A recent analysis article published by FORTE, Swedish Council for Health, Working Life and Welfare, discussed the use of drugs, including cannabis, in young people and how this use may be connected to mental health problems and the way the care system responds to them. Although overall alcohol and drug use among young people in Sweden has declined, a smaller subgroup uses substances more frequently. Compared with adults, the reasons behind youth substance use are less well understood, but individual studies suggest that co-occurring problems are common.
According to the article, although cannabis use is often linked to mental health issues at the population level, the direction of causality remains unclear, and some young people may use substances to self-medicate psychological distress, potentially worsening their symptoms. Maria Ungdom is Sweden’s largest specialised provider of care for young people aged 13 to 25 years with substance use problems, offering integrated support such as CBT and motivational interviewing through clinics across Stockholm and the country.
Despite annual surveys from clinics in major cities, knowledge about young people in substance use treatment remains limited compared with adults. Available data show that most patients are boys with an average age of 17 years, and young individuals, especially girls, have co-occurring mental health problems or criminal involvement, with an increasing proportion receiving concurrent psychiatric care.
Researchers from Stockholm University and Karolinska Institutet are studying how young people with substance use problems are treated in the Swedish care system, using Maria Ungdom as a case study. They analyse medical records, registry data from 2011–2021, and interviews with patients and staff to understand who receives which treatments and how care is delivered.
“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,” said Patrik Karlsson, Professor of Social Work at Stockholm University.
Research findings have revealed that girls often come into contact with specialised youth addiction care services at a younger age, possibly because norm-breaking behaviour stands out more among girls than boys. While coordinated care at Maria Ungdom can support young people with both substance use and mental health problems, requirements such as urine testing may create barriers and feelings of stigma for some patients, added Karlsson.
In his interview with FORTE, Philip Lindner, Associate Professor of Clinical Psychology at Karolinska Institutet and Head of R&D at Maria Ungdom, said decision-makers should not focus only on zero tolerance, as substance use is often linked to underlying problems and care should be adapted to each individual’s needs. The next step of the project is to examine how substance use and criminality are connected using the national registry and healthcare data.