Opioid addiction is a common problem among prisoners. The aim of this study was to examine differences between people who are incarcerated receiving opioid substitution treatment (OST) and those not receiving OST on addiction-related outcome variables during incarceration and after release from prison. Variables covered illicit use of opioids, non-prescribed substitution medication and other substances, opioid withdrawal symptoms, opioid craving, non-fatal overdoses and post-release substitution treatment. Interviews (European Addiction Severity Index, EuropASI) were conducted with 247 participants in German prisons before release. Participants were interviewed again 1 month and 3-6 months after release from prison. During incarceration, participants who received OST used less illicit opioids and non-prescribed substitution medication than those who did not receive OST. After release from prison, participants in the OST group reported less illicit opioid use and less non-prescribed substitution medication use, as well as less opioid craving. Participants who received OST in prison were more likely to be in OST at post-release follow-up than those who had not received in-prison OST. OST appears to have a positive effect on illicit opioid use and craving both in prison and after release, as well as on treatment at follow-up, which can be considered a protective factor.

The aim of this study was to identify and elucidate the differences between highly affiliated and low/non-affiliated participants in Alcoholics Anonymous (AA) meetings. A qualitative study of 24 participants was conducted in Romania between March and June 2021. Data were collected by means of in-depth interviews. Thematic analysis was used to obtain a comprehensive synthesis of the data collected. Highly affiliated individuals are those who identify themselves as AA members, are sober, have worked the 12 Steps, are satisfied with their lives, experience a state of well-being, accept the Higher Power, have hit the bottom, have a strong desire for abstinence, attend AA meetings on a regular basis, and are committed to both AA and their sobriety. Although there are common themes among both highly and low/non-affiliated individuals, the results suggest that addiction specialists should pay more attention to organisational commitment, spirituality, well-being and addiction-related concepts as it seems some of them may determine successful AA affiliation, while others may reflect on recovery outcomes. These findings could prove useful to motivate individuals who struggle with alcohol addiction and are reluctant in joining AA, since high AA affiliation is associated with a wide range of recovery benefits.

To explore gambling in the indigenous Sámi culture by studying thoughts, ideas and attitudes towards gambling among Sámi and people living in majority Sámi areas with knowledge of the culture. The topic was investigated in an inductive thematic analysis of semi-structured interviews with 14 people (n = 13 self-reported Sámi ethnicity). The majority of the informants knew of superstitious practices that were specific to the Sámi culture, though most did not believe that these could influence gambling outcomes. Several features of the Sámi culture, including religious commitment (Laestadianism), family-oriented societies, non-materialistic ideals and self-sufficiency ideals, were presumed to protect against developing gambling issues. There were reports of reduced trust in the Norwegian healthcare system and a lack of treatment services with sufficient knowledge about Sámi culture. Culture-specific factors protecting against development of gambling problems could be a factor in maintaining established gambling problems by increasing associated shame and stigma, resulting in a higher threshold for help-seeking among Sámi. The findings and their potential implications with regards to the existing literature are discussed.

In the UK, nicotine pouches are growing in popularity, particularly among young people. This study investigated the Instagram marketing strategies of one leading brand, Nordic Spirit. A total of 496 Instagram posts published by Nordic Spirit between 2019 and 2023 were collected and organised into themes using qualitative content analysis to identify recurring patterns. Then, multimodal critical discourse analysis was employed to explore the different linguistic and other semiotic resources at work in posts, their ideological patterns and how they work together to frame nicotine pouches as an essential product for young people. The study identified four key messages that Nordic Spirit uses to target young people: (1) fun and freedom; (2) Nordic happiness; (3) fuss-free and discreet; and (4) healthy and scientifically rational. It found that posts are often misleading, underplay the dangers of nicotine and frame nicotine pouches as trendy lifestyle products rather than as smoking alternatives. The results underline the dangers of such marketing strategies in encouraging nicotine addiction and dependence. Consequently, the UK government and Advertising Standards Authority should do more to clamp down on these social media posts and introduce tighter regulations to protect young people and uphold their freedom from exploitation.

