The limits of legitimacy
Service providers’ views on maintenance treatment in Sweden
Bibliographic Data
| ID | 15397649 |
|---|---|
| Authors | Mats Ekendahl (0000-0003-2295-4078, Stockholm University, corresponding author) |
| Year | 2011 |
| Volume | 19 |
| Issue | 5 |
| Pages | 427-437 |
| Publication date | 2011-01-12 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Addiction Research & Theory (JOURNAL) |
| Journal identifiers | ISSN: 1476-7392 • E-ISSN: 1606-6359 |
| Publisher | Taylor & Francis (PUBLISHER • GB) |
| DOI | 10.3109/16066359.2010.545158 |
| OpenAlex | W2003499593 |
| Language | EN |
| Citations received | 3 |
| References cited | 47 |
Background: It is widely acknowledged that the social meaning of maintenance treatment (MT) with methadone is context-dependent and that different discourses influence how this approach to opiate addiction problems is practised. In Sweden, MT has long been ideologically controversial, even if the past decade's emphasis on evidence-based interventions has made it more accepted and prevalent in the treatment system. MT may thus be seen as a discursive field where science and values are intertwined and impact practice jointly, which emphasises the importance of analysing how MT is attributed with meaning.Objectives: The study aims to identify and analyse the discourses that service providers in Swedish opiate addiction treatment refer to in their efforts to legitimise MT.Methods: Twenty-eight interviews focused on MT-related issues were conducted with Swedish social workers and health care workers. The material was analysed qualitatively according to discourse theory.Findings: Three key features of MT were identified: as therapeutic intervention; as beyond harm reduction and as pragmatic solution. The respondents constructed MT as a necessary medical and psychosocial treatment aimed at rehabilitation and patients’ complete break with drug abuse, which reflects a policy-context where solutions to drug problems are supposed to be resolute, thorough and abstinence-oriented.Conclusions: The service providers handled the controversy between science and values by drawing on a decent-life discourse, where opiate addiction problems are solved with a pragmatic stance towards evidence and where only interventions that make patients’ lives allegedly decent are considered legitimate (excluding, e.g. heroin prescription and liberal methadone distribution)
Addiction · Business · Context (archaeology · Criminology · Harm reduction · Ideology · Intervention (counseling · Legitimacy · Meaning (existential · Medical prescription · Political science · Politics · Psychiatry · Psychological intervention · Psychosocial · Psychotherapist · Public health · Service (business · Service provider · Sociology · HIV, Drug Use, Sexual Risk · Law · Medicine · Nursing · Opioid Use Disorder Treatment · Psychology · Substance Abuse Treatment and Outcomes · Social Work
Interpreting qualitative data
Discourse Analysis as Theory and Method
Substance and Substitution
Discourse Analysis
Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence
Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence
Stigma, social inequality and alcohol and drug use
An overview of systematic reviews of the effectiveness of opiate maintenance therapies
Discourse and social change
Archaeology of Knowledge
Demarginalizing the marginalized in substance abuse treatment
Using drugs
Trauma, damage and pleasure
The chronotope of the queue
Public health or human rights
Drug users’ views of substitute prescribing conditions
The construction of maintenance treatment legitimacy
Methadone
Evidence, values and drug treatment policy
Speaking Addictions
Understanding Drug-Using Clients' views of Substitute Prescribing
The social construction of reality
Agency and dependency within treatment
Buprenorphine substitution treatment in France
Historiography taking issue
Surprised by Methadone
Women and Heroin
Methadone Maintenance Treatment and Making Up People
The relevance of Foucault and Bourdieu for medical anthropology
Pleasure, power and dangerous substances
Disciplining Addictions
The Translation Perspective as an Alternative to the Policy Diffusion Paradigm
| Citations per year | 0.21 |
|---|---|
| Citation span | 2012 - 2020 (9) |
| Highly cited | No |