Police officers' perspective on doping and prevention among recreational athletes: a cross-sectional study.

Introduction: The use of anabolic androgenic steroids among recreational athletes has received growing attention in recent decades. Several countries have implemented bans on doping; however, recreational athletes and other subpopulations continue to use doping substances. Recognizing that the police play a crucial role in preventing the use and dealing of doping substances in Sweden, efforts have been made to intensify police interventions and enhance collaboration with other key actors. This study examined police officers' perceptions of doping as defined in Swedish law, related problems, and suggestions for effective prevention of doping in the society. Methods: A cross-sectional survey study was conducted using a web survey of police officers (N = 597). Data were analyzed using descriptive statistics and free-form text responses were analyzed using content analysis. Results: Participant responses to the survey (73.7% response rate) indicated that approximately 62.6% thought that doping is a societal problem, and approximately 26% perceived that the availability of doping substances has increased over the past three years. A total of 95.6% of respondents believed that doping occurred in connection with other crimes such as intimate partner violence (88.2%) and drug-related crimes (88.0%). Further, 96.3% of respondents perceived that it was their duty to prevent doping, but 63.8% indicated that doping-related work was not prioritized within their local police district. Discussion: Police officers perceived doping as a societal problem and expressed motivation to counteract it, highlighting increased knowledge, legislative changes, intensified doping prevention in gyms, and commitment from other societal actors to increase the effectiveness of doping prevention. Suggestions for increasing the efficiency of doping prevention included education and increased knowledge at all levels in the police organization, intensified prevention efforts at gyms, legislative changes to permit simplified doping test procedures, and breach of secrecy for postal items. There was also a suggestion for further engagement from other actors, such as healthcare workers, school officials, and non-governmental organizations.

Facilitators and barriers in preventing doping among recreational athletes: A qualitative interview study among police officers.

Background: Doping is a societal problem associated with health problems, violence, and other crimes, especially when combined with alcohol and drugs. Elite, as well as recreational athletes who exercise in gyms may use doping to enhance their performance and/or improve their appearance. According to Swedish law, manufacturing, selling, supplying, possessing, and using anabolic androgenic steroids and growth hormones is forbidden. Exceptions apply if these substances are used for medical purposes and prescribed by doctors. As doping is illegal, the police authority is vital in counteracting doping. Aim: We aimed to identify facilitators and barriers to effective doping prevention at gyms by examining police officers' views on doping as a societal problem, their experiences of doping prevention efforts, and their perceptions on what enables or hinders doping prevention. Methods: Interviews with police officers (n = 15) were conducted from December 2021 to May 2022. The interviews were recorded and transcribed verbatim. A targeted content analysis of the material was performed. Results: Facilitators for effective doping prevention involving the police included the recognition of doping as a societal problem; mobilization of key actors; motivated police management and officers; adequate resource allocation; collaboration between the police, gyms, and other relevant authorities; and skills development for police and other professions. Barriers to effective doping prevention included a lack of knowledge about doping, time-consuming processes around the detection and collection of evidence in doping offenses, and competing tasks for police officers. Conclusion: Doping prevention should become more efficient by taking advantage of existing facilitators and removing remaining barriers. This study could guide recommendations linked to the police organization and the surrounding society regarding doping prevention.

Attitudes to Cannabis Use and Public Prevention Information Among Young Adults: A Qualitative Interview Study With Implications for Prevention Practice.

Background: Cannabis use carries an increased risk of ill health and social problems, especially when initiated at a young age. Drug use is influenced by individual beliefs, knowledge, and attitudes, which are, in turn, governed by social and environmental factors. In recent years, a less restrictive attitude toward cannabis has been observed in many countries, with concerns about increased cannabis use among young people. The aim of the current study was to gain a deeper understanding of young adults' attitudes toward cannabis use and public prevention information about cannabis. Methods: A qualitative interview study was conducted among 32 anonymous informants aged 18-29 years in the Stockholm region. Participants were recruited through purposeful sampling, and semi-structured in-depth interviews were conducted using a digital video calling platform. A qualitative content analysis of the interviews was performed to generate categories and codes for cannabis use and attitudes toward prevention information. Results: Both cannabis users and abstainers perceived some risks with cannabis; however, for many users, the positive effects appeared to outweigh any expected harm. Furthermore, the existing public information was perceived as less credible because of an excessive focus on harm. The informants expressed a desire for neutral facts about the effects of cannabis, delivered by credible senders. Moreover, they felt that prevention information should be delivered by individuals whom young people look up to or with whom they can identify, for example, people with authority or famous people such as influencers. The informants also underlined the importance of dialogue with the target group and taking young people's experiences into account when providing information about cannabis. Conclusion: Current risk awareness associated with cannabis use among young adults is insufficient to prevent them from using cannabis. Public prevention information should preferably combine a fact-based focus on risks with recognition of cannabis' short-term desired effects, delivered by credible senders with authority or those with whom young people can identify.