The per capita intake of alcohol in Greenland has risen rapidly since it became commercially available, leading to a corresponding increase in addiction problems and demands for treatment services. Despite efforts to establish addiction treatment services, none were deemed adequate. In response, the Greenlandic parliament initiated a new treatment service strategy in 2015. The aim of this study was to explore the pre-implementation process of this national service by examining literature on addiction problems and treatment services. Using a scoping review and document analysis methodology, we focused on documents related to alcohol, cannabis, gambling, addiction and treatment within the context of Greenland. Data were sourced from parliamentary records, governmental publications and academic literature in the period 2010-2016, leading up to the decision on the new treatment service. A total of 54 documents were identified and organised into three main themes: the national discourse on addiction problems; strategies and action plans addressing addiction; and demographic mapping of addiction issues within the population. Notably, addiction problems emerged as a significant public concern across all themes. Three key documents emerged as pivotal in the implementation of the new treatment service: a government report from 2012; a parliamentary inquiry in spring 2013; and an agenda item in fall 2013. These documents played a crucial role in shaping discussions and decisions. The findings underscore the widespread recognition of addiction problems as a pressing issue in Greenland, as evidenced by the prominence of relevant documents in shaping policy discussions and the implementation of new treatment initiatives.

Online alcohol sales have grown rapidly, but their impact on alcohol consumption and harms is not well understood. This study explores the association between online alcohol purchasing and drinking behaviours during the late phase of COVID-19 pandemic in Poland. A nationally representative survey was conducted in May 2022 of 2000 Polish residents aged 18-50 years selected from a probability-based web panel. Measures included past-year alcohol purchasing through e-stores, food/delivery apps and retail apps. Alcohol consumption was quantified using the Beverage-Specific Quantity-Frequency method. Logistic regression was used to identify sociodemographic and behavioural correlates of online alcohol purchasing. Of the study respondents, 19% purchased alcohol through e-stores, 17% via delivery apps and 15% with retail apps. Spirits were commonly purchased in e-stores (57%), while beer was purchased via apps (58%-60%). Most online buyers took advantage of price promotions (69%-75%) and reported some kind of age verification (67%-68%). Higher odds of online purchasing were found among men (adjusted odds ratio [aOR] 1.38-1.54), younger drinkers (aOR 1.65-2.04) and to some extent university graduates (aOR 1.75 for e-stores purchases). Compared to moderate drinkers, risky (aOR 2.32-3.02) and harmful drinkers (aOR 5.06-6.61) showed substantially increased odds of buying alcohol online. Results suggest online alcohol purchasing, especially through mobile apps, is linked to more excessive drinking. Apps enable easy access to alcohol anytime anywhere, circumventing policies restricting sales to minors and intoxicated persons. With youth drinking declining globally, online sales are an emerging issue for public health. Restricting mobile app-based alcohol delivery could be an important policy measure to curb excessive drinking enabled by digital sales.

The use of drugs is an escalating concern, with significant implications for the health and daily functionality for individuals. It has proven challenging to provide accessible health and social services. In the context of addressing substance use issues in urban areas, public gathering places for individuals who use drugs play a multifaceted role, serving as sites of belonging, support and potential illicit activity. This qualitative study explores the experiences of healthcare and social workers regarding a public gathering place, referred to as "the Bench", in a medium-sized Norwegian city. A qualitative research design consisting of semi-structured focus group interviews and individual interviews with 13 participants representing various support agencies. The analysis resulted in four thematic areas: (1) belonging and a gateway to support and services; (2) balancing user autonomy at the Bench and systems support; (3) the role of a centralised location; and (4) the preventive role of support workers at the Bench. While the Bench fosters a sense of community and provides access to vital services, concerns about illicit activities persist due to its visibility. Nevertheless, its central location facilitates outreach efforts and ensures easy access to support services. The study underscores the preventive role of healthcare and social workers in stabilising the environment and mitigating conflicts. Furthermore, it highlights the importance of central locations for public gathering places, emphasising the proximity to low-threshold services. The Bench represents a crucial venue for establishing relationships and providing assistance to individuals who use drugs, contributing to harm reduction efforts in the community.

