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Although adult criminality is very often preceded by deviant behaviour in childhood, the majority of those who are registered for crime as juveniles do not appear in the criminal registers as adults. There is an apparent heterogeneity in criminal behaviour over time as well as in adult outcomes with respect to work, family and health, even among “persistent” juvenile delinquents and also adult offenders. In this paper we follow a Stockholm birth cohort born in 1953 until the age of 56 (2009). The study has its background in earlier work, where we have studied the social situation in adulthood for different categories of offender. Having previously focused on what happened to the boys and girls who were registered for crime during their teens or as young adults, we now focus on processes of inclusion and exclusion, and are particularly attentive to the significance of substance abuse, both for the criminal career and for the cohort members’ health and social situation in adulthood.