Mental health problems, health risk behaviors, and prevention: A qualitative interview study on perceptions and attitudes among elite male soccer players.

Background: The purpose of this study was to investigate the perception of mental health problems and health risk behaviors among Swedish male elite soccer players and their attitudes toward possible prevention strategies. Method: Twenty elite soccer players, aged 15-30 years, were recruited through purposive sampling and interviewed via a digital video calling platform. A semi-structured interview guide, encompassing questions about mental health problems, health risk behaviors among soccer teams, peer-relations, relations to coaches, and attitudes toward health risk behaviors, along with proposals for effective interventions, was employed. The interviews were transcribed verbatim and analyzed with qualitative content analysis. Results: The informants reported positive feelings in relation to playing soccer, good health, and few health risk behaviors. Risk factors included a large income, excessive free time, and the need for excitement. Stress and mental health problems were linked to performance pressure, social media, and injuries. Hesitation to talk openly about personal problems due to concerns about negative consequences and the "macho culture" was highlighted as barriers to admit and seek help for personal problems. Some statements indicated openness and the club's efforts to destigmatize personal problems. Positive attitudes toward prevention and suggestions for various measures were prominent. Conclusion: Future research and implementation of interventions should focus on the prevention of health risk behaviors and alleviation of stress and performance pressure, as well as continue the efforts to destigmatize mental health problems and raise awareness among coaches of the importance of their communication and behavior for players' mental health and performance. This could be achieved by developing strategic and systematic policy work, information, and dialogue among players and coaches, in addition to individual digital or face-to-face support, provided by professionals outside the soccer context.

Illicit Drug Use and Associated Problems in the Nightlife Scene: A Potential Setting for Prevention.

Illicit drug use is prevalent in the nightlife scene, especially at electronic dance music (EDM) events. The aim of the present study was to investigate illicit drug use patterns and consequences of drug use among frequent visitors of EDM events. Young adults (18-34 years old) who had visited at least six EDM events in Sweden during the past year participated in a web-based survey on drug use patterns and its consequences. Fifty-nine percent of participants had used illicit drugs during the past year, most often cannabis followed by ecstasy, cocaine, and amphetamine. Nightlife venues were identified as the main setting for the use of central stimulants, while cannabis was mostly used at home. Frequent alcohol and tobacco use was associated with illicit drug use. The most prevalent negative consequences of drug use were related to mental health, such as impairments in mood, sleep, and memory problems, but physical manifestations were also reported, such as palpitations and collapsing. These findings confirm that drug use is prevalent and associated with negative health effects among EDM nightlife attendees. The nightlife scene is a setting with promising potential to reach a high-risk target group with illicit drug use prevention interventions.

Drug dealing and drug use prevention - a qualitative interview study of authorities' perspectives on two open drug scenes in Stockholm.

BACKGROUND: The use of illicit substances causes various health and social problems globally. Moreover, open drug use and dealing in urban areas, i.e., open drug scenes, can cause public order problems, lead to the recruitment of marginalized and young people for drug use or sale, and induce feelings of insecurity in the general public. Although some international studies have described various ways to manage open drug scenes, such as law enforcement and social interventions, there is limited knowledge about the facilitators and barriers promoting or impeding the implementation of such interventions. The aim of the current study was to explore how different authorities describe the nature of two open drug scenes in Stockholm and to derive authorities' perspective on facilitators and barriers to implementing interventions to reduce open drug dealing, drug use, and related problems at these locations. METHODS: Semi-structured interviews with police officers, security staff, social workers, and municipality officials (n = 21) in the municipality of Stockholm were conducted and analyzed by qualitative content analysis. RESULTS: The analysis of the interviews generated the following categories: Problems, Interventions, Organizational factors, and External factors, revealing information about the strategic and daily counteracting work occurring at the open drug scenes as well as authorities' perceptions of facilitators and barriers to implementing interventions to reduce open drug dealing, drug use, and related problems. Facilitators included motivated and skilled professionals and organized collaboration between key actors. Prominent barriers were a lack of resources to maintain personnel continuity at the scenes, policies that impede information sharing and put security staff in danger, and people who use or sell drugs without having residence permits. CONCLUSIONS: To increase the possibility of successful implementation of interventions to counteract open drug dealing, politicians and authorities should pay attention to collaboration between key actors, sufficient resource allocation, possible modification of policy governing professional duties, and remedies to the vulnerability of individuals without residence permits.

