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Nordgren, J., Monwell, B., Johnson, B., Gunnarsson, N. V. & Johansson Capusan, A. (2024). Healthcare staff’s perspectives on long-acting injectable buprenorphine treatment: a qualitative interview study. Addiction science & clinical practice, 19(1), Article ID 25.
Open this publication in new window or tab >>Healthcare staff’s perspectives on long-acting injectable buprenorphine treatment: a qualitative interview study
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2024 (English)In: Addiction science & clinical practice, ISSN 1940-0632, E-ISSN 1940-0640, Vol. 19, no 1, article id 25Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
National Category
Substance Abuse
Identifiers
urn:nbn:se:mau:diva-66637 (URN)10.1186/s13722-024-00458-6 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2022-00228Medical Research Council of Southeast Sweden (FORSS), 931904
Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2024-04-09Bibliographically approved
Kapetanovic, S., Andersson, L., Svensson, R. & Johnson, B. (2024). Validation of the Super-Brief Pathological Narcissism Inventory (SB-PNI) among Swedish adolescents. Current Psychology
Open this publication in new window or tab >>Validation of the Super-Brief Pathological Narcissism Inventory (SB-PNI) among Swedish adolescents
2024 (English)In: Current Psychology, ISSN 1046-1310, E-ISSN 1936-4733Article in journal (Refereed) Epub ahead of print
Abstract [en]

This study examines the psychometric structure and properties of the Swedish version of the Super-Brief Pathological Narcissism Inventory (SB-PNI) among adolescents. In order to ensure the validity and feasibility of the measure, we examined the factor structure, measurement invariance across gender, age and ethnicity, and construct validity in relation to a number of correlates of narcissism in adolescence. Data were drawn from a large cross-sectional survey conducted in 35 schools in southern Sweden. The sample consisted of N = 5313 adolescents (Mage = 16.10 SD = 1.55) with 52.2% girls, 45.9% boys and 1.8% adolescents with unspecified gender, from compulsory and upper secondary schools in southern Sweden. The results showed that the measure holds a two-factor structure, suggesting the use of the subscales grandiosity and vulnerability separately, rather than as a unidimensional measure. The correlated factors grandiosity and vulnerability yielded full configural and metric invariance across gender, age, and ethnicity. Both grandiosity and vulnerability were correlated with externalizing and internalizing symptoms, as well as with low self-esteem. The study provides evidence for the utility of the SB-PNI among Swedish adolescents and indicates that the measure can be used across male and female adolescents of different ages and ethnic groups. 

Place, publisher, year, edition, pages
Springer Nature, 2024
National Category
Psychology
Identifiers
urn:nbn:se:mau:diva-66402 (URN)10.1007/s12144-024-05749-4 (DOI)001170492500003 ()2-s2.0-85186199898 (Scopus ID)
Available from: 2024-03-20 Created: 2024-03-20 Last updated: 2024-03-28Bibliographically approved
Walde, J., Andersson, L., Johnson, B. & Håkansson, A. (2023). Drug prescriptions preceding opioid-related deaths: a register study in forensic autopsy patients. PLOS ONE, 18(5), e0285583-e0285583
Open this publication in new window or tab >>Drug prescriptions preceding opioid-related deaths: a register study in forensic autopsy patients
2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 5, p. e0285583-e0285583Article in journal (Refereed) Published
Abstract [en]

Background/Aim: Opioid overdose deaths have increased in Sweden and other developed countries in recentdecades, despite increased treatment efforts and harm-reduction interventions. Furtherknowledge in this field is needed if this trend is to be reversed. Previous research suggeststhat mental health and patterns of prescription of opioids and other prescription drugs areassociated with increased opioid-related mortality. The present study therefore aimed toinvestigate what drugs were prescribed during the last six months of life to individuals with ahistory of illicit substance use who died with opioids present in their blood, the relationshipbetween drugs prescribed and drugs found in blood at time of death, and if prescription ofspecific drugs was temporally associated with death.

Methods: This was a retrospective, register-based observational study that utilized data from theNational Board of Forensic Medicine, the Prescribed Drug Registry, regional health careservices, and municipal social services. We used conditional logistic regression to findtemporal associations between the prescription and dispensing of drugs and time ofdeath.

Results: Prescription and dispensing of alprazolam and diazepam were temporally associated withdeath. The most frequently dispensed drugs were zopiclone, pregabalin, methylphenidate,diazepam and oxycodone. Methadone, alprazolam, and buprenorphine were the drugsmost often found in the blood. Opioids and tranquilizers in combination were found in a vastmajority of deaths, and prescription data suggested that the use of these drugs was illicit in amajority of cases.

