| 1. |
- Cisneros Örnberg, Jenny, 1975-
(författare)
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The Europeanization of Swedish Alcohol Policy
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this dissertation is to study the Europeanization of Swedish alcohol policy from 1995-2006. It analyses the development of Swedish and European alcohol policy and answers the following research questions: How has alcohol policy developed on the national and the EU level during this period? What are the Swedish alcohol policy initiatives on the EU level? What does the interplay between Swedish and European policy processes look like? Of interest for this dissertation is also how the Swedish view on alcohol policy has been received on EU level.The dissertation comprises four related articles and an introductory chapter. In the articles official documents and interviews are analyzed in the context of the literature on Europeanization, using the concepts framing, narrative and new modes of governance. Article I explores the history of negotiations between Sweden and the EU on the traveller’s allowances question. Article II and III analyse how Swedish authorities, first through research and later through formal policy-making during the Swedish Presidency, tried to reframe alcohol on the EU-level. Finally, the fourth article is a comparative analysis of the Nordic retail monopolies, analyzing how the monopolies have developed and reacted to national and international pressures on their activities.The dissertation shows that Swedish authorities have influenced the EU level by putting alcohol on the agenda, and offered pressure and economic support to make sure that alcohol as a public health question has become and been kept as a prioritized question. This development is, however, nested inside the changing scope and emphasis of the EU. The emergence of a European alcohol policy as a public health-oriented process has been made possible through a new focus on the EU level, with increased cooperation between member states and a trend toward harmonization of policy and frames when it comes to alcohol.
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| 2. |
- Hradilova Selin, Klara, 1969-
(författare)
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Measuring harm from drinking in Sweden : Self-reports from drinkers in the general population
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There are several traditions of conceptualizing and measuring harm from drinking. Two main approaches are considered in the introduction – the psychiatric epidemiology and the social survey research traditions. The present thesis adopts the latter, although, as discussed, on the empirical level there is no sharp borderline between the two perspectives, as there is not between personal (i.e. physical and psychological) and social harm from drinking as such. But while methods for studying personal harm are fairly well developed, social harm, i.e. adverse consequences of alcohol that involve social interaction, has received less attention. One of the aims of the thesis has been to explore different dimensions of harm from drinking, identify different harm areas and develop and apply area-specific measures using general population survey data.Two papers examine psychometric properties of a widely used screening instrument, the AUDIT (Alcohol Use Disorder Identification Test). While the first paper is concerned with the validity of the AUDIT, testing it against different criteria, the second paper focuses on the test-retest reliability of the instrument. In the third paper, a number of summary measures of different areas of alcohol-related harm are constructed using factor analysis. These measures are then, in the last paper, applied to estimate prevalence and risk of alcohol-related harm in the Swedish general population. The analyses are based on data from a national survey on drinking problems in Sweden collected in 2001-2002.It is concluded that the AUDIT screens well for both impaired self-control and social harm from drinking (as well as for high volume drinking), but performs less well when screening for health problems. The test-retest reliability of the AUDIT is relatively high. In the other two papers, constructing new summary measures and applying them to estimate prevalence of harm, it is concluded that, except for being young, no particular sociodemographic risk groups can be identified for different areas of harm from the same level and pattern of drinking. To what extent this reflects reality or is an effect of the methods we use and kind of population we reach in surveys is discussed.
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| 3. |
- Palm, Jessica, 1973-
(författare)
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Moral concerns - Treatment staff and user perspectives on alcohol and drug problems
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Constructions of alcohol and drug problems, as well as of treatment, show a great variation that can be understood from the perspective of societal needs to categorize individuals as deviant. The thesis deals with contemporary perspectives, among staff in treatment of alcohol and drug problems and a group of drug users, on alcohol and drug problems and how these problems should be handled in the public sphere. The thesis consists of four papers covering: (1) views of treatment staff on alcohol and drug problems, (2) views of treatment staff on gender issues, (3) views of treatment staff on priorities of client groups and (4) views on the “user” from the point of a union for drug users. The first three papers use questionnaire-data from a treatment systems study in Stockholm County. The first and third papers deal with questions directed to treatment staff whereas the second paper besides staff data analyses data from interviews with 1865 individuals entering treatment for alcohol and drug problems. The fourth paper is a discourse analysis of texts written by the Swedish users union.The results shows that staff see alcohol and drug problems as social problems, diseases and moral problems. Staff also perceive men and women in treatment as different, both in terms of their problems and their treatment. These experienced differences were supported by comparisons between men and women in treatment in a few cases, but mostly differences were not that great or did not appear at all. When staff were asked to make priorities between groups of clients they seem to take past actions of the clients into account rather than using the egalitarian reasoning regulating priorities in official documents. Taking past actions into account indicates a moral approach to alcohol and drug problems. The analysis of the Swedish users union also points at a moral perspective on drug problems in the dominating drug policy discourse, pronounced in the opposition of the union. In this opposition the union constructs the user as a “consumer”, as “weak”, “sick” and “innocent”. The union shows signs of a human rights perspective, a public health perspective and a disease perspective as well as a direct opposition to the perspective of the user as a criminal.Seen together the papers show the importance of categorizing subjects for and in treatment as well as the constructed nature of alcohol and drug problems. A moral perspective seems to be the base for many categorizations (distinguishing between normal and deviant as well as between more and less culpable “troubled persons”) and is not as clearly in conflict with medical and social perspectives as one might expect. The thesis also indicates a strengthened medical approach with connections to individualisation of problems and market orientation. To classify a certain group of individuals as deviants is important for our construction of normality and inclusiveness, whether the deviance is in terms of illness or moral failure. Treatment of deviance can be seen as a manifestation and reproduction of this categorization and research on treatment and deviance plays an important part in this process.