Illicit Drugs in the Nightlife Setting: Changes in Employee Perceptions and Drug Use over a Fifteen-Year Period.

BACKGROUND: Illicit drug use is common in nightlife settings and associated with various public health-related problems, making this an important arena for prevention. Purpose/objectives: To assess perceived prevalence of illicit drug use in the Stockholm nightlife setting, use of and attitudes toward illicit drugs among employees at licensed premises. Also, to make comparisons with two identical measurements from 2001 and 2007/08, and to explore potential differences related to own drug use, type of licensed premise, age or gender. Methods: Cross-sectional surveys were conducted at three time-points: 2001, 2007/08, and 2016/17, comprising employees at licensed premises in Stockholm participating in STAD's Responsible Beverage Service training program. A total of 665 persons (mean age 28 years, 53% women) were included in the 2016/2017 measurement. Results: A majority of the respondents reported having observed patrons intoxicated by illicit drugs in the last six months, and agreed that patrons intoxicated by illicit drugs should be asked to leave licensed premises. The belief that one had observed patrons intoxicated by illicit drugs was more common among respondents who had themselves been using illicit drugs during the last year, and also among employees at nightclubs. Furthermore, comparisons with previous time-points showed a significant increase in the proportion of employees using illicit drugs. Almost half of the respondents in the youngest age group (18-24 years) reported illicit drug use during the last year. Conclusions/importance: Observation and use of illicit drugs are common among employees in the Stockholm nightlife setting and has increased significantly during the past decade.

Effects of an automated digital brief prevention intervention targeting adolescents and young adults with risky alcohol and other substance use: study protocol for a randomised controlled trial.

INTRODUCTION: Adolescence and young adulthood is a period in life when individuals may be especially vulnerable to harmful substance use. Several critical developmental processes are occurring in the brain, and substance use poses both short-term and long-term risks with regard to mental health and social development. From a public health perspective, it is important to prevent or delay substance use to reduce individual risk and societal costs. Given the scarcity of effective interventions targeting substance use among adolescents and young adults, cost-effective and easily disseminated interventions are warranted. The current study will test the effectiveness of a fully automated digital brief intervention aimed at reducing alcohol and other substance use in adolescents and young adults aged 15 to 25 years. METHODS AND ANALYSIS: A two-arm, double-blind, randomised controlled trial design is applied to assess the effectiveness of the intervention. Baseline assessment, as well as 3-month and 6-month follow-up, will be carried out. The aim is to include 800 participants with risky substance use based on the screening tool CRAFFT (Car,Relax, Alone, Forget, Friends, Trouble). Recruitment, informed consent, randomisation, intervention and follow-up will be implemented online. The primary outcome is reduction in alcohol use, measured by Alcohol Use Disorders Identification Test total score. Secondary outcomes concern binge drinking, frequency of alcohol consumption, amount of alcohol consumed a typical day when alcohol is consumed, average daily drinks per typical week, other substance use, mental health, sexual risk behaviours and perceived peer pressure. Moreover, the study involves analyses of potential moderators including perfectionism, openness to parents, help-seeking and background variables. ETHICS AND DISSEMINATION: The study was approved by the Swedish Ethical Review Authority (no. 2019-03249). The trial is expected to expand the knowledge on digital preventive interventions for substance using adolescents and young adults. Results will be disseminated in research journals, at conferences and via the media. TRIAL REGISTRATION NUMBER: 24 September 2019, ISRCTN91048246; Pre-results.

Alcohol policies and attitudes toward alcohol prevention at Swedish student unions.