Conclusion: Prescription of certain drugs, especially alprazolam and diazepam, should be made withgreat caution to patients with a history of illicit substance use or concurrent use of opioids.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2023
National Category
Substance Abuse
Identifiers
urn:nbn:se:mau:diva-59927 (URN)10.1371/journal.pone.0285583 (DOI)001024638000001 ()37256903 (PubMedID)2-s2.0-85160737010 (Scopus ID)
Funder
Region Skåne
Available from: 2023-06-02 Created: 2023-06-02 Last updated: 2023-08-17Bibliographically approved
Svensson, R., Moeller, K., Johnson, B. & Shannon, D. (2023). For Whom Do Unstructured Activities Matters? The Interaction Between Unstructured and Structured Activities in Delinquency and Cannabis Use: A National Self-Report Study. Crime and delinquency, 69(10), 2022-2045, Article ID 001112872211104.
Open this publication in new window or tab >>For Whom Do Unstructured Activities Matters? The Interaction Between Unstructured and Structured Activities in Delinquency and Cannabis Use: A National Self-Report Study
2023 (English)In: Crime and delinquency, ISSN 0011-1287, E-ISSN 1552-387X, Vol. 69, no 10, p. 2022-2045, article id 001112872211104Article in journal (Refereed) Published
Abstract [en]

This study examines whether unstructured and structured activities interact in their association with delinquency and cannabis use. We hypothesize that unstructured activities are more strongly associated with delinquency and cannabis use for those who are less engaged in structured activities. Data are drawn from three nationally representative self-report studies conducted between 2005 and 2011 in Sweden, and include 19,644 adolescents. The results support the hypothesis that unstructured activities interact with structured activities in the association with delinquency and cannabis use. The association between unstructured activities and these outcomes is stronger for those with lower levels of structured activities. Sporting activities constitute the structured activity that most clearly interacts with unstructured activities in the association with delinquency and cannabis use.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
unstructured activities, structured activities, sports, delinquency, cannabis use
National Category
Substance Abuse
Identifiers
urn:nbn:se:mau:diva-54058 (URN)10.1177/00111287221110448 (DOI)000828849400001 ()2-s2.0-85135007298 (Scopus ID)
Available from: 2022-08-02 Created: 2022-08-02 Last updated: 2023-10-18Bibliographically approved
Svensson, R., Johnson, B. & Olsson, A. (2022). Does gender matter? The association between different digital media activities and adolescent well-being. BMC Public Health, 22, 1-10, Article ID 273.
Open this publication in new window or tab >>Does gender matter? The association between different digital media activities and adolescent well-being
2022 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, p. 1-10, article id 273Article in journal (Refereed) Published
Abstract [en]

Background:

Previous research on the relationship between social media use and well-being in adolescents has yielded inconsistent results. We addressed this issue by examining the association between various digital media activities, including a new and differentiated measure of social media use, and well-being (internalizing symptoms) in adolescent boys and girls.

Method:

The sample was drawn from the four cross-sectional surveys from the Öckerö project (2016–2019) in eight municipalities in southern Sweden, consisting of 3957 adolescents in year 7 of compulsory education, aged 12–13. We measured the following digital media activities: playing games and three different activities of social media use (chatting, online sociability, and self-presentation). Our outcome measure was internalizing symptoms. Hypotheses were tested with linear regression analysis.

Results:

Social media use and playing games were positively associated with internalizing symptoms. The effect of social media use was conditional on gender, indicating that social media use was only associated with internalizing symptoms for girls. Of the social media activities, only chatting and self-presentation (posting information about themselves) were positively associated with internalizing symptoms. Self-presentation was associated with internalizing symptoms only for girls.

Conclusion:

Our study shows the importance of research going beyond studying the time spent on social media to examine how different kinds of social media activities are associated with well-being. Consistent with research in psychology, our results suggest that young girls posting information about themselves (i.e. self-presentation) might be especially vulnerable to display internalizing symptoms.

Place, publisher, year, edition, pages
BioMed Central, 2022
National Category
Sociology
Identifiers
urn:nbn:se:mau:diva-50252 (URN)10.1186/s12889-022-12670-7 (DOI)000753873200008 ()35144587 (PubMedID)2-s2.0-85124500768 (Scopus ID)
Funder
Malmö University
Available from: 2022-02-16 Created: 2022-02-16 Last updated: 2024-02-05Bibliographically approved
Svensson, R. & Johnson, B. (2022). Does it matter in what family constellations adolescents live? Reconsidering the relationship between family structure and delinquent behaviour.. PLOS ONE, 17(4), Article ID e0265964.
Open this publication in new window or tab >>Does it matter in what family constellations adolescents live? Reconsidering the relationship between family structure and delinquent behaviour.
2022 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 4, article id e0265964Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: This study examines the associations between ten family structure types and delinquency, including four groups of symmetrical and asymmetrical living arrangements. We also adjust for attachment to parents and parental monitoring.

