Nordic Studies on Alcohol and Drugs

Taking as a point of departure Mary Douglas' grid-group analysis, elaborated on by Aaron Wildavsky in his cultural theory, the article explores the variations in the development of methadone treatment programmes in the Nordic countries from the mid-1960's to the mid-1990's. In Sweden, the first Nordic country to start an organized treatment of heroin addicts with methadone in 1966, the strategy has been characterized by many rules and strong control. In Denmark, methadone treatment was introduced in the late 1960's, and it has been characterized by few rules and weak control. In Norway, methadone treatment was banned in 1979, after some years of occasional experiments. But the spread of HIV among intravenous heroin addicts altered the attitudes and a small and highly regulated program was set up in the beginnings of the 1990's. In Finland, the attitude has been reserved, primarily due to the small population of heroin addicts. The organized treatment in the 1970's was limited, and still is, as it was set up again in 1995. In spite of the differences, however, there are two main patterns of harmonization that should be noticed. Firstly, as a result of HIV, regulated programmes have been developed in all four countries in the 1990's. Secondly, the prevailing abstinence-oriented philosophy has been questioned and supplemented by harm-reducing measures. Today, there is a stronger tendency to treat drug addicts as clients in the Nordic welfare state, entitled to individual treatment in the countries' general health and welfare systems.

The article compares alcohol policy to electronic media policy as forms of cultural protectionism. This protectionism has coincided with an era of economic protectionism, which in Finland started after World War I and the Finnish Civil War in 1918, and which is now ending as a result of the GATT agreement and Finland's membership of the European Union. During that era, the Finnish nation has not only been protected against imports of foreign agricultural products. The Finnish common people have also been constructed as a populace in need of civilization, and that is why the borders have been closed to bad influences, such as cheap liquor and mass culture. The article discusses the way in which this ‘bio-policy’ (Foucault) affecting peoples' living conditions has formed the Finnish culture, and its notions about art, mass communication and alcoholic drinking. As to notions of alcohol, it is predicted that the meanings of protest aroused by state control policy are gradually fading, and will give way to notions of drinking problems as evidence of a disease.

The progression of narcotics abuse from first use to regular use (> 2 days per week) to established abuse (a year prior to enrollment in a rehabilitation program) was analysed from a sample of 1 268 men and women in Sweden, who were interviewed at the beginning of treatment (BAK/SWEDATE-project). Cannabis was the most common initial substance, but amphetamine (CS), heroin (opiates) and hallucinogens were also cited. There were a number of paths from debut toward regular use and established abuse. However, from first use to regular use, most subjects continued with the initial substance. Between regular use and established abuse, subjects began using other substances as well. After approximately 10 years of abuse, extensive multiple drug abuse could be noted. Four main paths are described. Also cannabis, CS and heroin abuser progression is described. The results show significant gender differences. The progression was quicker for women: first use occurred earlier, the transition to regular use took place quickly and they were younger when they entered treatment. A larger share of women than men used heroin and amphetamine. Alcohol consumption was high and most extensive among cannabis-abusing women. The results are discussed in relation to earlier research on the stepping stone model and the drug career and show the importance of early intervention.