Bengt Svensson

Involuntary discharge from medication-assisted treatment for people with a heroin addiction - patients' experiences and interpretations.

Aims To examine what happens to patients who have been involuntarily discharged from medication-assisted treatment (MAT) with methadone or buprenorphine in Malmö, Sweden. Material And Method A total of 35 people, with a long history of heroin addiction, were interviewed, including ten women. Most interviewees were recruited among visitors with discharge experiences at the local needle exchange programme. The article focuses on these informants’ experiences and interpretations of being discharged. Results Discharge had little legitimacy and was perceived as unfair. Several of the interviewees went back to heroin abuse while others tried to create their own maintenance programmes by buying methadone or buprenorphine on the black market. Many resorted to crime or prostitution to make ends meet. Conclusions According to National Board of Health and Welfare regulations, discharge and a three-month exclusion from all MAT is an appropriate response to violation of rules. Exclusion nevertheless led to harsh consequences. The interviewees’ living conditions were consistently impaired, as were their physical and mental health and contacts with family members, since they soon returned to a lifestyle and drug abuse similar to that before treatment.

Amphetamine use and sexual practices

AIM – This article examines how men and women who have left problematic drug use describe their own previous use of amphetamine in the context of sexual activity as well as the views in the drug-using environments on amphetamine and sex. METHODS – The article builds on a qualitative study of sexuality, intimate relationships and drug use against the backdrop of the exit process from drug abuse. The 35 interviewees comprise a heterogeneous group in terms of both drug abuse history and life circumstances in general. RESULTS – In the sexual practices of our informants, amphetamine has been used to increase sexual desire and to enhance sexual experience. Initially, the drug appears to facilitate pornography inspired sexual experimentation, which is experienced as something positive, but gradually this is for many transformed into sexual practices that are seen as practically manic, with marathon sex being an important component. Among men, sometimes the sexual interest is channeled into an intense masturbating, as a substitute for a sexual partner or in order not to disturb the amphetamine experience by involving a live partner. Once amphetamine use starts to lead to problematic effects on social life and mental and physical health, desire becomes increasingly difficult to maintain. Although amphetamine is associated with sex in the amphetamine environment there is also room for toning down sexual activity and instead use the total focus of the high for crime (breaking) or other practical acitivties such as repairs or housecleaning (tinkering). CONCLUSION – Our study shows that amphetamine has a reputation for enhancing sexual experience, which has increased its powers of attraction for both men and women. The impact of amphetamine on sexuality is influenced by personal experiences and culturally determined expectations. Even when one manipulates the sexual act with amphetamine the strong individuality that characterizes human sexuality in general remains. The total experience of mixing amphetamine and sex, which for most is changing in a negative direction over time, appears to be a result of the interaction between the drug, the social and relational setting and the sexual script of the individual.

'Better safe than sorry' : Women's stories of sex and intimate relationships on the path out of drug abuse

This article focuses on the role of sexuality and intimate relationships during women’s exit processes from drug abuse. Drawing from qualitative interviews with Swedish women the article explores how their sexual practice is played out both during drug use and in the new drug-free life situation. The conflictual transition process evolves around the individual’s attempts to adapt to various sexual scripts made available to them. An element of shame regarding past sexual experiences is enforced by a strong desire to create a new identity as ‘ordinary’. The safest option then is to abstain from sex even if it may lead to frustration and longing. To some, toning down sexuality is a welcome respite, to others a meaningless wait. Why does the beautiful, lovely sexuality never come?

Gambling with life - injection drug use, risk taking and overdoses

Aims: This article describes experiences of overdose among a group of long time heroin users. The main aim is to seek understanding for circumstances, motives and actions concerning the phenomena o ...

Parents as victims of property crime committed by their adult children with drug problems : Results from a self-report study

Parents who are subjected to crime by adult children with drug problems have been neglected in victimological research. We have examined how common it is for parents to fall victim to theft and burglary committed by their children and how the risk varies depending on the parents’ and children’s circumstances. A self-report questionnaire on victimisation was distributed to parents of adult children with drug problems (n = 687). The data were collected by means of a postal survey sent to members of the Swedish organisation Parents Against Drugs (Föräldraföreningen mot narkotika) (n=411) and through an online questionnaire that was disseminated on social media and among treatment facilities and other support associations for family members (n=276). Half (50.7%) of the parents declared that they had at one point or another been victims of theft or burglary committed by their children. The level was higher among older parents, among those whose children had more severe drug problems and among parents of children with attention deficit hyperactivity disorder. Of the respondents, 9.9% had been exposed to property crime during the past year. The level was higher among parents of children who were currently taking drugs, among parents of younger children and among parents whose children were living at home. Parents of adult children with drug problems run a high risk of being subjected to property crime by their children. The risk appears to be mostly related to the children’s drug problems and certain other circumstances pertaining to the children. Further research is needed on the extent and nature of this type of crime and about risk prevention for the parents.

