Background and Aims A crucial, but under‐appreciated, aspect in experimental research on psychosocial treatments of substance use disorders concerns what kinds of control groups are used. This paper examines how the distinction between different control‐group designs have been handled by the Cochrane and the Campbell Collaborations in their systematic reviews of psychosocial treatments of substance abuse disorders. Methods We assessed Cochrane and Campbell reviews ( n = 8) that were devoted to psychosocial treatments of substance use disorders. We noted what control groups were considered and analysed the extent to which the reviews provided a rationale for chosen comparison conditions. We also analysed whether type of control group in the primary studies influenced how the reviews framed the effects discussed and whether this was related to conclusions drawn. Results The reviews covered studies involving widely different control conditions. Overall, little attention was paid to the use of different control groups (e.g. head‐to‐head comparisons versus untreated controls) and what this implies when interpreting effect sizes. Seven of eight reviews did not provide a rationale for the choice of comparison conditions. Conclusions Cochrane and Campbell reviews of the efficacy of psychosocial interventions with substance use disorders seem to underappreciate that the use of different control‐group types yields different effect estimates. Most reviews have not distinguished between different control‐group designs and therefore have provided a confused picture regarding absolute and relative treatment efficacy. A systematic approach to treating different control‐group designs in research reviews is necessary for meaningful estimates of treatment efficacy.

This article explores and analyses, with the help of both client and social worker data on 423 applications for social assistance in Sweden, (i) the extent to which social assistance benefits and labour market strengthening measures are granted and (ii) factors concerning clients as well as social workers that are associated with the granting of benefits. Considering (i), the results show that social assistance is granted in about 74% of cases while only 6% of applicants are granted additional labour market strengthening measures. With regard to (ii), the results indicate that the granting of benefits seems to depend on a broad spectrum of factors at both the client and the social worker levels. For example, more experienced social workers are less willing to grant social assistance while chances increase when an applicant is already registered at the local public employment service and/or social insurance office. Moreover, the granting of benefits also co-varies with more or less invariable factors at the client level: social workers are in general more generous towards women and people born outside Sweden, but rather less generous vis-à-vis single parents. The findings are discussed in terms of workfare and professionalization among social workers.

A key question in drugs research is why people use psychoactive substances. Diverse motives such as boredom, habit, and pain relief have served as explanations, but little is known about how adult cannabis users motivate their use in prohibitionist policy contexts, like Sweden. The aim is to explore what motives a sample of adult Swedish cannabis users refer to when they give meaning to their use. We ask: what aspects of cannabis use (e.g. drug effects, individual characteristics and social contexts) are emphasized in their accounts, and how are such aspects combined to describe motives and justify use? In this study, motives are perceived as culturally situated action, and our analysis is based on online text messages (n = 238) and interviews (n = 12). Participants emphasized either the characteristics of the use situation (motives such as party, relaxation and social function) or of him-/herself as an individual (motives such as mindfulness, identity marker and somatic function). They often mentioned medical and recreational motives in the same account, and carefully presented themselves as rational individuals. The motives reflect that the drugs discourse is increasingly medicalized, that responsibility is highly esteemed in contemporary societies, and that cannabis use is still stigmatized in Sweden.

Alcohol consumption is a major contributor to the disease burden among adolescents. The adolescent alcohol abstainer is still often depicted as problematic in the research literature and in prominent theoretical frameworks. However, over the past two decades, there has been a marked trend of declining youth drinking in Sweden. The declining trend has led to a shift in the majority behaviour of youth, from drinking to non-drinking. It is plausible that this trend has also shifted the position of non-drinkers. This paper examines the position of non-drinkers in a nationally representative sample of Swedish adolescents. A survey was carried out in 2017 in 500 randomly selected schools. A total of 5549 respondents (15–16-year-olds) agreed to participate and answered the questionnaire. A minority (42.8%) had consumed alcohol during their lifetime. The results show that non-drinkers had better health and school performance when compared to drinkers. The results also showed that there were no differences in the social position between non-drinkers and drinkers. These findings are new and indicate a changed position of non-drinkers among Swedish adolescents. With non-drinking being the majority behaviour among Swedish adolescents this seems to have shifted the position of non-drinkers. There is a need for research on the long-term importance of not drinking during adolescence.

The Strength and Difficulties Questionnaire (SDQ) is one of the most common screening instruments for emotional and behavioral problems in children and adolescents. Although exploratory factor analyses support the originally proposed 5-factor structure of SDQ as well as a 3-factor model, the evidence from confirmatory factor analyses is more mixed. Some of the difficulties items in SDQ are positively worded and it has been proposed that this leads to method effects, i.e. these items share variance that is due to the method used rather than to a substantive construct. Also, there seems to be minor factors in some subscales. This study tests a series of 3- and 5- factor models pertaining to the factor structure of SDQ, also considering method effects and minor factors. The sample consists of a nationally representative cohort of Swedish adolescents born in 2001 (n = 5549). Results show a relatively better fit of the 5-factor model compared with the 3-factor model although neither of these had a satisfactory fit. Model fit was improved when specifying cross-loadings of the positively worded difficulties items on the prosocial scale as well as minor factors on the hyperactivity scale. Although no model provided a completely satisfactory fit to the data, the results show that the 5-factor model performs better than the 3-factor model and has an acceptable fit. We conclude that for the purposes of epidemiological research, SDQ has acceptable factorial validity, provided that researchers consider method effects and minor factors.

There is a lack of research on how youth make sense of substance abuse treatment. The aim of this article was to explore how young people in Stockholm, Sweden, perceive outpatient treatment for cannabis use, position themselves as subjects in relation to it, and how they respond to staff’s appeals to rationality and responsible action. The data, consisting of 18 interviews with clients recruited from six treatment centers, were explored using narrative and thematic analysis. Results show that the young clients understood their histories in a responsibilized way where the risk information about cannabis they received was considered crucial. Those who resisted treatment rejected cannabis problematizations by staff, did not value interventions and felt that they had control over their use. Those who complied with treatment said that cannabis problematizations helped them acknowledge their own difficulties, handle substance dependence and mature. We conclude that treatment resistance among young cannabis users would perhaps be prevented if the adult world acknowledged that some believe it is rational and responsible to use cannabis. While the criminal offense of substance use is often expiated through ‘treatment’ in Sweden, young clients establishing a substance use identity could possibly be avoided if cannabis was not equated with risk.