Intrigued by the overwhelmingly positive response to the needle and syringe exchange program (NSP) by people who inject drugs in Stockholm, this article sought to untangle harm reduction in a prohibitionist drug policy context. The article drew on assemblage thinking and used semistructured individual interviews with 32 people who inject drugs, and three focus groups with staff at the Stockholm NSP. The aim was to dissect harm reduction in the form of NSP and how it worked to move people who inject drugs towards or away from drug-related harm. The analysis identified how bodies such as the NSP regulations, the setting, and stigma gathered in ways that reduced the capacity to move forward and enroll, as the inclusion of the NSP in the assemblage would decrease the capacity to uphold other connections considered to be more important. Regular NSP visitors however described how free injecting equipment, staff care, continuity, and trust were important objects that gathered in ways opening up for movement towards less harm. Fiercely, these profoundly caring experiences at the NSP could also block new becomings and moves forward as people who inject drugs, discouraged from previous negative experiences of other service providers and structural stigma, refrained from other connections that could improve their wellbeing. They risked becoming locked in at the NSP and similar services. A significant consequence of the agential cuts of us researchers, the staff, and policymakers alike, targeting primarily those that do access and benefit from harm-reducing interventions, is that alternative solutions embracing also those locked out and locked in become unimaginable.

Aim: This article examines how Swedish parents navigate the multifaceted challenges of parenthood while struggling with substance use problems, including both alcohol and illicit drugs, and societal stigma. It explores how parents present themselves as responsible caregivers while distinguishing between acceptable and harmful substance use in the context of parenting. Methods: The study uses data from unstructured 15 life story interviews, conducted over the phone or Zoom. The participants narrated their life stories related to substance use problems, covering various topics like education, relationships, and parenting. The interviews were analyzed using thematic analysis to reveal strategies used by participants to mitigate perceived harm from substance use problems, enabling them to present themselves as responsible parents. Results: Three main themes were identified: Hiding, compensating, and disappearing, focusing on time and place. The analysis shows that Swedish parents manage parenthood with substance use problems and societal stigma by concealing substance use problems and maintaining a ‘façade of normality’, often scheduling use when children are asleep. Some resort to hiding substances to create the illusion of moderation. Despite challenges, like needing alternative locations for substance use problems, parents emphasize active engagement in their children’s lives. Conclusion: This study highlights how parents with substance use problems navigate parenthood amid societal stigma, revealing their strategies and challenges. These insights are vital for healthcare professionals and policymakers crafting support interventions to address parental experiences and associated emotional burdens.

The comorbidity between problem gambling and substance use/abuse is high in many populations previously studied. However, the occurrence of problem gambling among individuals with substance abuse has not been thoroughly studied, which is especially true for individuals in inpatient or compulsory care. The present early-stage study explored the presence of gambling and problem gambling among inpatients in compulsory care in Sweden who has been court-ordered to treatment for their substance abuse (alcohol and/or drugs). The study furthermore investigates the use of preventive measures and treatment seeking. The most effective strategy to recruit participants (no incentive, incentive and incentive and face-to-face recruitment) was also explored. Twenty-one participants were recruited and seven of them had at-risk or problem gambling and none of them had accessed treatment. The best way of recruiting was to offer a gift certificate and inform about the study face-to-face. The implications are that individuals in compulsory care for substance abuse need to be screened for problem gambling, that recruitment for studies in this population is best carried out by offering incentives and educational efforts and that it might be beneficial for the clients in compulsory care to be offered gambling treatment. 

Background. Drug policy is prone to build on rationales based on different moralities rather than evidence. Less is known about how moralities influence drug policy implementation in practice. The aim was to analyze expressions of moralities among local policy-makers, professionals, and drug users in the context of the Stockholm needle and syringe exchange program (NSP).

Methods. Using political documentation from Stockholm (2003–2016), focus group (12 NSP staff), and 32 drug user interviews, moralities concerning drug policy and harm reduction were analyzed based on moral foundations theory and boundary work.

Results. Three main moral dilemmas were identified concerning the subjects, aims, and orientation of drug policy: whether drug users are worthy of inclusion to society; if the general public should be prioritized or the health of drug users, and the orientation of practices as based on control or autonomy. Policy debate was driven by virtues such as purity and authority, whereas staff and drug users valued care, fairness and liberty.Conclusions. The prohibitionist and abstinence-oriented Swedish drug policy has created social boundaries on the practice-level. Hence, users’ perspectives, and those who care about them, should be extensively involved in political discussions to foster a more moral and humane drug policy.

This study analyzes how emerging adults negotiate their relation to alcohol in the context of declining youth drinking and how this relationship changes over time. The sample consists of longitudinal qualitative interview data (N = 28) with 9 boys and 19 girls aged 15 to 21. The participants were recruited through schools, social media and non-governmental organizations from mainly the Stockholm region and smaller towns in central Sweden to reach a heterogeneous sample in terms of sociodemographic factors and drinking practices. We interviewed the participants in-depth three times between 2017 and 2019. Thematic coding of the whole data with NVivo helped us select four cases for more detailed analysis, as they represented the typical trajectories and showed the variation in the material. We used the master narrative framework and Bamberg’s narrative positioning analysis to examine the data. The analysis demonstrates what kinds of narrative alignments in identity development encourage heavy drinking, moderate alcohol consumption, and fuel abstinence. The results suggest that the decline in youth drinking is produced by a co-effect of multiple master narratives that intersect and guide the identity development away from heavy drinking.