METHODS: Data are drawn from four cross-sectional surveys conducted between 2016 and 2019 in southern Sweden. The sample consists of 3,838 adolescents, aged 14-15. Negative binomial models were used to calculate the associations between family structure and delinquency.

RESULTS: The results show that those living in single-father, single-mother, father-stepmother, mother-stepfather families report significantly more delinquency than adolescents living with both their parents. Adolescents living in "symmetrical" family arrangements, i.e. both parents are single or have a new partner, reported lower levels of delinquency, whereas adolescents living in "asymmetrical" family arrangements, i.e. where either the mother or the father, but not both, have a new partner, reported higher levels of delinquency. Most of the associations between family structure and delinquency decline when adjusted for attachment to parents and parental monitoring.

DISCUSSION: This study shows that it is important to move on to the use of more detailed categorisations of family structure in relation to delinquency. We need to increase our knowledge about the group of adolescents that moves between parents and especially about the different constellations of asymmetrical and symmetrical living arrangements.

Place, publisher, year, edition, pages
PLoS, 2022
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mau:diva-51288 (URN)10.1371/journal.pone.0265964 (DOI)000791994200042 ()35417470 (PubMedID)2-s2.0-85128331629 (Scopus ID)
Available from: 2022-05-04 Created: 2022-05-04 Last updated: 2024-02-05Bibliographically approved
Andersson, L. & Johnson, B. (2022). Dödlig överdos skedde ofta utan person nära som kunde ingripa: Kunskap om närvaron av vittnen är betydelsefull för hur naloxonprogram bör utformas. Läkartidningen, 119(4-5), Article ID 21121.
Open this publication in new window or tab >>Dödlig överdos skedde ofta utan person nära som kunde ingripa: Kunskap om närvaron av vittnen är betydelsefull för hur naloxonprogram bör utformas
2022 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 119, no 4-5, article id 21121Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Läkartidningen Förlag AB, 2022
Keywords
Opioider, heroin, överdos, naloxon, narkotikadödlighet
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-49674 (URN)35077567 (PubMedID)
Available from: 2022-01-26 Created: 2022-01-26 Last updated: 2023-12-21Bibliographically approved
Johnson, B., Liahaugen Flensburg, O. & Capusan, A. J. (2022). Patient perspectives on depot buprenorphine treatment for opioid addiction: a qualitative interview study. Substance Abuse Treatment, Prevention, and Policy, 17(1), Article ID 40.
Open this publication in new window or tab >>Patient perspectives on depot buprenorphine treatment for opioid addiction: a qualitative interview study
2022 (English)In: Substance Abuse Treatment, Prevention, and Policy, E-ISSN 1747-597X, Vol. 17, no 1, article id 40Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Recently developed buprenorphine depot injections have the potential to reduce risk for diversion and misuse, and to increase adherence with fewer visits for supervised intake. However, it is unclear how patients perceive this new form of medication. The purpose of this study was to explore patients' experiences of depot injections and their reasons for continuing, discontinuing, or declining depot injection treatment.

METHODS: We conducted semi-structured qualitative interviews with 32 people, 14 of whom had ongoing depot injection treatment, 11 who had discontinued depot-injections and switched to other medication and seven who had declined treatment with depot formulations. Interviews were transcribed, coded, and analysed using NVivo, based on this overall stratification into three participant groups.

RESULTS: The main categories relate to the effects and side effects of the depot formulation, social and practical factors, psychological benefits and disadvantages, and interactions with treatment staff. Social and practical factors were of importance for choosing depot formulations, such as increased freedom and their making it easier to combine treatment with work and family life, as well as psychological advantages including "feeling normal". Initial withdrawal symptoms that resolved themselves after a number of injections were reported by most participants. Reliable information and patient-staff relationships characterized by trust helped patients to cope with these initial problems. Those who discontinued treatment often did so near the beginning of the treatment, reporting withdrawal symptoms and insufficient effects as the main reasons. Coercion and insufficient information contributed to a negative pharmaceutical atmosphere at one of the clinics, which may have adversely influenced perceptions of depot formulations and decreased willingness to accept and continue treatment.

CONCLUSIONS: Buprenorphine depot injections may have social, practical, and psychological benefits compared to other formulations. However, depot injections are not perceived as an attractive option by all patients. Trust, consistent and adequate information, and awareness of the implications of the pharmaceutical atmosphere should be considered when introducing new medications.

