Alcohol dependence profoundly affects the family and social network of the afflicted person. The most frequent difficulties in activities and participation have to do with interpersonal interactions, economic and work life, dealing with aggression and legal problems. Problems with high-risk behaviours and in seeking appropriate treatment are also common. Treatment targeted at reduction or cessation of alcohol use is effective in reducing these psychosocial difficulties. The ICF offers a structure for systematic evaluation of the wide range of difficulties encountered in alcohol dependence.

ObjectiveTo construct a metric of the impact of brain disorders on people’s lives, based on the psychosocial difficulties (PSDs) that are experienced in common across brain disorders.Study DesignPsychometric study using data from a cross-sectional study with a convenience sample of 722 persons with 9 different brain disorders interviewed in four European countries: Italy, Poland, Spain and Finland. Questions addressing 64 PSDs were first reduced based on statistical considerations, patient’s perspective and clinical expertise. Rasch analyses for polytomous data were also applied.SettingIn and outpatient settings.ResultsA valid and reliable metric with 24 items was created. The infit of all questions ranged between 0.7 and 1.3. There were no disordered thresholds. The targeting between item thresholds and persons’ abilities was good and the person-separation index was 0.92. Persons’ abilities were linearly transformed into a more intuitive scale ranging from zero (no PSDs) to 100 (extreme PSDs).ConclusionThe metric, called PARADISE 24, is based on the hypothesis of horizontal epidemiology, which affirms that people with brain disorders commonly experience PSDs. This metric is a useful tool to carry out cardinal comparisons over time of the magnitude of the psychosocial impact of brain disorders and between persons and groups in clinical practice and research.

Aims: This 11-month study analysed illicit drug sales on the anonymous Tor network, with a focus on investigating whether a seller's reputation and capacity increased daily drug sales. Design and setting: The data was gathered from Silkkitie, the Finnish version of the Silk Road, by web crawling the site on a daily basis from November 2014 to September 2015). The data includes information on sellers (n=260) and products (n=3823). Measurements: The measurements include the sellers' reputation, the sale amounts (in euros), the number of available products and the types of drugs sold. The sellers' capacity was measured using their full sales potential (in euros). Fixed-effects regression models were used to estimate the effects of sellers' reputation and capacity; these models were adjusted for the types of drugs sold. Findings: Overall, illicit drug sales totalled over 2 million euros during the study, but many products were not sold at all, and sellers were active for only a short time on average (mean=62.8 days). Among the products sold, stimulants were most widely purchased, followed by cannabis, MDMA, and psychedelics. A seller's reputation and capacity were both associated with drug sales. Conclusion: The Tor network has enabled a transformation in drug sales. Due to the network's anonymity, the seller's reputation and capacity both have an impact on sales.

Aim The article outlines, at the level of political discourse, changes in drug and criminal policy that may have influenced the penal system as a backdrop to the rise of prison-based drug treatment programmes (PBDT) in Finland. Methods and Data Our perspective is historical. The article is based on historical and political documents, scholarly research and white papers. Results The history of PBDT in Finland is characterised by an absence of drug treatment programmes until the 1980s, first initiatives at the end of the 1980s, enthusiastic programme development from the mid-1990s, and decreasing interest during recent years. Unlike the National Drug Strategy, the Prison Drug Strategy aimed at a drug-free environment (zero tolerance) and implemented harm-reduction measures only to a limited extent. Conclusion The development of PBDT represents the new way of performing treatment in prisons, with features of managerialism. PBDT is also affected by an organisational segregation of rehabilitation and medical treatment, which prevents integration of harm-reduction measures with rehabilitative treatment, and is in conflict with general aims of integrating substance abuse treatment to mental and healthcare services in Finland. In the spirit of a new kind of Penal Welfarism, the role of documented individual risk and needs assessment in defining an offender's sentence has increased.

No abstract