Nordic Studies on Alcohol and Drugs最新文献

Aim: To investigate the informal caregiving experiences of adult offspring of patients recently hospitalized with alcohol-related liver disease (ALD).

Methods: A narrative analysis was conducted building on 13 semi-structured qualitative interviews with adult offspring of patients who were recently hospitalized with ALD at a department of medicine. Analytical frameworks were the rites of passage framework and its concept of liminality, combined with Taylor's social imaginaries and Järvinen and Bloch's complementary role requirements.

Results: Adult offspring of patients with ALD described longstanding mental health issues that had worsened in response to their parent's repeated hospitalizations. They described how internalized and institutionalized ideas about family shaped a strong sense of moral obligation to care for their parent, which was often intensified when hospital staff implicitly positioned them as caregivers. The offspring described a prolonged liminal phase marked by recurring crises that prevented them from regaining a stable and ordinary everyday life.

Conclusions: The study demonstrates the emotional and moral dilemmas of informal caregiving in adult offspring of a parent hospitalized with ALD. This is a psychosocially vulnerable group whose wellbeing may be further compromised when they are drawn into caregiving roles. Healthcare professionals should avoid reinforcing such roles and rather engage in open dialogue, acknowledge their position and needs.

Aim: The present study examined the joint development and co-occurrence of psychological distress (mainly depressive and anxiety symptoms), heavy episodic drinking (HED) and daily cigarette smoking from adolescence to adulthood.

Methods: Data were drawn from two prospective longitudinal cohorts: the TAM study (N = 2194; ages 16-52 years) and the FinnTwin16 study (N = 5563; ages 16-35 years). Latent class analysis identified distinct trajectory groups, and multinomial regression was used to examine associations with sociodemographic factors.

Results: Across both cohorts, several trajectory groups emerged: low levels of all three health concerns, high levels of all and high distress with low-to-moderate substance use. In the TAM cohort with longer follow-up time, additional groups included increasing HED and a group indicating moderate levels of all with a peak in daily cigarette smoking. Sociodemographic factors were associated with trajectory group membership. Men were more likely to belong to groups characterized by higher HED and lower distress, while women were more often in groups with higher distress and lower substance use. Participants from non-nuclear families were more likely to belong to groups with elevated substance use or distress. Low parental socioeconomic position was associated with increased likelihood of belonging to high-risk groups in both cohorts.

Conclusions: These findings highlight the importance of considering the interplay between substance use and mental health across the life course, as well as the role of early sociodemographic context in shaping these trajectories. Tailored interventions and treatment should account for these differing developmental patterns and background factors.

Aim: Social investments are strategic allocation of resources to welfare programs, such as education or health care, expected to generate social and economic returns. In Europe, social investment has become a well established policy paradigm, yet research has rarely examined how it impacts how state-citizen relationships are understood. This article explores how the social investment discourse functions as a frame of interaction within welfare programs for young people with drug problems in Denmark.

Design: Theoretically, the article draws on Foucault's concept of discourse, Goffman's theory of frames and Hacking's notion of looping effects. Empirically, it presents two contrasting cases of young people with drug problems who position themselves as, respectively, good and bad investments.

Results: The social investment discourse provides some youths and their relatives with means to legitimize requests for help; it enables a selfpresentation as "a good investment", which can strengthen their sense of entitlement to welfare. In contrast, others come to view themselves as "bad investments". For them, the discourse frames programs as a waste of money, which risk to undermine the sense of entitlement among individuals who fear they might fail to benefit from welfare programs.

Conclusions: Social investment is a policy paradigm; it is not designed as a frame of self-presentation. Nevertheless, once its rationality enters public discourse, it produces new interactional frames and subject positions. An unintended but significant effect is that the discourse may stigmatize marginalized citizens, undermine their sense of entitlement to welfare, and weaken the universal, normative and rights-based principles underpinning the Nordic welfare states.

Aim: This study explores the justification for psychedelics use among 40 Finnish interviewees.

Methods: We conducted and analyzed 40 thematic interviews with Finnish psychedelics users employing justification analysis as an analytical framework. The study investigates justifications as expressed by the users.

