Esben Houborg

The Political Pharmacology of Methadone and Heroin in Danish Drug Policy

This article uses the concept of “political pharmacology” to show that drugs are complex and mutable entities, the constitution of which is as much a political (power) issue as it is a technical one. The article analyzes the negotiations and struggles that have been involved in the constitution of methadone and heroin as maintenance drugs in Denmark. Danish drug policy on medical-maintenance treatment was for many years dominated by a medico-administrative technocracy. But from the mid-1990s, this technocracy, and the way it defined maintenance treatment and maintenance drugs, was challenged by drug users and other actors. They were, among other things, dissatisfied with the medical constitution of maintenance drugs as “stabilizing medications” and demanded that the drugs should also be allowed to function as “intoxicating substances.”

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.

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.

Addiction, Drugs, and Experimentation Methadone maintenance treatment between “in here” and “out there”

In Denmark, outpatient substitution treatment has traditionally been associated with a great deal of ambivalence and control. Until the late 1990s, a condition for entering substitution treatment was that the user ceased using illicit drugs. Failure to comply would in many cases mean expulsion from treatment. However, since the late 1990s/early 2000s, a more liberal substitution treatment policy has developed, which recognizes continued attachments to illicit drugs and drug scenes for many drug users. With this shift in treatment rationality, treatment encounters between social workers and drug users can be analyzed as experiments enacting new relations between legal and illegal drugs, bodies, and environments. Drawing analytical inspiration from material semiotics and actor-network theory, this article focuses on how “outside” relations are articulated and become visible “inside” outpatient treatment encounters. Against this backdrop, we analyze the trial and error involved in stabilization as a set of ongoing processes relating to configurations of heterogeneous material networks. The article presents by way of a case study a detailed analysis of these entanglements, drawing on data from two qualitative studies of outpatient substitution treatment in Denmark.

Methadone, a contested substance: Danish methadone policy in the 1970s

BACKGROUND During the 1970s in Denmark, there was a great deal of controversy about the role of methadone in Danish drug policy. At stake were not just epistemological issues about how to explain drug problems or indeed technical issues about the best possible treatment for such problems, but also social issues about how drug problems and drug treatment affected and were affected by social change. The paper uses an analytical framework in which drugs are co-constructed with their social worlds. It uses this framework to investigate how conflicts emerged about the different ways of conceiving of the relationship between methadone and Danish society. METHODS Documentary data from the archives of a pressure group of parents of children with drug problems, the archives of an addiction doctor, newspaper articles, and policy documents from that time were coded in order to identify and analyze central controversies. RESULTS The methadone controversy of the 1970s was not just about the best treatment methods, but also a matter of the future of the Danish welfare state. The nation debated whether it should medicalise a social problem or solve it through social reform. CONCLUSION Drug treatment is not just a technical issue, but also a political issue and this needs to be accounted for when making drug policy.

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.

Drug policing in four Danish police districts

Abstract Results from a study of zero-tolerance drug policy in Denmark are presented. Database research shows that an increasing number of Danes are criminalized for possession of illicit drugs and that particular characteristics of offenders increase the chance of being criminalized. Qualitative case studies show ambiguous results. Criminal records do not indicate that particular people are singled out. Interviews with police officers indicate that appearance of persons and non-offending behavior can play a role in suspicion formation and legal action. The ambiguity of the results can be seen as a reflection of the differences in the data where some of the grounds for police intervention may be seen by police officers as not appropriate for official recording. To resolve these issues and provide better knowledge regarding drug policing in Denmark, further research is needed.

Heroin assisted treatment and research networks

Purpose – The purpose of this paper is to map research communities related to heroin-assisted treatment (HAT) and the scientific network they are part of to determine their structure and content. Design/methodology/approach – Co-authorship as the basis for conducting social network analysis with regard to degree, weighted degree, betweenness centrality, and edge betweenness centrality. Findings – A number of central researchers were identified on the basis of the number of their collaborative relations. Central actors were also identified on the basis of their position in the research network. In total, 11 research communities were constructed with different scientific content. HAT research communities are closely connected to medical, psychiatric, and epidemiological research and very loosely connected to social research. Originality/value – The first mapping of the collaborative network HAT researchers using social network methodology.

ALICE RAP: Interim Report on Gambling

Permission to include in Alberta Gambling Research Institute research repository granted by Fleur Braddick on November 25, 2013.