‘More cure and less control’ or ‘more care and lower costs’? Recent changes in services for problem drug users in Stockholm and Sweden

Abstract

This article deals with the development of drug services in Stockholm, Sweden since the mid-1990s. Initially, data were collected as part of a European Union comparative study of the development of drug services in six major European cities. However, the present article uses these data to analyse to what extent the traditional ‘Swedish model’ of dealing with narcotic drugs can be said to have come to a crossroad. The article describes and analyses changes in drug use, and in the structure, organization and utilization of social services based, as well as healthcare-based drug services in Stockholm during the past decade. As pointed out in the article, the ‘drug-free society’ is still the ultimate goal of Swedish drug policy. However, as the Stockholm example hints, when it comes to the care and treatment of individual drug problems, there seems to be an on-going shift, from in-patient treatment towards measures such as substitution treatment, outpatient care and housing. The article discusses whether these changes signify a softening of Sweden's restrictive drug policy, or whether they rather point to a ‘re-medicalization’ of drug services, and shift in focus from ‘cure’ and social re-integration towards a focus on ‘care’ and on attempts to avoid ‘public nuisance’.

Notes

Notes

[1] In comparison, Swedish alcohol policy has often been described as ‘middle-way’, and formed in a democratic, political process (e.g. Blomqvist, 1998; Hübner, 2001).

[2] First issued in 1980.

[3] First issued in 1982, and revised in 1989 and 2004.

[4] Changes in percent corrected for selective attrition in data for some age groups (Trolldal & Svensson, 2007).

[5] For example, on a national level the number of misusers released from such care decreased rapidly from about 1500 persons in 1994 to about 500 in 1998 (SoS, 2007a).

[6] Although many researchers and practitioners took another view, the committee basically found the voiced fears to be well grounded.

[7] Interventions and clients in substance misuse treatment.

[8] This fits with statistics from the Social Services Administration of Stockholm, that shows that the by far most common intervention received from social services is sporadic or more regular, investigative or supportive talks with a social worker.