Prevention programs targeting parents with ethnic minority backgrounds aiming to strengthen their parenting practices is a developing intervention field. The aim of our study was to gain understanding of how deliverers perceive working with a Swedish, practice-based, culturally informed, parenting program called Self-Assured Parents (SAP), that targets immigrant mothers living in social disadvantage with teenage children. 

We conducted four focus groups with 17 course leaders and collected survey data from 23 course leaders. The interview data was analyzed with thematic analysis and the survey data are presented with descriptive statistics. 

Four themes were identified: general assessment of SAP, language issues and interpretation, cultural sensitivity, and emotional energy. Course leaders reported a high degree of program acceptability, feasibility and appropriateness. They found recruitment and the use of interpreters to be the main challenges. Although SAP is a culturally informed program, issues regarding the culture of the mothers were seldom mentioned as a challenge. Social interactions with the course participants were described as energizing, which we relate to Randall Collins’ concept emotional energy. 

Course deliverers in parental education programs for immigrant mothers need to pay attention to recruitment and language issues, but may not necessarily need to focus on cultural aspects to a large extent. We propose that parental prevention programs may benefit from theoretical discussions about emotional and relational energy.   

Background: Long-acting injectable buprenorphine (LAIB) formulations are a novel treatment approach in opioid agonist treatment (OAT), which provide patients with a steady dose administered weekly or monthly and thus reduce the need for frequent clinic visits. Several studies have analyzed patient experiences of LAIB but the perspective of OAT staff is unknown. This study aimed to explore how healthcare staff working in OAT clinics in Sweden perceive and manage treatment with LAIB.

Methods: Individual qualitative interviews were conducted with OAT physicians (n = 10) in tandem with nine focus group sessions with OAT nurses and other staff categories (n = 41). The data was analyzed with thematic text analysis.

Results: Five central themes were identified in the data: (1) advantages and disadvantages of LAIB, (2) patient categories that may or may not need LAIB, (3) patients’ degrees of medication choice, (4) keeping tabs, control and treatment alliance, and (5) LAIB’s impact on risk and enabling environments in OAT. Overall staff found more advantages than disadvantages with LAIB and considered that patients with ongoing substance use and low adherence were most likely to benefit from LAIB. However, less frequent visits were viewed as problematic in terms of developing a treatment alliance and being able to keep tabs on patients’ clinical status. Clinics differed regarding patients' degrees of choice in medication, which varied from limited to extensive. LAIB affected both risk and enabling environments in OAT.

Conclusions: LAIB may strengthen the enabling environment in OAT for some patients by reducing clinic visits, exposure to risk environments, and the pressure to divert medication. A continued discussion about the prerequisites and rationale for LAIB implementation is needed in policy and practice.

Background: Experiences of intoxication elude scientific research because of their immediate and ‘inner’ nature for the intoxicated individual. In this chapter, we show how ‘trip reports’ – reports of psychedelic intoxication – from online drug information forums and libraries allow for further understanding the experience of psychedelic intoxication from LSD, DMT and psilocybin by examining psychonauts’ (i.e., recreational psychedelic users) own understandings. Methods: The chapter draws on textual ethnography to analyze the trip rapports, approaching the reports as ‘native’ texts that allow for understanding constructions, conventions and practices of intoxication among participants in online psychonaut culture. We reviewed approximately 100 reports from three online drug information forums and libraries: Bluelight, Erowid and Shroomery. By focusing on nine of these reports, we demonstrate how they can be used to analyze psychedelic intoxication. Results: Our analysis shows how psychonauts construct their experiences by combining the context of psychedelic intoxication with inner aspects. The context refers to psychosocial factors of the psychonaut, such as expectations, and their material and social surroundings, such as interior design and other people present during intoxication. The inner experience refers to the arguably psychologically internal reactions and experiences of intoxicating effects, and how the psychonauts narrate them. Conclusions: Our findings show that intoxication follows observable patterns which may best be unraveled by approaching it as structured experience. Yet, the structure of these experiences is not necessarily framed in mystic or religious ways, suggesting that trip reports may complement current research on psychedelic intoxication that approaches it as religious or mystic experiences. Moreover, we suggest that further research should examine the systematics of context and inner experience of psychedelic intoxication which might aide the development of better methods for harm reduction and the study of the therapeutic potential of psychedelics.

Background: Khat is a psychoactive plant with stimulant qualities that is a legal commodity in several nations on the Arabian Peninsula and in East Africa. However, khat is also used in diaspora settings in Europe and North America, where it is a criminalized substance and surrounded with controversy. This chapter focuses on khat use and its association with the Somali community in Sweden to analyze a case of ethnified intoxication.

Methods: I carried out 16 qualitative semi-structured interviews with representatives from Somali civil society organizations in Malmö, Sweden and analyzed the material with an abductive approach.

Results: The interviewees resisted a common stereotyping of the Somali minority as a homogenous problematic ethnic collective burdened by khat use. They discussed both problematic and positive aspects of khat use and differentiated between khat use and khat abuse. Overall, the interviewees constructed the solutions to problematic khat use less in relation to the drug itself or to ethnicity and culture, and more to the socioeconomic situations of the users in a diaspora setting.

