Bagga Bjerge

Drug policy, control and welfare

The aim of this article is to understand the recent changes of Danish drug policy, which have changed both the balance between and the content of control and welfare. For this purpose, Danish drug policy is seen as a ‘policy space’ where different political rationalities are articulated and played out against each other. The political rationalities articulated within the realm of drug policy are furthermore seen to be influenced by the political rationalities that dominate penal policy and welfare policy more generally. To account for the policy space of Danish drug policy today the article builds on analyses of legislation, policy documents and research related to the policy process. The article is furthermore built on secondary literature about Danish drug policy. The article finds that Danish drug policy articulates a particular mix of neo-conservative and neo-liberal political rationalities that constitutes the basis for the balance between control and welfare in Danish drug policy today.

Shifts in Opioid Substitution Treatment Policy in Denmark from 2000–2011

This article discusses how opioid substitution treatment policy has developed from 2000 to 2011 in Denmark. Empirically, it takes its point of departure in a stakeholder analysis including 17 qualitative interviews with stakeholders who have played important roles in this field. Analytically, it is inspired by Kingdons concepts of agenda and policy window. Three major shifts are identified: a shift from psychosocial to medical thinking and practice, from an abstinence driven ideology to health care, and from perceptions of passive clients to user involvement. These shifts are discussed in relation to the legal context of substitute prescribing medicine.

Stakeholders in opioid substitution treatment policy: similarities and differences in six European countries.

Based on the research papers within this special issue, this overview discusses similarities and differences in stakeholding in drug user opioid substitution treatment policy in Britain, Denmark, Italy, Austria, Poland, and Finland. It explores factors that have influenced stakeholder activity, including the importance of crisis, the impact of evidence, the availability of resources, the wider political context, the influence of moral frameworks and ideologies, and the pressure of external influences. The paper highlights the important differences in the emergence and evolution of stakeholder groups and in the political, cultural, and economic circumstances, which both constrain and enable their activities.

Empowered and self-managing users in methadone treatment?

Empowerment is a keyword in treatment. Users should have the means and possibilities to influence their treatment and become self-managing. Drawing on ethnographic fieldwork in a Danish methadone treatment project, we find that the practices of users and staff are often not carried out in accordance with governmental intentions. We identify a gap between the official notions of treatment and practices. We analyse the notions and practices of empowerment by applying two analytical perspectives. First, we apply a constructionist perspective in which empowerment is analysed as wanting to set users ‘free’ but also as ways to govern. We elaborate the analysis by applying a more practice-oriented focus. Drawing on this perspective, we analyse the ways in which staff and users constantly produce, construct and negotiate institutional practices that differ from the governmental intentions for treatment.

From Zero Tolerance to Non-Enforcement: Creating a New Space for Drug Policing in Copenhagen, Denmark

The neighborhood of Vesterbro in Copenhagen has housed the largest open drug scene in Denmark since the 1980s. In recent years there has been a remarkable change in the police strategy towards this drug scene from zero tolerance to a non-enforcement strategy. This article presents a case study of this change in strategy and its implications for more general discussions about drug control and harm reduction. With inspiration from the governmentality literature, in particular how government involves the construction of governable spaces, and police research that emphasizes the territorial aspects of policing, the article seeks to characterize the difference between the two drug control strategies at Vesterbro. The analysis is based on original research and secondary literature. The article concludes that the non-enforcement strategy opens up the drug scene to new kinds of intervention by police and social welfare institutions, and that it changes the relationship between social welfare provision and policing.

Rationalities of choice and practices of care: Substitution treatment in Denmark

As in many Western countries, notions of active, free, and self-managing citizens have become key concerns in Danish social policies. This article describes how these key concerns have made their inroads into laws and guidelines for delivery of social welfare services and how these laws and guidelines are intended to be implemented in social work practices. In the first part of the article, we analyze how policies envision drug users as active, free and self-managing citizens. In this view, citizens are assumed to have the desire to become more involved in their treatment and to choose the goals of their own treatment. In the second part, we focus on how this rationale changes under actual conditions of social work practice. Drawing on ethnographic fieldwork among social workers and drug users, we show how their daily encounters are not based on the presumption of individual choice. Rather, the life situations and problems of drug users conflict with the predominant idea that drug users are self-managing citizens who should be “empowered.” Instead, we argue that daily treatment encounters are not so much about individual choice and self-management, but rather, about improving the overall situation of drug users.

Drug policy research at the Centre for Alcohol and Drug Research

The Centre for Alcohol and Drug Research (CRF) has since its foundation in 1991 had a strong tradition for research in drug control. However, researchers at CRF have also started to study drug policy not only from a control perspective but also from a perspective of health and welfare issues. From 2005, CRF has developed a particular interest in how welfare policies related to drug issues come into being and how they are implemented in practice in different welfare institutions. These studies, in opposition to more established drug policy studies based primarily on quantitative and statistical data, use a broader variety of empirical data collected using qualitative interviews and ethnographic observations. The article investigates the development of drug policy studies at CRF and discusses the theoretical and analytical implications of this development. The development is related to, first that the organization of the Danish drug field has changed and a variety of new social and health initiatives have emerged, necessitating a thorough investigation; and, second that more anthropologists and sociologists have been employed at CRF, complementing researchers trained primarily in legal studies.

The shifting roles of medical stakeholders in opioid substitution treatment: a comparison between Denmark and the UK

Purpose – The purpose of this paper is to examine the shifting roles of medical professionals as stakeholders in opioid substitution treatment (OST) policies and practices in Denmark and the UK within the past 15 years. Design/methodology/approach – The paper is based on literature reviews, documentary analyses and key informant interviews with a range of stakeholders involved in OST and policy in Denmark and UK. The study is part of the EU-funded project: Addictions and Lifestyles in Contemporary Europe: Reframing Addictions Project. Findings – Denmark and the UK are amongst those few European countries that have long traditions and elaborate systems for providing OST to heroin users. The UK has a history of dominance of medical professionals in drugs treatment, although this has been recently challenged by the recovery movement. In Denmark, a social problem approach has historically dominated the field, but a recent trend towards medicalisation can be traced. As in all kinds of policy changes, multiple ...