiple risk and protective factors in alcohol and drug preventive interventions for adolescents. Language: en

Background: A multi-component alcohol prevention programme targeting licenced premises has been ongoing in Stockholm since 1996. An earlier study has established that this led to a 29% reduction in police-reported violence. The objective of the present study is to calculate the programme's cost-effectiveness from a societal perspective; the cost of implementation, the savings made as a result of fewer assaults, unlawful threats and violence towards officials, and the health gains in terms of quality-adjusted life-years (QALYs). Methods: The costs included administration, studies of alcohol serving practices, community mobilization, responsible beverage service training and stricter alcohol law enforcement. For the purpose of estimating how the decrease in violence affected savings and health gains, a survey among victims of violence ( N = 604) was performed. Results: The cost of the programme was estimated at Euro 796 000. The average cost of a violent crime was estimated at Euro 19 049, which implies overall savings of Euro 31.314 million related to the judicial system (78%), production losses (15%), health care issues (5%) and other damages (2%). Accordingly, the base case cost-saving ratio was 1 : 39. The average loss of health state weighting among the victims at 0.09 translates into 236 gained QALYs for society as a whole, which should be compared with the modest proportion of savings in the health sector. Conclusion: The most significant concern is the low response rate (35%), and caution needs to be exercised when interpreting our results. Yet, a reasonable conclusion is that the monetary and human benefits have been considerable.