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- Blomqvist, Jan, et al.
(författare)
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'More cure and less control' or 'more care and lower costs'? Recent changes in services for problem drug users in Stockholm and Sweden
- 2009
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Ingår i: Drugs. - : Informa UK Limited. - 0968-7637 .- 1465-3370. ; 16:6, s. 479-496
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Tidskriftsartikel (refereegranskat)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'.
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| 4. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
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A study of service user involvement in practice in the Swedish substance abuse treatment system : Methods, participants, and outcomes
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Demands for service user involvement has a long history in the general health and welfare sectors in Sweden, but user involvement has been lagging behind as concerns substance abuse treatment. “The position of the service user in substance treatment: A study of user involvement in practice” therefore sought to analyze perceptions of user involvement and the extent to which alcohol and drug users in this treatment sector can influence the choice of intervention in their own case. The study included both the perspectives of the service users and their professional service providers. The relationship between user involvement, satisfaction, and outcomes were explored, as well as potential differences in perceptions and experiences between various service user groups and service providers. The study applied a qualitative research approach by interviewing 36 service users and 23 service providers (pairs of service users and providers), and following them up three months later.The primary goal of the present technical report was to provide a quantitative exploration of research participant characteristics, user involvement and treatment satisfaction by different groups, including outcomes. The report uses tabular formats as well as several summaries of interview accounts. The report also outlines our theoretical point of departure and detailed information concerning the research methods and methodological considerations.[A Swedish summary is available in the report]
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| 5. |
- Storbjörk, Jessica, 1977-, et al.
(författare)
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Brukarinflytande på vårdmarknaden : en paradox i missbruks- och beroendevården?
- 2018
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Ingår i: Socialtjänstmarknaden. - Stockholm : Liber. - 9789147113019 ; , s. 85-115
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Kapitlet behandlar brukarinflytande inom missbruks- och beroendevården och diskuterar den potentiella konflikten mellan denna företeelse och New Public Management (NPM). Kapitlet diskuterar hur företeelser som ofta förknippas med NPM (t.ex. upphandling och ramavtal, valfrihet, prestationsbaserade ersättningssystem) inverkar på handlingsutrymme och vårdbeslut utifrån personalens och brukarnas utsagor, liksom hur klienter och patienter ser på sina möjligheter till inflytande i en NPM-inspirerad vård.
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| 7. |
- Holmén, Elin, et al.
(författare)
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Take-Home Naloxone and risk management from the perspective of people who survived an opioid overdose in Stockholm — An analysis informed by drug, set and setting
- 2023
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Ingår i: International journal of drug policy. - 0955-3959 .- 1873-4758. ; 115
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Tidskriftsartikel (refereegranskat)abstract
- Background: Take-Home Naloxone (THN) programs were introduced in Sweden in 2018 —a country with one of the highest rates of overdose mortality in the EU and a severe stigmatisation of people who inject drugs. This qualitative study builds on the international research that has expanded a previously narrow and medical focus on overdose deaths. It uses Zinberg’s framework to look beyond the role of the “drug ”to include the attitudes and personality of the person ( “set ”) and contextual factors ( “setting ”). This study explores the impacts of THN from the perspective of overdose survivors. Methods: Between November 2021 and May 2022 semi-structured interviews were conducted with 22 opioid overdose survivors, recruited among clients of the Stockholm needle and syringe program. All the participants had been treated with naloxone in an overdose situation. The interviews were processed through thematic analysis using deductive and inductive coding in accordance with the theoretical framework. Results: Interviewees included men and women who used different types of drugs. THN has impacted on “drug ”in terms of naloxone-induced withdrawal symptoms and peers having to deal with survivors’ emotions. Exploring “set ”revealed feelings of shame following naloxone revival for the person who overdosed. Despite such reactions, participants retained an overwhelmingly positive attitude towards THN. Participants integrated THN into their risk management practices ( “setting ”) and some acknowledged that THN provided a new way to treat overdoses without necessarily needing to interact with authorities, especially the police. Conclusion: The THN program has influenced “drug, set and setting ”for participants, providing increased safety at drug-intake and transferring overdose management and the burden of care to the community. The lived experi- ence of participants also exposes the limitations of THN indicating that there are additional unmet needs beyond THN programs, particularly in terms of “setting ”.