Place, publisher, year, edition, pages
BioMed Central, 2022
Keywords
Depot injections, Opioid addiction, Pharmaceutical atmosphere, Qualitative interviews, Treatment
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-52205 (URN)10.1186/s13011-022-00474-2 (DOI)000800128300001 ()35614466 (PubMedID)2-s2.0-85130699243 (Scopus ID)
Available from: 2022-06-08 Created: 2022-06-08 Last updated: 2024-02-05Bibliographically approved
Johnson, B., Richert, T. & Svensson, B. (2022). Physical Violence and Property Damage towards Parents, Committed by Adult Children with Drug Problems. Journal of family Violence, 37, 165-180
Open this publication in new window or tab >>Physical Violence and Property Damage towards Parents, Committed by Adult Children with Drug Problems
2022 (English)In: Journal of family Violence, ISSN 0885-7482, E-ISSN 1573-2851, Vol. 37, p. 165-180Article in journal (Refereed) Published
Abstract [en]

Drug use has previously been identified as a risk factor for child-to-parent abuse. We examine how common it is for parents to be exposed to physical violence and property damage by adult children with drug problems, and whether such victimization varies based on factors related to the parents and the adult children, respectively. A self-report questionnaire on victimization was completed by 687 parents of adult children with drug problems. The data were collected via a postal questionnaire to members of the Parents Against Drugs association and a web-based questionnaire to persons recruited via social media, treatment centers and other associations for families of drug users. The proportion of parents who reported having been exposed to physical violence was 19% ever, 6% during the past year. The proportion who had been exposed to property damage was 40% ever, 10% during the past year. Exposure during the past year was higher among parents whose children were currently experiencing drug problems. Mental health problems in the children were associated with higher levels of parental victimization, particularly in the form of physical violence. Parental victimization was also associated with the children being younger and still living at home. Exposure to property damage was higher among parents of male children. Adult children's drug problems are of significance for parental victimization; they do not however appear to constitute a major risk factor but rather one risk factor among several others. Exposure to physical violence is clearly related to the presence of mental health problems in the children.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Parent abuse, Physical violence, Property damage, Adult children, Drug problems
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-17909 (URN)10.1007/s10896-020-00181-1 (DOI)000546218800001 ()2-s2.0-85087641307 (Scopus ID)
Available from: 2020-08-13 Created: 2020-08-13 Last updated: 2024-02-05Bibliographically approved
Liahaugen Flensburg, O., Johnson, B., Nordgren, J., Richert, T. & Svensson, B. (2022). "Something wasn't right"-parents of children with drug problems looking back at how the troubles first began. Drugs: education prevention and policy, 29(3), 255-264
Open this publication in new window or tab >>"Something wasn't right"-parents of children with drug problems looking back at how the troubles first began
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2022 (English)In: Drugs: education prevention and policy, ISSN 0968-7637, E-ISSN 1465-3370, Vol. 29, no 3, p. 255-264Article in journal (Refereed) Published
Abstract [en]

In this study we analyze how parents of adult children with drug use problems view the initial stages of identifying their children's troubles as a severe drug problem. We focus on the parents' accounts of the discovery process by identifying significant events in the parents' narratives through 'the micro-politics of trouble'. The study is based on an analysis of 32 semi-structured interviews with parents of adult children (aged 18+) with drug problems. Four themes emerged from the parents' narratives: (1) the first signs of a problem, (2) drug problem or teenage defiance? (3) the awakening, (4) a passing phase. The different themes show how the parents' interpretations of the situation influence their definitions and thus their actions. Early signs and indicators of something being wrong do not initially result in parents framing the situation as problematic as they are perceived as everyday concerns and dealt with as such. Our focus on the initial phase of the problem definition process and how this affects the parents may provide a better understanding of the parents' situation and needs for support. This may be of use to professionals in the fields of social work and drug treatment who meet these parents and may have a role to play in the development of support measures that can improve their situation.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Discovery process, drug problems, parents, symbolic interactionism, trouble, qualitative interviews
National Category
Social Work
Identifiers
urn:nbn:se:mau:diva-41537 (URN)10.1080/09687637.2021.1897525 (DOI)000629044700001 ()2-s2.0-85102719486 (Scopus ID)
Available from: 2021-04-01 Created: 2021-04-01 Last updated: 2024-02-05Bibliographically approved
Projects
The Öckerö Method: An Experimental Evaluation; Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA); Publications
Svensson, R., Johnson, B. & Olsson, A. (2022). Does gender matter? The association between different digital media activities and adolescent well-being. BMC Public Health, 22, 1-10, Article ID 273.
Föräldrar till vuxna barn med narkotikaproblem; Malmö University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1601-2706

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