Abstract: In the study “Women and Men in Swedish alcohol and Drug Treatment,” it is possible to compare alcohol consumption and problems among respondents in the general population with those in clients entering alcohol treatment. The differences between these groups have led researchers to talk about the “two worlds” of alcohol problems-in general and in clinical populations. The aim of this article is to study the relative strength of factors in predicting entering and the clinical population. The studied factors are demographics and marginalization; volume and frequency of drinking; alcohol dependence; social response to drinking (suggestions to cut down or seek treatment by informal actors, e.g. family and friends, and formal actors such as employer, the social services or judicial system); and treatment history. The client sample includes 1202 clients (71% men) interviewed face-to-face when entering inpatient and outpatient treatment facilities in Stockholm. In the general population survey, 3557 persons aged 18-75 years were interviewed. The two samples differ significantly. As expected, clients were older, more marginalized and reported more severe alcohol problems, and many reported previous treatment experiences and social responses. Logistic regression analyses show that previous treatment, unemployment/institutionalization and having an unstable living situation are the strongest predictors of who is in treatment, followed by age, alcohol dependence and frequency of drinking. Formal pressures to cut down or seek treatment are also important and males are more likely to be in treatment. The results support a notion of the treatment system as a place for handling marginalized people, beyond and beside their extent of drinking.

Abstract: The aim of this article is to identify which aspects of drug treatment are most closely associated with recovering drug users’ ability to obtain paid employment. Based on a cohort study of 1033 individuals, this article reports on a logistic regression analysis of the factors associated with the achievement of paid employment 33 months after the initiation of treatment for drug dependency. While the results show a close relationship between the cessation of illegal drug use and individuals’ ability to obtain paid employment, they also show that abstaining from drug use is unlikely to be successful on its own. The factor that showed the strongest independent association with the achievement of paid employment was the receipt of employment-related assistance. The study’s findings are, therefore, strongly supportive of the provision of employment support programmes as the most important mechanism for helping recovering drug users to obtain employment.

Abstract: In this article, it is suggested that an important cultural image of intoxication in some Western societies appears to be ’intoxication as ecstasy’, intoxication as escape from the everyday into a ’wild’ and ’natural’ state. The purpose of this article is to discuss this cultural image and its link to gendered ideas about sexuality and, on the basis of this discussion, to develop a hypothesis for further testing. The hypothesis developed proposes that women – via the cultural linking of their sexuality to biological processes of reproduction – are placed closer to nature than men. This makes women’s drinking and intoxication seem more dangerous than men’s, because drinking and intoxication would seem to make women come even closer to nature. It is suggested that women’s ’dual licentiousness’ threatens the distinction between nature and culture.

Abstract: Background: Young people in European countries are experiencing high levels of alcohol and drug use and escalating levels of sexually transmitted infections. Individually these represent major public health priorities. Understanding of the association between sex and substance use, and specifically the strategic roles for which young people utilise substances to facilitate sexual activity, remains limited. Methods: Respondent driven sampling methodology was used in nine European cities to survey 1,341 16-35 year olds representing youth and younger adults who routinely engage in nightlife. Participants self-completed questionnaires, designed to gather demographic, social, and behavioural data on historic and current substance use and sexual behaviour. Results: Respondents reported strategic use of specific substances for different sexual purposes. Substances differed significantly in the purposes for which each was deployed (e.g. 28.6% of alcohol users use it to facilitate sexual encounters; 26.2% of cocaine users use it to prolong sex) with user demographics also relating to levels of sexual use (e.g. higher levels of: ecstasy use by males to prolong sex; cocaine use by single individuals to enhance sensation and arousal). Associations between substance use and sex started at a young age, with alcohol, cannabis, cocaine or ecstasy use before age 16 all being associated with having had sex before the age of 16 (odds ratios, 3.47, 4.19, 5.73, 9.35 respectively). However, sexes differed and substance use under 16 years was associated with a proportionately greater increase in early sex amongst girls. Respondents’ current drug use was associated with having multiple sexual partners. Thus, for instance, regular cocaine users (c.f. never users) were over five times more likely to have had five or more sexual partners in the last 12 months or have paid for sex. Conclusion: An epidemic of recreational drug use and binge drinking exposes millions of young Europeans to routine consumption of substances which alter their sexual decisions and increase their chances of unsafe and regretted sex. For many, substance use has become an integral part of their strategic approach to sex, locking them into continued use. Tackling substances with both physiological and psychological links to sex requires approaching substance use and sexual behaviour in the same way that individuals experience them; as part of the same social process.