Research project Older adults make up over a quarter of all people seeking treatment for alcohol problems in Sweden, yet little is known about whether the care they receive actually meets their needs. The Towards Recovery-Oriented Systems of Care for Older Persons with Alcohol Problems (ROSC-OPAP) project maps interventions across social and healthcare services, evaluates their effectiveness, and explores how older adults experience treatment — to build a more recovery-oriented care system.
ROSC-OPAP studies adults aged 50 and older who have received treatment for alcohol problems through social services and healthcare in Sweden. Using linked register data, patient-reported outcomes, and qualitative methods, the project identifies what interventions are provided, whether they reduce alcohol use and improve quality of life, and how service users experience care. The goal is to generate knowledge that supports a learning, recovery-oriented addiction treatment system that promotes self-determination and responds to the complex needs of older adults.
Collaborator Organizations:
· Unit for Clinical Alcohol Research, University of Southern Denmark.
· Department of Clinical Neuroscience, Karolinska Institutet.
· Department of Social Work, University of Denver.
Problematic alcohol use is increasingly common among older adults in Sweden. Over 40% of those aged 50–64 and 30% of those aged 65–84 drink at a high-risk level. Over a quarter of all people seeking substance use treatment are aged 50 or older, and most have additional physical and mental health problems alongside social problems such as unstable housing or unemployment. Despite this, relatively little is known about which interventions they actually receive or whether these match their needs.
ROSC-OPAP uses the framework of Recovery-Oriented Systems of Care (ROSC) to study adults aged 50 and older who sought treatment for alcohol problems between 2007 and 2023.
The project links individual-level data from municipal social services, the national quality register for addiction care, and health and social registers from:
· The National Board of Health and Welfare (NBHW)
· Swedish Social Insurance Agency
· Statistics Sweden and
· The Swedish National Council for Crime Prevention.
It examines what treatments and supports people received, whether these interventions reduced alcohol use and improved quality of life, and how participants experienced the care process.
The project includes four studies: mapping of interventions across the care continuum, evaluating effects on alcohol use, assessing effects on quality of life and health trajectories, and exploring treatment experiences of service users and staff. Advanced statistical methods, such as difference-in-differences, latent growth mixture modelling, and predictive and survival models assess intervention effects and long-term social and health trajectories. Patient-reported outcomes and experiences are central to the analysis. ROSC-OPAP is one of the first studies to apply the ROSC framework to older adults in the Swedish addiction treatment system. By generating evidence from real-world data, including patient-reported outcomes and experiences, the project aims to support quality improvement work and better care access.
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