Illicit drug abuse in second-generation immigrants: a register study in a national cohort of Swedish residents

Aims: This study investigates ethnic and socioeconomic risk factors for hospital admissions related to illicit drug abuse in second-generation immigrants in Sweden. Method: Cox analyses of proportional hazards were used to estimate the relative risk of sociodemographic covariates in analyses of register data on hospital admissions because of illicit drug abuse during 1990 - 99. The study population was a national cohort of 1.25 million residents (aged 10 - 30 years). Results: Second-generation immigrants had two- to three fold higher age and sex-adjusted relative risks (RRs) for hospital admissions because of illicit drug use compared with the Swedish majority population with a limited variation between different ethnic groups. The RRs decreased greatly after the model was adjusted for socioeconomic indicators of the childhood household. Intercountry adoptees had the highest risk for hospital admission related to illicit drug abuse of all study groups after adjustment for sociodemographic variables (RR 2.8). Conclusions: Second-generation immigrants are at particular risk for illicit drug abuse in Sweden. Adverse socioeconomic living conditions are very important in explaining this high risk.