Being a Parent to an Adult Child With Drug Problems: Negative Impacts on Life Situation, Health, and Emotions:

This study is about the vulnerability of parents to adult children with drug problems. The study is based on a self-reporting questionnaire (n = 687) distributed to parents in Sweden via family member organizations, treatment centers, and online communities. Most parents reported extensive negative consequences on relationships, social life, and mental health due to their children’s drug problems. Most parents also experienced strong feelings of powerlessness, grief, guilt, and shame. Many parents reported a negative impact on their economy and work ability. In general, fathers claimed to feel less of a negative impact than mothers. A more severe drug problem and life situation for the child was associated with a greater negative impact for the parents. Many parents experienced difficulties in securing adequate help both for their child and for themselves. The study shows the need for increased support efforts for this parent group.

Life as a drug user

This article is based on a field study I made in trying to understand the everyday life of drug users. I tried to answer the question why drugs stay in addicts’ lives. Is it because of the power of the drug? Or has life on the drug scene any advantages compared to the available life in ordinary society? The material, which was collected through ethnographic fieldwork in the milieus where the drug users spend their time, is based primarily on observations, conversations, and in-depth interviews. In this article I focus on a group of seven key informants, five men and two women, whom I met during the field-work. In between 1989 and 1995 I met these and other informants more than five hundred times. I introduce a metaphor by which I look at the addicts relation to the drug as a love affair. The relationship begins with a phase of falling in love, which leads to a decision either to live separately or to live together. In the latter case, the relationship is established as a marital relation, characterized by security, habits and routines, moments when passionate love flares up again, periods of doubt, and possibly a decision to break up. This break-up can lead to divorce from the drug, but the relationship can also be resumed after a period of separation. When I began my study after having worked for many years as a social worker, one of my basic assumptions was that there was a solidarity among drug addicts and that it was one of the main attractions of a life on drugs. I have since arrived at the conclusion that there is extensive sociality, but without solidarity. There is outward solidarity, vis-à-vis outsiders, authorities of various kinds. The primary expression of this outward solidarity is the principle of not to “snitch”. There is no inward solidarity, however. People let others down, trick their friends, steal from each other, expose others to risk, ignore pleas for help, and so on. The lack of solidarity is due to the fact that the addicts all do business with each other. The most important ways of making a living are based on deals: selling drugs to other addicts, doing break-ins together and sharing the loot, receiving goods from others and offering to sell them, exchanging goods for drugs, treating someone to a fix and expecting a fix in return, charging people who use their flat as a crash-pad, arranging contacts with pushers, selling on a commission basis for a pusher. Relations between the actors in the drugs world are generally permeated with economic relations. The lack of real solidarity is perhaps the main reason why addicts want to leave drugs behind. Only one of the key informants never talked about kicking the habit. Quite a few of them have tried to break out of their addiction. These attempts to break out - or to break into normal society - have demonstrated some of the difficulties facing an addict who wants to get established in ordinary life. As competent drug addicts, with a large network of contacts and a short planning perspective, they come to a world where this competence has no value, where it is essential to be able to plan ones economy, and where they know very few people who do not take drugs. They move to a new world, but the old world of drugs is always alongside it. Even if they move to a new town, they can recognize people of “their own kind” around them. Although staying in the addicts’ world means misery, betrayal, and even death, it has other features: the sociality, eventfulness, the short perspectives, the everything-will-work-out-fine attitude, the sense of competence, having something to do (in the form of criminal ways of making a living), and the artificial pleasure of the drugs. This can be contrasted with the alternatives offered to them by ordinary life: solitude, unemployment, poverty, idleness, the sense of being superfluous. Despite the difficulties, many of the informants make constant attempts to break into ordinary life. I see this as an expression of their having the same basic goals in life as people in general: that they want to live a normal life and be respected by normal people. The result of their efforts depends to a large extent on how they can fill the emptiness they meet when they quit drugs and a lifestyle completely connected with drugs.