Results: We found almost the full spectrum of Boltanski and Thévenot's justification logics represented in the interviewees' use justifications, with the exception of the logics of the market world. We formed an additional 'world of self' to capture justifications connected to various personal experiences, including pleasure, which is often overlooked in clinical research. The participants tended to make a distinction between the use of psychedelics and other drugs or intoxicating substances. The justifications employed ranged from personal level to societal level, and from spiritual to technological justifications. Overall, the justifications appeared largely influenced by the new wave of psychedelic research, self-experienced benefits and ideals of individualism. Reported positive effects included feelings of euphoria and other positive feelings, even when the use was motivated by self-development or self-medication.

Conclusions: The positive and more recreational aspects of psychedelics use are important for users and could be an essential part of the therapeutic benefits of psychedelics, which is often overlooked in the research.

Aims: Over the past 20-25 years, Sweden has placed growing focus on local alcohol prevention, as reflected in national action plans. However, municipal efforts vary considerably. Identifying the factors that influence stronger local alcohol prevention is important, given its association with reduced alcohol-related harm. The present study aims to examine the characteristics of municipalities with more comprehensive alcohol prevention efforts, focusing on: (i) need, indicated by alcohol consumption and related problems; (ii) financial resources; (iii) political orientation; and (iv) sociodemographic and socioeconomic factors.

Methods: Local alcohol prevention is measured using a developed version of the Alcohol Policy Magnitude Measure (APMM), covering 209 municipalities from 2011 to 2021. Linear and logistic regressions examine how APMM scores relate to factors such as alcohol use, harm, resources, politics and demographics. Both crude and adjusted models assess the robustness of these associations.

Results: Left-wing governance, larger populations and younger demographics were consistently linked to higher alcohol prevention levels. Of four need indicators, only one showed a consistent association. Financial resources were significant only in adjusted models, while education and foreign background showed mixed results. Unemployment was not associated with alcohol prevention, and income was significant only in crude models. These patterns were largely confirmed in analyses focusing on the top 10% of municipalities in terms of prevention activity.

Conclusions: Stronger alcohol prevention was not linked to higher consumption, harm or resources, but rather to left-wing governance, larger populations and younger residents. This highlights the influence of political and sociodemographic factors on local prevention levels.

Aim: To examine the strategies and tactics of the alcohol industry during the COVID-19 pandemic in Botswana, a time when the country implemented a hard lockdown with strict restrictions on the sale, distribution and consumption of alcohol.

Methods: A qualitative content analysis was conducted of newspaper articles (n = 11), policy documents (n = 2) and other online sources (n = 2) published between 2020 and 2021.

Results: The study shows that the alcohol industry was actively involved in influencing alcohol policy during the COVID-19 pandemic in Botswana. It mainly employed five main strategic framings, emphasising individual drinking behaviour, corporate social responsibility as a "good" deed, downplaying alcohol's role in COVID harm, treating the Botswana government as a "strategic partner" and using legal action to influence policy towards commercial interests to contradict public health protocols.

Conclusions: The activities by the alcohol industry during the COVID-19 provide insight into the increasing influence that industry actors have in Botswana policy-making. The studied strategies undermine public health interventions, demonstrating the urgent need to determine how this business sector impact health interventions in low and middle-income countries.

Aim: Decisions made by social work professionals determine the scope and nature of the help clients receive. These decisions rest on professional judgement, making it essential to understand the foundations of such judgement to grasp social work practice. This qualitative study explores professional decision-making and practice among Danish addiction counsellors working in outpatient treatment for alcohol use disorders. The aim was to examine what the counsellors base their professional judgements on and the reasoning that informs their decisions.

Methods: Utilizing the vignette method, we conducted semi-structured interviews with 12 addiction counsellors. Interviews were analyzed using thematic analysis.

Results: Our findings show how the counsellors base their professional judgements and decisions on knowledge and values, respectively. We identified differences among counsellors in how values were understood and applied. Several values lacked clear definitions and appeared in varying or subtly distinct forms.

Conclusions: The study underscores the need to clarify the values guiding social workers' judgements and decisions. Values shape how knowledge is used, making their clarification essential for evidence-based practice. Without such clarity, value-based practice becomes meaningless, and values cannot effectively guide professionals in their clinical work.