It has been suggested that a pivotal explanation for the drastic decrease in young people’s alcohol consumption is the younger generations concern with taking responsibility for a variety of areas in their lives. Emanating from this, the overall aim of this article is to consider how alcohol and drinking situations are enacted among a group of emerging adults in Sweden from this ‘generation sensible’, and how they describe the relation between alcohol, pleasure and control. The study is based on 23 qualitative interviews with people aged 19–23. Inspired by assemblage theory we analyzed how important human and non-human elements congregate in described drinking situations. The analysis showed that alcohol is enacted as a strong psychoactive substance and described like other (illegal) drugs, rather than being seen as more harmless and acceptable. Pleasure in drinking is made possible through control and planning, and in downplaying the importance of drinking and the transgressive power of intoxication. We suggest that the risk-taking element in drinking is stigmatized among groups of emerging adults. It is concluded that while alcohol is described as unimportant to several participants, alcohol assemblages are not, therefore participants work hard to shape drinking situations to counteract loss of control.

The paper analyses how the Covid-19 pandemic affected young people’s alcohol-related assemblages, trajectories of becoming and identity claims in Sweden. The data is based on longitudinal qualitative interviews among heavy and moderate drinking young people (n=23; age range 15–24 years). The participants were interviewed two to three times before the Covid-19 pandemic and once at the end of it, between 2017 and 2021. The analysis draws on actor-network theory and narrative positioning approach. The analysis demonstrates how the lockdown produced trajectories of becoming boring, normal, stress-free, self-caring, self-confident and shielded. In these trajectories, drinking was positioned into relations that either increased young people’s capacities for well-being or decreased them. Due to the lockdown, some participants learnt to be moved by relations that contributed to replace drinking with competing activities, while others experienced that the lockdown made drinking a more attractive activity, turning it into a collective force that helped them to overcome isolation. The results show how drinking is a heterogeneous activity which may increase or decrease young people’s capacities for well-being, depending on what kinds of assemblages and trajectories of becoming it is embedded in.

Youth gambling is commonly described in policy and research as a high-risk behavior. To design relevant measures to prevent gambling problems among youth, it is important to understand how youth themselves relate to gambling. To explore how youth navigate their position on gambling in the context of their everyday lives, we conducted qualitative interviews with 35 participants aged 17–21 years in Sweden; 15 had gambled and 20 had experience of others’ gambling. The thematic analysis showed that both gamblers and non-gamblers overall had negative attitudes toward gambling and emphasized repeatedly discourses of personal responsibility in it. The participants used various neutralization techniques to navigate the economic and addictive risks of gambling. Youth who gambled distanced themselves from the risks of gambling by drawing a line between themselves and excessive gamblers, between safe and unsafe gambling, or highlighted how their skills and strategic thinking made gambling less problematic. Also, gambling in liminal circumstances abroad or in alcohol-serving venues offered a safe time and place for gambling by separating it from everyday life practices. The findings provide important cues to how young people locate gambling in their everyday life, which is useful knowledge for policy and prevention.

Since the 2000s, there has been a worldwide trend of decreased alcohol consumption among young people. Although recent studies have given multiple explanations for this, we know little about the meaning of alcohol for this generation as they enter adulthood. The aim of this article is therefore to describe and analyze the age-related views toward alcohol among this group as they transition from adolescents to adults. The study was based on 39 qualitative interviews with people aged 17–21. Theoretical concepts such as doing age and symbolic boundaries were used to analyze the material and investigate how age can structure alcohol use, and how alcohol consumption can be narrated to produce maturity and adulthood. The analysis showed that participants presented their relation to alcohol in nuanced and responsible ways, signaling maturity. The participants’ navigation of acceptable alcohol consumption differs in terms of agency and control in different life phases. ‘Doing adulthood’ in relation to alcohol for abstainers and drinkers seems to center on the same understandings of legitimate behavior: being moderate, nuanced, and in control. This focus linked alcohol to the position these emerging adults hold in wider society, given that participants incorporated societal demands for a neoliberal lifestyle.

Background: The Covid-19 restrictions – as they made young people's practices in their everyday life visible for reflection and reformation – provide a productive opportunity to study how changing conditions affected young people's well-being and drinking practices.

Methods: The data is based on qualitative interviews with 18- to 24-year-old Swedes (n=33) collected in the Autumn 2021. By drawing on the socio-material approach, the paper traces actants, assemblages and trajectories that moved the participants towards increased or decreased well-being during the lockdown.

Results: The Covid-19 restrictions made the participants reorganize their everyday life practices emphatically around the home and communication technologies. The restrictions gave rise to both worsened and improved well-being trajectories. In the worsened well-being trajectories, the pandemic restrictions moved the participants towards loneliness, loss of routines, passivity, physical barriers, self-centered thoughts, negative effects of digital technology, sleep deficit, identity crisis, anxiety, depression, and stress. In the improved well-being trajectories, the Covid-19 restrictions brought about freedom to study from a distance, more time for significant others, oneself and for one's own hobbies, new productive practices at home and a better understanding of what kind of person one is. Both worsened and improved well-being trajectories were related to the aim to perform well, and in them drinking practices either diminished or increased the participants’ capacities and competencies for well-being.

Conclusions: The results suggest that material domestic spaces, communication technologies and performance are important actants both for alcohol consumption and well-being among young people. These actants may increase or decrease young people's drinking and well-being depending on what kinds of relations become assembled.