Both gambling and digital gaming are growing in popularity and there is ongoing discussion about their convergence. This population-based longitudinal survey study investigated how gambling and digital gaming types contribute to at-risk gambling and gaming. The study was based on a representative sample of 18-75-year-olds from mainland Finland. Survey data were collected at 6month intervals in 2021-2022, starting in April 2021. Of original T1 respondents, 58.95% took part in all four time points. In total, 3,608 observations from 902 individuals were analysed. Outcome measures were at-risk gambling and gaming based on the Problem Gambling Severity Index and the Internet Gaming Disorder Test. Various types of gambling and gaming were investigated. Population-averaged models showed that different forms of gambling were associated with a higher risk of at-risk gaming. Online casino games were associated with the highest likelihood of at-risk gambling and gaming. Prevalence of digital gaming problems was low. Hybrid models were used to investigate the longitudinal within-person and between-person effects of gambling and gaming activities. Online casino games and offline slot machines increased at-risk gambling. Microtransactions within digital games increased at-risk gambling and gaming over time, but the amount of money spent on digital gaming was small compared to gambling. Our results underline the risks of EGMs and online gambling for the participants. Although gambling and gaming are converging, harm is mostly based on gambling.

The aim of this study was to explore how stakeholders perceive illicit drugs at licensed premises, existing and potential prevention interventions, and to identify facilitators and barriers to reduce illicit drugs at these locations. Semi-structured interviews with police officers, licensed premises owners, security staff and municipality officials ( = 28) in seven counties in middle Sweden were conducted and analysed using qualitative content analysis. The informants reported frequent illicit drug use and dealing at licensed premises, causing a negative influence on the restaurant environment. Efforts to prevent illicit drugs varied with respect to type and intensity but included environmental and situational changes as well as education and training, policy implementation and law enforcement. Facilitators for the reduction of illicit drugs are confidence that sufficient resources are allocated, motivated and skilled stakeholders who see benefits of prevention and collaborate closely, along with visible results. General societal prevention was also seen as important. Identified barriers were perceived drug-positive norms and high availability and use in the society, perceived lack of prioritisation and resources, difficulties to collaborate due to e.g., secrecy between organisations, lack of action among stakeholders due to financial considerations, perceived confusion about roles and mandate, and owner's and staff's fear of threats and violence from criminals or own involvement in crime. To maximise the potential of successful prevention, authorities should support owners of licensed premises to act firmly against illicit drugs by providing training, ensure that they apply a strict policy, work for increased stakeholder collaboration and provide appropriate police resources. Authorities should also investigate criminal activities among owners and staff as well as combat organised crime and availability of illicit drugs in the society.

To analyze how the Police in Sweden perceives the drug problem and how it relates to changes in drug politics in the direction of liberalization. The material analyzed consists of a content-analysis of the magazine of the Swedish Narcotic Police Association, covering 145 issues since the start in 1988, concentrating on lead articles, editorials and other articles on principles and politics. The magazine demonstrate an alarmistic view of the drug problem, criticize government agencies and the media for liberal views, question the motives of proponents of decriminalization and legalization, leaves the costs of control of drug interventions aside, and sees the Police as guardian of status quo and as the defender of the goal of Swedish drug policy: "a drug-free society".

