AIMS - The objective of the study was to explore perceptions of different addictions among Swedish addiction care personnel. DATA - A survey was conducted with 655 addiction care professionals in the social services, health care and criminal care in Stockholm County. Respondents were asked to rate the severity of nine addictions as societal problems, the individual risk to getting addicted, the possibilities for self-change and the perceived significance of professional treatment in finding a solution. RESULTS - The images of addiction proved to vary greatly according to its object. At one end of the spectrum were addictions to hard drugs, which were judged to be very dangerous to society, highly addictive and very hard to quit. At the other end of the spectrum were smoking and snuff use, which were seen more as bad habits than real addictions. Some consistent differences were detected between respondents from different parts of the treatment system. The most obvious was a somewhat greater belief in self-change among social services personnel, a greater overall change pessimism among professionals in the criminal care system and a somewhat higher risk perception and stronger emphasis on the necessity of treatment among medical staff. CONCLUSION - Professionals’ views in this area largely coincide with the official governing images displayed in the media, and with lay peoples’ convictions.

The aim of this study was to examine the influence of user, staff and work unit characteristics on addiction care practitioners’ assessments of the severity of alcohol and drug use. A factorial survey was conducted among 489 social workers, therapists, nurses, doctors and executives from 77 addiction care units in the three largest Swedish counties. Staff assessed the severity of 10 fictive scenarios, vignettes (n = 4724), describing persons with varying social characteristics who were users of alcohol, cannabis or cocaine. The effects of user, respondent and work-unit variables on the practitioners’ severity assessments were estimated using multilevel regression analysis. The results show that perceived severity was influenced not only by the substance, the frequency and character of the negative consequences of the use, but also by the age, socio-economic status and family situation of the user. Women, older respondents and respondents with a medical education rather than a social work education were on average more inclined to assess the vignettes as being more severe. Analyses of various interactions revealed that practitioners viewed the drinking of young men as being less severe than that of young women. Doctors saw women's use as more problematic than men's, irrespective of the context. To conclude, alcohol and drug consumption is judged by different norms, depending on various characteristics of the users, of the practitioners and also of their workplaces. To avoid potential negative consequences of the application of such varying standards in addiction care, more individual reflection and workgroup discussion are needed.

The aim of the study was to analyze addiction care staff (N=447) perceptions of needs for psychosocial and medical treatment, and possibilities for self-change in relation to fictitious cases. By means of a factorial survey and multilevel analysis, the importance of user, respondent and work characteristics were estimated, with a particular focus on the comparison between healthcare staff and social services staff. Healthcare staff were more skeptical than social services staff towards self-change and assessed the need for medical treatment to be greater. Despite the ongoing medicalisation of Swedish addiction care, psychosocial interventions were still seen as a central part of treatment by both groups. The importance of user characteristics for the assessments was surprisingly similar across the two groups of staff, suggesting that staff perceptions are analogous to the governing images of substance use and treatment needs that prevail in society.

Men’s and women’s drinking tend to elicit different societal reactions, which may be attributed to different perceptions of masculinity and femininity. This study analyzes addiction care practitioners’ constructions of substance use and treatment needs in relation to gender. Data were collected by means of six focus group interviews with 30 addiction care practitioners. An interpretative repertoire of difference emerged, whereby women were constructed as being different from men in psychological, social, and biological respects. The practitioners related to gender in addiction care as an ideological dilemma resulting from the contradictory ideals of on the one hand treating everybody equally and on the other giving special attention to what is regarded as women’s needs. Reflections emerged regarding the need to be aware of one’s own stereotyped assumptions, and also to be attentive toward men’s specific problems, thus constituting a reflective repertoire. In order to avoid potentially stereotyped treatment, the application of a gender-sensitive approach should acknowledge the variety of ways in which femininity and masculinity may be performed.