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| 4. |
- Rødner Sznitman, Sharon, 1978-
(författare)
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Socially Integrated Drug Users : Between Deviance and Normality
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this thesis is to improve our knowledge of substance users in the normal population. The main concern is with how the meaning of drug use is constructed. To answer this, the thesis draws on different theoretical principles and mixed methods design. The thesis is made up of four sub-studies, with interconnected foci. The first three papers are based on a qualitative research project in which 44 socially integrated drug users in Stockholm were interviewed. The fourth paper is a cross-national quantitative analysis of nationally representative student samples. The first of the three qualitative papers explores the construction of the informant’s self-identity. The second paper analyses the informant’s perceptions of drug-related risk, whilst the third paper analyses the drug users’ perception of differences between men’s and women’s drug use. The fourth paper sets the detailed analyses of the first three papers in a broader comparative frame, exploring differences in the correlates of drug use, in light of the different levels of drug use in Sweden and Switzerland. The thesis reveals that the drug users are striving to be understood as normal integrated citizens of Swedish society. They present themselves as inherently different from drug abusers and the informants’ risk perceptions are based on a modified form of core Swedish cultural ideals of conscientiousness. The informants also waver back and forth when called upon to discuss gender and drug-taking. On the one hand they were explicit about existing differences between men’s and women’s drug use; on the other hand they were quite uncomfortable having to explicitly explain them, as this meant that they needed to draw on conservative gender roles, something which in Swedish society is a strong sign of being politically incorrect. Furthermore, the thesis shows that young drug abstainers and cannabis users are quite similar in regards to conventional social bonds.
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| 5. |
- Storbjörk, Jessica, 1977-
(författare)
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The social ecology of alcohol and drug treatment : Client experiences in context
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this thesis is to study how individuals with alcohol and drug problems come to treatment – who is in treatment and who is not? It further studies the goal and role of treatment according to different groups – clients, staff and politicians. How can we understand clients’ experiences in a context?The main data is from the Women and men in Swedish alcohol and drug treatment-study, with a representative sample of clients as well as complementary data on the views of staff and the general population.The thesis comprises four related papers: (1) explores who is in treatment and who is not by analysing the client and the general population samples; (2) studies reasons for coming to treatment among clients by focussing on self-choice in relation to informal, formal, and legal social pressures to seek treatment; (3) investigates alcohol and drug related events among misusers and the role of these events in treatment entry, and in relation to level of marginalization of the clients; (4) analyses motives for and conflicts surrounding changes in the treatment system on an organizational level.The thesis reveals that clients in treatment are marginalized (regarding housing, work, family, etc.). At treatment entry, clients report self-choice as well as a range of pressures to seek treatment as reasons for coming. The events are influential in treatment seeking, especially events and pressures in relation to significant others. In addition, it is shown that changes in the treatment system are not only driven with the interests of the clients in mind. Professional struggles, economic cuts, and coincidences are of importance. It is shown that different actors have competing as well as compatible and matching views on the goals of treatment. Finally, some notable changes in the treatment system are discussed.
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| 6. |
- Tryggvesson, Kalle, 1970-
(författare)
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Freedom in a bottle : Young Swedes on rationales and norms for drunken behaviour
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is today much evidence for a positive relationship between alcohol and violence. There are however still many questions about the nature of the relationship. Somewhat simplified, the research on the link between alcohol and violence can be divided into four different lines of research, research focusing on: the effect of alcohol as a psychoactive substance, the drinking context, the personality of the drinker, and societal attitudes, expectations and values. The dissertation focuses on the last area, the importance of the cultural context. One influential theory within this field is the time-out theory formulated by MacAndrew and Edgerton in the late 1960s. Since drunken comportment varied between cultures and between different contexts within the same culture and changed over time, they suggested that the effects of alcohol on people’s behaviour was socially constructed. They suggest that many societies had a created a time-out situation for drunken behaviour that explained people’s behaviour while drunk.The general aim for this dissertation is to study young Swedes’ attitudes, experiences and expectations around drunken behaviour, with a special focus on expectancies around alcohol as a cause and excuse for violence. Three different data sets have been used. The first study is based on 4 focus-group interviews with Swedish football fans during the European football championship in Holland in 2000. The second material is eight focus-group interviews involving 47 students aged 18-20 living in Stockholm. The last material is a nationally representative survey of young adults, 16-25 years old. One part of the survey consisted of 4 vignettes which we used to elicit cultural norms around drunken behaviour.The findings suggest that young Swedes believe that alcohol can be used as a means to accomplish a pleasurable state of mind, and that alcohol could be used as a means to transgression – since alcohol reduce inhibitions it could be used to put them in a less controlled mode. The rationale for those changes was often described in terms of the psychoactive effect of alcohol. However, it was also shown that the context was important. When the situation demanded alcohol the most, their expectations together with the situation almost turned water into beer. It was also shown that there was a norm which said that one should not use alcohol as an excuse, but on the other hand, the participants said that they used alcohol as an excuse and that they thought that it was accepted. Alcohol could work as an excuse since alcohol made the aggressor look less deviant and the acts less severe. The vignette studies indicated that an aggressor who was drunk when he committed a violent act was seen as less blameworthy than a sober or less drunk aggressor. However, this applied only under certain circumstances: alcohol seemed to be a better excuse if the victim is drunk as well and the act is relatively severe.Taken together, the studies suggest that the Swedish drinking culture provides people with a drunken excuse, which helps young people to expand the room for possible action.
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