Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Emeritus Cornelis De Jong, Radboud University, Netherlands
- Second opponent: Associate Professor Anne Berit Bech, University of Inland Norway
- Third member and chair of the evaluation committee: Professor Ingrid Melle, University of Oslo
Chair of the Defence
Associate Professor Kristin Lie Romm, University of Oslo
Principal Supervisor
Associate Professor Linda Elise Couëssurel Wüsthoff, University of Oslo
Summary
Despite extensive research on substance use, gaps in representation and generalisability remain, especially for people with severe substance use who often face complex health and social challenges and limited access to care. Many studies have focused on individuals in treatment or incarceration settings, potentially excluding those outside these environments. This study therefore investigated people with ongoing substance to better reflect their lived experiences.
The aim was to examine the prevalence of functional cognitive impairment, overlapping psychopathology, and harmful alcohol use, and to explore possible associations with sociodemographic factors and substance use patterns. Data were drawn from a cross-sectional study including participants from municipal low-threshold services and a hospital-based substance use treatment unit in Oslo. Participants completed demographic and substance use assessments and were screened for cognitive impairment, mental health symptoms, trauma, and harmful alcohol use, alongside toxicological blood analyses.
The findings revealed a high burden of cognitive and mental health problems. Around three quarters of participants scored below the cutoff for possible cognitive impairment. Nearly all screened positive for at least one psychopathology and reported traumatic experiences, with younger age and frequent substance use associated with multiple overlapping conditions. Harmful alcohol use was identified in one quarter of participants and was more common among women, those reporting non-opioids as their main substance, and younger individuals.
Overall, the results demonstrate extensive and overlapping cognitive, psychological, and substance-related challenges in this population. Conducting assessments in participants’ everyday environments improved external validity and showed that systematic screening is feasible outside traditional clinical settings. The findings highlight the need for flexible, integrated care approaches to reach those with the greatest needs.
Additional information
Contact the research support staff.