Conclusion: The association between khat use and Somali ethnicity and culture was resisted by the interviewees, but it also meant that they engaged in ethnic boundary-making since khat use has been thoroughly ethnified in Sweden. I suggest that reflection by scholars and practitioners is needed to avoid overly simplified explanations of khat use, and that historical cases of drug scares about the intoxicant use of ethnic and other minorities should inform current practices and policies.

Fatal opioid overdoses usually occur without anyone being present and able to intervene. Knowledge of the presence of witnesses is important for how naloxone programs should be designedDrug mortality has increased in Sweden during the 2000s. The vast majority of deaths are opioid overdoses. The National Board of Health and Welfare recommends that the antidote naloxone and a brief overdose education should be offered to people who are at risk of opioid overdose. A retrospective registry study of 193 forensically examined fatal opioid overdoses in Skåne showed that over 80 percent occurred in private residences, most often the deceased’s own home. Other people were present in just over 40 percent of the 193 deaths, but usually in another room or asleep. In most cases, the witnesses were friends, partners, parents, or other people close to the deceased. Naloxone programs should be expanded to include family members and other persons who are close to opioid users, and who therefore may witness or be present early in case of an overdose.

Objective: Family members of a person with drug addiction often experience negative impacts on their lives and face barriers to seeking professional support. More knowledge is needed about such barriers so they can be reduced. This article examines the help-seeking experiences of parents of adult children with drug addiction, a group that has received little attention in research. Method: We conducted in-depth interviews with 32 parents of adult children with drug addiction in Sweden. Results: Parents described problems in encounters with social services and barriers to adequate support for their children. On a psychological level, they described feelings of shame and guilt, negative views of social services, and fear of stigma and loss of control that were barriers to seeking professional support. On an interpersonal level, barriers to help were connected to problems in the interaction among parents, children, and social services. On a structural level, barriers pertain to deficiencies in the availability and quality of support measures, inadequate cooperation between authorities, and a shift in responsibility from the state to the individual and the family. Conclusions: Parents of children with drug addiction are a vulnerable group that often experience problems in their contacts with authorities. A more collaborative approach by social services may abate parents’ self-blame and concern and may strengthen their role in their children’s treatment process.

BACKGROUND: Several studies have examined the effect of community interventions on youth alcohol consumption, and the results have often been mixed. The aim of this study is to evaluate the effectiveness of a community intervention known as the Öckerö Method on adolescent alcohol consumption and perceived parental attitudes towards adolescent drinking.

METHOD: The study is based on a quasi-experimental design, using matched controls. Self-report studies were conducted among adolescents in grades 7-9 of compulsory education in four control and four intervention communities in the south of Sweden in 2016-2018. Baseline measures were collected in autumn 2016 before the intervention was implemented in the intervention communities. Outcomes were the adolescents' alcohol consumption, past-year drunkenness, past-month drunkenness and perceived parental attitudes towards alcohol.

RESULTS: Estimating Difference-in-Difference models using Linear Probability Models, we found no empirical evidence that the intervention has any effect on adolescents' drinking habits, or on their perceptions of their parents' attitudes towards adolescent drinking.

CONCLUSION: This is the first evaluation of this method, and we found no evidence that the intervention had any effect on the level of either young people's alcohol consumption or their past-year or past-month drunkenness, nor on their parents' perceived attitudes toward adolescent drinking. A further improvement would be to employ a follow-up period that is longer than the three-year period employed in this study.

TRIAL REGISTRATION: ISRCTN registry: Study ID: 51635778 , 31th March 2021 (Retrospectively registered).

In this study, we examine differences in alcohol drinking between first- and second-generation non-European immigrant and native-Swedish adolescents. We also examine whether parental and peer attitudes toward alcohol are associated with the acculturation of drinking habits among adolescents with an immigrant background. The study is cross-sectional and based on a school survey conducted in 2016–2019 in eight municipalities in southern Sweden. The sample consists of 3743 adolescents in year 9 of compulsory education, aged 14–15 years, of which 538 (14.4%) had a non-European immigrant background. Non-European immigrant adolescents reported significantly lower levels of drinking than native-Swedish adolescents. Second-generation immigrants reported a higher level of consumption than first-generation immigrants, and among first-generation adolescents, drinking was more prevalent the longer the adolescents had resided in Sweden, which suggests acculturation of drinking habits. This acculturation is mainly related to changes in peer attitudes toward alcohol. Immigrant adolescents with a longer stay in Sweden reported having friends with more positive attitudes toward alcohol. Among first-generation immigrants, drinking was more common among boys than girls. These differences were primarily found among immigrant adolescents with a relatively short period of residence in Sweden, which suggests that acculturation occurs more quickly among boys than among girls.

Codependency is a term used to describe a range of behaviors among persons who are affected by the problematic drug use of family members. This article analyzes how 32 Swedish parents of adult children with drug problems talked about and understood codependency. The sociology of trouble was used as a theoretical framework and three significant themes were identified in the interviews. The parents spoke about how they defined codependency troubles, how they discovered codependency, and how they set boundaries for their children. The parents talked about their situations as highly distressing, and third-party troubleshooters defined their troubles and problems as codependency. The parents generally rejected the advice to “close the door” on their children and engaged in a range of remedial actions. The analytical focus of this study on the identification, definition, and remedial actions of parents gives valuable insights into family disruptions related to drug problems.