Nyhet
Young people use drugs as medicine for mental ill‑health
Fewer young people drink alcohol or use drugs, but a smaller group are high‑frequency users. The reasons why young people use substances are relatively unknown compared with what is known about adults’ use. But individual studies indicate that co‑occurring problems are common.
Illustration: Victoria Hugosson
Young people generally drink less alcohol than before. Among ninth‑grade students, around 40 percent have tried alcohol, compared with 50 percent in 2005 and as many as 90 percent in the 1970s. Fewer have also tried drugs, but cannabis use among young people has increased somewhat in recent years. The increase is seen mainly among those who already use cannabis, and who now use it more frequently.
Research often makes a population‑level connection between increased cannabis use and mental ill‑health, but it is difficult to determine what is cause and what is effect. Some young people use cannabis or other substances as a form of self‑medication for psychological distress, which can worsen their condition.
Maria Ungdom provides support
Maria Ungdom is Sweden’s largest specialised care provider and has supported young people aged 13 to 25 who use substances since 1966. In Stockholm County alone, there are 27 Mariamottagningar, of which 21 are local centres known as Minimarior, all part of Region Stockholm’s addiction services. Similar support is available in the rest of the country.
The Minimarior bring together different competencies from both the region and municipal social services. The most common forms of support are cognitive behavioural therapy (CBT) and motivational interviewing, adapted to the needs and circumstances of each individual.
Today we know relatively little in general, about young people in treatment for substance use problems, compared with what we know about adults.
Patrik Karlsson
Professor of Social Work at Stockholm University. Photo: Lotta Segelberg
The clinics in Stockholm, Malmö and Gothenburg conduct annual surveys that show the gender distribution, age, primary substance used, and the presence of other problems among visitors. Even so, knowledge about problematic substance use among young people remains limited, says Patrik Karlsson, professor of social work at Stockholm University.
– Today we know relatively little in general about young people in treatment for substance use problems compared with what we know about adults. We know that most of those who come to the clinics are boys, that the average age is 17, and that many have co‑occurring problems, particularly the girls. These may involve mental health issues or criminality. There are indications that co‑occurring problems have increased; in recent years, a larger proportion report that they are receiving simultaneous psychiatric care.
A case study
Patrik and a group of other researchers from Stockholm University and Karolinska Institutet are analysing how young substance users are handled in the Swedish care system, based on a case study of Maria Ungdom. They are seeking answers about which individuals receive which types of treatment, how needs are assessed, and how care is delivered in practice. The study is based on medical record reviews, registry data from the period 2011 to 2021, and interviews with young people and staff.
But the picture that emerges of which young people use substances and why can be misleading if one relies solely on the clinics’ records. Unlike adults, who usually seek help voluntarily, some of Maria Ungdom’s young visitors feel forced to attend by social services, school, or guardians. This leads to more young people from disadvantaged areas being directed to Maria Ungdom, while substance use in more affluent areas often remains largely hidden.
– It is a heterogeneous group that comes to the Mariamottagningar, much like in any other healthcare setting. It ranges from those who have tried cannabis once or twice and only make a few visits, to those who continuously use other drugs and have very severe problems. The issue is that society does not always become aware when young people from well‑resourced backgrounds use, for example, cannabis, Patrik explains.
One hypothesis we have is that girls with norm‑breaking behaviour, to a greater extent than boys with similar difficulties, deviate from what is considered “typical” among their peers.
Philip Lindner
Associate Professor of Clinical Psychology at Karolinska Institutet and Head of R&D at Maria Ungdom. Photo: Ahang Bashi
Girls should be identified earlier
Philip Lindner is a co‑researcher in the project and Head of R&D at Maria Ungdom. He explains that it is more common for girls to come into contact with Maria Ungdom at younger ages than boys.
– One hypothesis we have is that girls with norm‑breaking behaviour deviate more from what is considered “typical” among their peers compared with boys who have similar difficulties, and therefore they are noticed earlier.
Patrik sees major advantages in the combined expertise at Maria Ungdom. Young people who use drugs for medical reasons, for example to manage anxiety or other psychological distress, can receive more coordinated and effective support.
– It can reduce the risk that patients are “passed around” between different services and is particularly important for young people with complex needs. One of the biggest challenges is managing young people with both substance use problems and severe mental health issues. They may sometimes feel they must provide negative urine samples to gain access to other psychiatric care, which can become a barrier to receiving the help they need, says Patrik.
The young people’s own experiences vary greatly. Most find the care helpful and motivating, while others experience it as intrusive and stigmatising. This is particularly true for those who are required to provide urine samples.
– One thing to reflect on is what it does to people when they are labelled as having used drugs and the negative consequences that can follow, when their problems may in fact stem from something else, Patrik says.
Care should be tailored to the individual
Do you have any advice for decision‑makers?
– One should not focus solely on zero tolerance for substance use; it is not always the biggest problem. There are often underlying issues that drive the use. There has been a strong focus on preventive work for the general population of young people. But that risks missing the group about whom we have limited knowledge. I hope our results will lead to a better understanding of the heterogeneity among young people with substance use problems, and that care can be better adapted to each individual’s needs, says Patrik.
The next step for the project is to gain a broader picture of how substance use and criminality are connected, using registry data from the Swedish National Council for Crime Prevention and clinical data from healthcare services.
Drug use among young people
Surveys have been conducted every year since 2007. The results vary between years, and the proportion of boys reporting drug use is usually slightly higher than the proportion of girls.
Grade 9 students: In 2024, six percent of girls and five percent of boys reported having used drugs at some point.
Upper‑secondary year 2 students: In 2024, 14 percent of girls and 16 percent of boys reported having used drugs at some point.
Source: The Public Health Agency of Sweden
Lotta Segelberg
