Change search
ReferencesLink to record
Permanent link

Direct link
Limits of evidence: The case of psychosocial interventions in a Swedish review of maintenance treatment research
Stockholm University, Faculty of Social Sciences, Department of Social Work. Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). (Addiction Research Group)
2009 (English)In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, Vol. 26, no 4, 399-414 p.Article in journal (Refereed) Published
Abstract [en]

In Sweden, maintenance treatment (MT) with methadone has been a controversial exception to drug-free treatment. However, efficacy, prescription control and the provision of simultaneous psychosocial treatment (PST) have provided MT with political legitimacy. This view, notably stressing that PST is an important complement to medication, was presented in central Swedish policy documents that paved the way for less strict MT regulations in 2005.

Aim: The present study aims to analyse how the various stakeholders involved in this policy process described and evaluated the efficacy and legitimacy of PST within the framework of the MT discussion.

Data & method: The data consists of a document authored by a state agency (a preliminary review of MT research) and various stakeholders' written commentaries on it. Different representations of PST (so-called constructions) were coded thematically and analysed using discourse analytical concepts.

Results: The results show that stakeholders' constructions of PST draw on different discourses related to the governance of Swedish opiate addiction treatment. Four constructions were identified, PST as: "mere complement" (narrow empirical discourse); "underrated intervention" (practitioner discourse); "preferred intervention" (ideological discourse) and "complex intervention" (anti-reductionist discourse).

The study illustrates how the narrow empirical discourse's construction of PST as a mere complement was challenged by the three other discourses, but shows that the former remained the dominant influence on subsequent MT regulations. It also highlights that references to beliefs and alleged facts are intertwined in stakeholders' rhetorical efforts to assign meaning to PST.

This suggests that science and ideology are interrelated in policy discussions on opiate addiction treatment, and that firm conclusions about the value of help interventions rely as much on scientific evidence as on strategic argumentation

Place, publisher, year, edition, pages
Helsingfors: National Institute for Health and Welfare , 2009. Vol. 26, no 4, 399-414 p.
Keyword [en]
psychosocial treatment, methadone, maintenance treatment, discourse, evidence
National Category
Social Sciences Social Work
Research subject
Social Work
URN: urn:nbn:se:su:diva-31762OAI: diva2:278487
Available from: 2009-11-26 Created: 2009-11-26 Last updated: 2010-01-15Bibliographically approved

Open Access in DiVA

No full text

Other links

Search in DiVA

By author/editor
Ekendahl, Mats
By organisation
Department of Social WorkCentre for Social Research on Alcohol and Drugs (SoRAD)
Social SciencesSocial Work

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Total: 66 hits
ReferencesLink to record
Permanent link

Direct link