Substance misuse and violent crime: Swedish population study

BMJ 2004; 328 doi: (Published 20 May 2004) Cite this as: BMJ 2004;328:1233
  1. Martin Grann, associate professor (,
  2. Seena Fazel, senior research fellow2
  1. 1 Centre for Violence Prevention, Karolinska Institute, PO Box 23000, SE-104 35 Stockholm, Sweden
  2. 2 Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
  1. Correspondence to: M Grann
  • Accepted 30 November 2003


Many studies have reported strong associations between substance misuse and violent crime.1 But the population impact of people diagnosed with substance use disorders on such crime is not known. Calculating the population impact and the relative importance of different classes of drugs is necessary to estimate the likely public health effect of any developments in services and treatment interventions in preventing violent crime.

To investigate the overall impact of substance misuse on violent crime, we estimated the population attributable risk using data from high quality national psychiatric and crime registers in Sweden from 1988 to 2000.

Participants, methods, and results

Swedish citizens have a unique identification number that can be used to link data across health and crime registers. The hospital discharge register contains diagnoses of all individuals who are admitted to any general, psychiatric, or secure hospital for assessment or treatment. All patients are given a clinical diagnosis on discharge according to ICD-9 (until …

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