Medicalisation of the social perspective: Changing conceptualisations of drug problems in Finnish social care and substance abuse treatment

AIMS - Starting from the notion of the Finnish “non-medical approach” in the handling of alcohol and drug problems, this article analyses expressions of the medicalisation of drug problems and drug users in Finnish social work and specialised substance abuse treatment. The article focuses on the first drug wave, in the 1960s, and the second, at the end of the 1990s. DESIGN - The data consists of all texts on illegal drugs found in the years 1968-1972 and 1997-2001 in two leading journals of social work, one from the social care and social service field, the other issued by the key provider of specialist substance abuse treatment. The texts were systematically analysed (author(s), problem descriptions, suggested solutions, and words used for the problem and the drug user). RESULTS - In both periods, we found in the journals a social perspective on drugs and drug problems. There is more emphasis on prevention and more optimism on the possibilities of prevention in the first than in the second period. During the first period the call for medicine or medical solutions are few and the medical voices rare. Medical expertise gets more space in both journals in the second period. The predominant understanding of the problem changes from drugs as part of a new youth culture, possibly an epidemic in the first period, to a dependence/ addiction in the second. The description of the user shifts from a young person to a (marginalised) dependent or addict. The proposed solutions in the 1960s are (youth focused) social policy and social change, while the 1990s solutions highlight refined treatment and more specific interventions. The society seems difficult to change, and so do the established institutions. CONCLUSIONS - The medicalisation of the Finnish perspective on drugs in the 1990s is expressed through a narrowing of perspective on illegal drugs as social problems. While present, the social perspective is impotent