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| 8. |
- Klingemann, Harald, et al.
(författare)
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The Treatment Response : Systemic Features, Paradigms and Socio-Cultural Frameworks
- 2016
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Ingår i: The SAGE Handbook of Drug & Alcohol Studies. - London : Sage Publications. - 9781446298664 - 9781473921986 ; , s. 260-286
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Bokkapitel (refereegranskat)abstract
- Following some introductory notes on addiction treatment management as a specific case of societies’ response to deviant behaviours and social problems, an overview of the theoretical classifications and dimensions of addiction treatment systems is presented. The anti-thesis to these ideal-type system concepts is represented by the market New Public Management model oriented towards outcomes, regardless of the nature and organizational features of addiction interventions. As complementary to these general theoretical orientations, this serves as a review of specific issues concerning ‘a combined and integrated approach versus a specialized and segregated approach’, ‘the quest for the best treatment modalities’, ‘empirical and ethical aspects of coercion in treatment’ and ‘the relevance of user needs and orientation’. The empirical part begins by highlighting the ‘expert survey‘, ‘case study‘ and dynamic diffusion‘ approaches as treatment mapping strategies and informs on some key results, e.g. from the WHO Atlas –SU survey and the International Studies in the Development of Alcohol and Drug Treatment Systems. Results from an expert survey from fourteen countries conducted in 2014 illustrate the role of general political changes, efforts to control treatment systems, integration dynamics, the treatment gap and changing outcome criteria with concrete current examples. The conclusions point to the relative importance of professional addiction interventions drawing upon self-change research and the role of alternative lay help and outline factors in impeding system changes.
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| 9. |
- Lerkkanen, Tuulia, et al.
(författare)
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Debating the Drug Policy in Sweden : Stakeholders’ Moral Justifications in Media 2015–2021
- 2023
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Ingår i: Contemporary Drug Problems. - : SAGE Publications. - 0091-4509 .- 2163-1808. ; 50:2, s. 269-293
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Tidskriftsartikel (refereegranskat)abstract
- Drug-related harms continue to increase globally and governments struggle in search of effective and legitimate countermeasures. The choice between policy options is intertwined with the arguments that dominate drug policy discussions, which in turn are closely related to who has access to the policy debate. In this study, we examine stakeholders’ visibility and moral justifications of argumentation in the Swedish drug policy debate in the media (2015–2021). Justification analysis (JA) is used as a methodological and theoretical tool to illustrate the moral principles behind the claims by the stakeholders. The results show that the most visible stakeholders were politicians, government agencies and molders of public opinion. Furthermore, the stakeholders with successful active attempts to participate in the debate were molders of public opinion, NGOs, and politicians. The silent stakeholders in the media were people who use drugs and significant others. Stakeholders generally revolve around a dividing line regarding the restrictive features of Swedish drug policy, and were divided into proponents, opponents and neutral ones. All stakeholder groups included all three sides, hence reflecting the ingroup dissonance that may explain the continuing deadlock in Swedish drug policy. Justifications that value evidence-based policymaking (industrial worth) was used in the argumentation by the majority of the stakeholder groups, often combined with other moral justifications. This notion challenges the dichotomy of evidence and values in drug policy debates. Proponents relied more on the justifications that value paternalism (domestic worth), while opponents leaned toward the justifications valuing civil rights and social justice (civic worth). The development of Swedish drug policy may depend on the relative strength of these two value positions (domestic versus civic worth) in society and among stakeholders in power. This study continues the discussion of making contesting values explicit in the drug policy, serving a riveting case for international comparison.
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| 10. |
- Lerkkanen, Tuulia, et al.
(författare)
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Oenighet och olika värderingar i den svenska narkotikapolitiska debatten
- 2023
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Sammanfattning av den vetenskapliga artikeln Debating the drug policy in Sweden: Stakeholders’ moral justifications in media 2015–2021 (https://doi.org/10.1177/00914509231159394) i ett mer lättilgängligt format på svenska online.
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