Storbjörk S. On the significance of social control: treatment-entry pressures, self-choice and alcohol and drug dependence criteria one year after treatment
Int J Soc Welfare 2011: ••: ••–••© 2011 The Author(s), International Journal of Social Welfare © 2011 Blackwell Publishing Ltd and the International Journal of Social Welfare.
This article explores how self-choice and treatment-entry pressures are associated with one-year treatment outcome (dependence symptoms, 0–6, 12 months) among alcohol and drug misusers, respectively. Informal pressures (from family and friends), formal pressures (related to work, healthcare, social services, social allowances, child custody) and legal pressures (related to the police, criminal justice system, compulsory treatment) were analysed. A sample (N= 1,210) representative of the addiction treatment system of Stockholm County was interviewed when starting a new treatment episode and after one year. Regression analyses indicated that self-choice and pressures are associated with outcome among alcohol misusers but not among drug misusers when controlling for background factors and severity. Self-choice (without pressures) correlated with a good outcome (a lower number of dependence criteria). Pressures were generally associated with poorer outcome. Alcohol misusers who had experienced threats regarding child custody did better in comparison with those not experiencing such pressure. The difference in results by drug type and implications were discussed.