Studies have shown an association between parental problematic substance use (PSU) and children's out-of-home care (OHC). But there is little researech on the kind of urban neighbourhoods in which such associations typically show up. This study aims to shed light on the associations between neighbourhood characteristics, parental PSU and children's OHC. Using register data, we explore the spatial concentration of parental PSU and children's OHC in urban areas. Register data of all children born in Finland in 2002 and their biological parents living in 14 Finnish cities were used to follow the children from birth until their 18th birthday or first OHC episode. The study looks at parental PSU andother individual-level indicators as well-as the sociodemographic neighbourhood characteristics. Cox proportional hazards modelling was used as the analysis method. Parental PSU increased the probability of children's OHC regardless of neighbourhood type. The probabilty was highest if both parents had PSU (hazard ratio [HR] = 8.05, 95% confidence interval [Cl] 6.38-10.16), but this outcome did not look the same for all neighbourhoods. The risk of children's OHC placements was higher in suburbs compared to city centres (HR = 1.76, 95% Cl 1.38-2.25). As parental substance use is a complex problem that is often intertwined with other life challenges, such as financial difficulties and mental health problems, it is insufficient to treat caregiver conditions, such as problematic substance use in isolation. Services that increase positive, pro-social connections may be lacking in the neighbourhoods with the most challenges.

The aim was to examine cross-sectoral collaborations of a Danish emergency department (ED) and two municipal treatment centres in the uptake area regarding patients with alcohol problems. The study was a qualitative exploratory study. We conducted individual interviews with ED nurses and secretaries ( = 21) and group interviews ( = 2) in municipal alcohol treatment centres with three and four participants, respectively. Interviews were analysed, first with qualitative content analysis, then by applying the analytical concept "boundary object". Three themes emerged: (1) Responsibilities in practice; (2) Professional contrasts; and (3) The social nurse in a unique position. Themes illuminated a low degree of collaboration characterising the intersectoral work. Blurred responsibilities, challenged communication and acute versus long-term focus were some of the factors not supporting cross-sector collaborations. However, the function of the social nurse was highly appreciated in both sectors and plays a central role. Nonetheless, implicit limitations of this function entail that not all patients with alcohol problems are referred and handled within an ED setting. Overall, we found a lack of collaborative work between healthcare professionals in ED and municipalities for patients with alcohol problems. However, the "social nurse" function was greatly valued in both sectors due to a mediating role, since healthcare professionals in both sectors experienced lack of organisational structures supporting collaborative network, perceived temporal barriers, limited knowledge exchange and differences in approaches to patients.

In this study, we investigated if health professionals' evaluations of driving ability corresponded with measures of severity of alcohol use and measures of cognitive functions necessary for safely driving a car. A total of 90 participants from a multicentre study were included. Participants were categorised into three groups: (1) the group judged fit to drive (FIT); (2) the group judged not fit to drive (UNFIT); and (3) the group who had lost their driver's licence due to legal sanctions (LEGAL). The participants' AUDIT scores, earlier treatment episodes and results from neuropsychological tests of reaction time, attention and visuospatial ability were included in the analyses. We found a significant difference in the severity of alcohol use disorder (AUD) and visuospatial abilities between the FIT and UNFIT groups. Half of the UNFIT group had at least mild visuospatial difficulties, compared to only a quarter in the FIT group. There were no group differences in reaction time or attentional measures. The LEGAL group had more severe AUD than the other groups. The FIT group did not perform differently from the UNFIT group on attention and reaction time measures. The UNFIT group had more visuospatial impairments, but even half of this group had normal scores. It is uncertain whether the differences between the two groups are of practical significance. The quality of health professionals' evaluations may be questioned, and the results highlight the need for more reliable and valid criteria for doing fitness to drive evaluations.

In 2018, the UK Government published its Serious Violence Strategy setting out the Government's commitment to adopting a public health approach to 'serious violence' in England and Wales and encouraging a multi-agency, whole system public health approach to violence prevention. There has been very little research attention and commentary on the roles of alcohol and illegal drugs in the construction of "serious violence" within the Strategy. Drawing on thematic analysis of key policy documents, the ways in which drugs and alcohol have been conceptualised in recent violence policy in the English and Welsh context are explored through the analytical framework of "framing". The overwhelming emphasis on violence associated with the drugs market has skewed attention towards exceptional and sensationalist forms of "serious" violence and diverted it from more common and widespread forms of "everyday" violence, including domestic and alcohol-related violence. Omitting these from the policy purview has implications for those affected and how resources are allocated. To advance inclusive and holistic violence prevention, a wider framing of violence is required and both illegal drugs and alcohol need to be embedded for meaningful working across populations and organisational boundaries.