AIMS: High alcohol consumption among young adults is of great concern. About half of all young adults in Sweden are university students, and high alcohol consumption is common in this group. This makes student unions a potential arena for alcohol prevention. Little is known about attitudes toward alcohol prevention and to what extent Swedish student unions have written alcohol policies. The aim of the present study was to investigate whether student union representatives consider alcohol to be a problem, their attitudes toward alcohol prevention, the presence of written alcohol policies at student unions, and factors possibly associated with the existence of such policies. METHODS: During November 2014, student union representatives (n = 95) were invited to participate in a web-based questionnaire; data were obtained from 78 unions. RESULTS: The majority (93%) reported positive attitudes toward alcohol prevention, and many also recognised that alcohol consumption could be a problem (47%). Furthermore, 81% reported having an alcohol policy at their student union. Unions that frequently arranged pubs were more likely to have a policy (OR = 1.9). CONCLUSIONS: Many participants recognised that alcohol consumption could be a problem and reported positive attitudes toward alcohol prevention in the student union setting. This, together with the fact that the majority of student unions had written alcohol policies, suggests that the student union setting is a promising arena for alcohol prevention.

A web-based group course intervention for 15-25-year-olds whose parents have substance use problems or mental illness: study protocol for a randomized controlled trial.

BACKGROUND: Depending on the definitions used, between 5 and 20 % of all Swedish children grow up with at least one parent suffering from alcohol problems, while 6 % have at least one parent who has received inpatient psychiatric care, conditions that may affect the children negatively. Nine out of ten Swedish municipalities therefore provide support resources, but less than 2 % of these children are reached by such support. Delivering intervention programs via the Internet is a promising strategy. However, web-based programs targeting this at-risk group of children are scarce. We have previously developed a 1.5-h-long web-based self-help program, Alcohol & Coping, which appears to be effective with regards to adolescents' own alcohol consumption. However, there is a need for a more intense program, and therefore we adapted Kopstoring, a comprehensive Dutch web-based psycho-educative prevention program, to fit the Swedish context. The purpose of the program, which in Swedish has been called Grubbel, is to strengthen protective factors, such as coping skills and psychological well-being, prevent the development of psychological disorders, and reduce alcohol consumption. METHODS/DESIGN: The aim of the current study is to evaluate the effectiveness of Grubbel, which targets 15-25-year-olds whose parents have substance use problems and/or mental illness. Specific research questions relate to the participants' own coping strategies, mental health status and substance use. The study was initiated in the spring of 2016 and uses a two-armed RCT design. Participants will be recruited via social media and also through existing agencies that provide support to this target group. The assessment will consist of a baseline measurement (t0) and three follow-ups after six (t1), 12 (t2), and 24 months (t3). Measures include YSR, CES-DC, Ladder of Life, Brief COPE, AUDIT-C, and WHOQOL-BREF. DISCUSSION: Studies have revealed that the majority of children whose parents have substance use or mental health problems are not reached by the existing support. Thus, there is an urgent need to develop, implement, and evaluate novel intervention programs and disseminate successful programs to a broader audience. This study, investigating the effects of a web-based intervention, therefore makes an important contribution to this field of research. TRIAL REGISTRATION: ISRCTN10099247 . Retrospectively registered on August 31, 2016.

Gender differences in the prediction of parental servings of alcohol to adolescents and youth drunkenness.

This longitudinal study, funded by the Swedish National Institute of Public Health, explored gender differences in predictors of parental servings of alcohol to youth and youth drunkenness. Data were collected from 1,752 Swedish 7th-grade youth and their parents, at three occasions between 2007 and 2010. Measurements included youth alcohol use, parental warmth, and parental control. Two-level logistic regressions showed that 15-year-old girls are more likely to be served alcohol at home compared to boys, and that there are some gender differences in predictors of drunkenness. Limitations and implications of the findings are discussed and areas for future research identified.

The Örebro prevention programme revisited: a cluster-randomized effectiveness trial of programme effects on youth drinking.

AIMS: This study aimed to assess the effectiveness of the Örebro prevention programme (ÖPP), an alcohol misuse prevention programme that aims to reduce youth drinking by changing parental behaviour. DESIGN: Cluster-randomized trial, with schools assigned randomly to the ÖPP or no intervention. SETTING: Forty municipal schools in 13 counties in Sweden. PARTICIPANTS: A total of 1752 students in the 7th grade and 1314 parents were assessed at baseline. Students' follow-up rates in the 8th and 9th grades were 92.1% and 88.4%, respectively. MEASUREMENTS: Classroom questionnaires to students and postal questionnaires to parents were administered before randomization and 12 and 30 months post-baseline. FINDINGS: Two-level logistic regression models, under four different methods of addressing the problem of loss to follow-up, revealed a statistically significant programme effect for only one of three drinking outcomes under one loss-to-follow-up method, and that effect was observed only at the 12-month follow-up. CONCLUSIONS: The Örebro prevention programme as currently delivered in Sweden does not appear to reduce or delay youth drunkenness.