The aim of this study was to investigate: (1) whether self-reported acute alcohol-related consequences among adolescents in the Nordic countries have declined in concert with the decline in alcohol consumption; (2) whether the relationship between alcohol consumption and alcohol-related consequences has strengthened; and (3) whether the decline in alcohol-related consequences can be attributed to the decline in alcohol consumption. Data are from the European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional surveys in 2007, 2011 and 2015. Participants were students aged 15-16 years in 2007 (n = 16,035), 2011 (n = 14,765) and 2015 (n = 13,517). Alcohol consumption variables included lifetime and 12-month alcohol use, volume ethanol at last drinking occasion and heavy episodic drinking in the past 30 days. Self-reported acute alcohol-related consequences were measured as a sum index of experiencing the following at least once within the last 12 months: (1) an accident or injury; (2) being victimised by robbery or theft; or (3) had trouble with the police. For all alcohol indicators, adolescent alcohol use decreased between 2007 and 2015. The highest prevalence estimates were found in Denmark, and here only the number of current drinkers decreased significantly. In addition, a decreasing trend in self-reported acute alcohol-related consequences was observed. We did not find a strengthening of the alcohol consumption consequences association from 2007 to 2015, except in Iceland. When all surveys were combined, the decrease in alcohol-related consequences could be explained by a decrease in alcohol consumption. Overall, adolescents aged 15-16 years exhibited decreasing trends in both alcohol consumption, less markedly in Denmark, and in our sum index of alcohol-related consequences between 2007 and 2015. Except for Iceland, we found no support for a strengthening of the alcohol-consequences association with declining drinking among adolescents.

This paper provides an overview of the legal framework for alcohol produced for personal use in European Union (EU) Member States. We reviewed the national excise duty legislations of EU Member States and conducted an online mapping survey, in which 10 alcohol experts from seven EU Member States plus Iceland participated. We found that the production of alcohol for personal use is tax exempt in 12 jurisdictions, with four countries stipulating a maximum volume of alcohol that can be produced for personal use. The most common alcoholic beverages concerned were beer and wine, while only one country set a tax exemption for spirits. The results were complemented by the alcohol expert mapping survey; tax exemptions were reported for two additional Member States. Legal exemptions for the production of alcohol for personal use were established in every second EU Member State and may therefore contribute to the unrecorded consumption of alcohol in these countries. In light of the detrimental health effects of alcohol, economic interests to support the local small-scale production of alcohol have to be carefully evaluated against public health interests.

Some previous studies suggest that the consumption of tobacco and nicotine products overall declined during the COVID-19 pandemic, but the results are mixed. We investigated tobacco and nicotine product sales in Finland, including the sales of nicotine replacement therapy (NRT). Our particular focus was on nicotine pouches used as NRT. We aimed to evaluate the effect of the COVID-19 pandemic on the sales of tobacco and NRT products in 2020 by comparing the sales to the previous year. The data were derived from a large sales group (S group) in Finland, representing 46% of the market share in grocery trade in 2020. The gross weekly sales of tobacco (cigarettes, loose tobacco) and NRT (patches, inhalers, tablets, gum and "other", consisting mainly of nicotine pouches) were retrieved from February to December 2020 from 1062 points of sale throughout the country and compared to the same period in 2019. During this period, there was a significant increase in cigarette sales. Moreover, the sales of NRT were significantly higher throughout 2020 compared with 2019. Specifically, the sales of nicotine pouches sold as NRT increased, especially after the travel restrictions in Finland were initiated and the national boundaries closed in the spring of 2020. During the COVID-19 pandemic in Finland, the sales of cigarettes and NRT products increased, especially those of nicotine pouches sold as NRT. Our findings call for further research to reveal the factors leading to this increase and to determine whether the situation is long-standing.