Polyphonic narratives: The mixing of Alcoholics Anonymous and relapse prevention in stories about recovery and relapse.

Aim: This exploratory study analyses the interplay between the treatment philosophies of Alcoholics Anonymous (AA) and Relapse Prevention (RP) in personal stories of addiction. While the basic ideas of AA and RP are compatible in many ways, they also carry some fundamental differences. Methods: The data consisted of interviews with 12 individuals recovering from substance use problems, who had experience of both AA and RP. The analysis drew on a dialogical narrative perspective, and the concept polyphony was used to shed light on the interplay between different treatment philosophies in personal stories of relapse. Findings: Although sometimes resulting in incoherence, the treatment philosophies were combined idiosyncratically, in ways that appeared productive for the participants' self-images and recovery journeys. Conclusion: The combination of AA and RP philosophies in narratives of relapse and recovery may reflect a new treatment discourse where individualisation and responsibilisation stand in a complicated relationship with collectivism and surrendering to so-called addicting processes.

How Covid-19 restrictions affected young people's well-being and drinking practices: Analyzing interviews with a socio-material approach.

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.

Self-interpellation in narratives about craving: Multiple and unitary selves.

The concept of addiction seeks to explain why people act contrary to their own best interest. At the centre stage of addiction discourse is craving, conceptualised as a strong urge to use substances. This article analyses how talk therapies such as relapse prevention and self-help groups shape identity constructions and understandings of craving among clients. Drawing upon interviews with individuals who have engaged in talk therapies in Sweden, we analyse how craving is made up through 'self-interpellation', that is, personal narratives about past, present or future thoughts, feelings and actions. The main 'self-interpellation' included multiple selves, where craving was elided by the true self and only felt by the inauthentic self. Less dominant were narratives which drew on a unitary self that remained stable over time and had to fight craving. The notion of multiple selves appeared as a master narrative that the participants were positioned by in their identity constructions. We conclude that this multiplicity seems ontologically demanding for people who try to recover from substance use problems. A demystification of craving, in which neither substance effects nor malfunctioning brains are blamed for seemingly irrational thoughts and actions, may reduce the stigmatisation of those who have developed habitual substance use.

Becoming Safe, Legal, Mature, Moderate, and Self-Reflexive: Trajectories of Drinking and Abstinence among Young People.

In recent years, a vast body of research has investigated trends of declining alcohol consumption among youths. However, the extent to which restrictive-youth approaches towards drinking are maintained into adulthood is unclear. The aim of this study is to explore how young people's relation to alcohol changes over time. Our data are based on longitudinal qualitative in-depth interviews with 28 participants aged 15 to 23 conducted over the course of three years (2017-2019). The study draws on assemblage thinking by analysing to what kinds of heterogeneous elements young people's drinking and abstinence are related and what kinds of transformations they undergo when they get older. Five trajectories were identified as influential. Alcohol was transformed from unsafe to safe assemblages, from illegal to legal drinking assemblages, from performance-orientated to enjoyment-orientated assemblages, and from immature to mature assemblages. These trajectories moved alcohol consumption towards moderate drinking. Moreover, abstinence was transformed from authoritarian assemblages into self-reflexive assemblages. Self-control, responsibility, and performance orientation were important mediators in all five trajectories. As the sober generation grows older, they will likely start to drink at more moderate levels than previous generations.

Has illicit drug use become normalised in groups of Swedish youth? A latent class analysis of school survey data from 2012 to 2015.

BACKGROUND: It is often assumed that illicit drug use has become normalised in the Western world, as evidenced for example by increased prevalence rates and drug-liberal notions in both socially advantaged and disadvantaged youth populations. There is accumulating research on the characteristics of young illicit drug users from high-prevalence countries, but less is known about the users in countries where use is less common. There is reason to assume that drug users in low-prevalence countries may be more disadvantaged than their counterparts in high-prevalence countries, and that the normalisation thesis perhaps does not apply to the former context. AIM: This article aims to explore to what extent such assertions hold true by studying the characteristics of young illicit drug users in Sweden, where prevalence is low and drug policy centres on zero tolerance. MATERIAL AND METHOD: We draw on a subsample (n = 3374) of lifetime users of illicit drugs from four waves of a nationally representative sample of students in 9th and 11th grade (2012-2015). Latent class analysis (LCA) on ten indicators pertaining to illicit drug use identified four classes which we termed "Marijuana testers", "Marijuana users", "Cannabinoid users" and "Polydrug users". FINDINGS: Indications of social advantage/disadvantage such as peer drug use, early substance-use debut and truancy varied across groups, particularly between "Marijuana testers" (low scores) and "Polydrug users" (high scores). CONCLUSIONS: Our findings corroborate the idea that the majority of those who have used illicit drugs in the Swedish youth population have tried marijuana a few times only. We discuss whether or not the comparably large share of socially advantaged "Marijuana testers" in a comparably small sample of lifetime users can be interpreted as a sort of normalisation in a prohibitionist drug policy context.

Favorable effects of clearly defined interventions by parents at the start of treatment of adolescents with restrictive eating disorders.

OBJECTIVE: To study the effect of clearly defined and decisive parental interventions at the start of treatment of restrictive eating disorders (ED) in adolescents. METHOD: Forty-seven adolescents with ED (anorexia nervosa = 6, bulimia nervosa = 1, EDNOS = 40) and their families participated. Parents were advised to (1) keep the adolescent home from school, (2) eat all meals together with the adolescent, (3) prevent any form of exercise, and (4) prevent vomiting during the first week of treatment. Weight change was followed up to three months and EDE-Q administered at start of treatment and at three months. RESULTS: Thirty (64%) of the families accomplished all four interventions during the first week of treatment. Their adolescents gained ∼ 1 kg of weight at one week, 2 kg at one month, and 4 kg at three months while adolescents in families who did not accomplish all four interventions gained only 1.4 kg up to three months. Scores on the EDE-Q decreased during treatment and in adolescents of families who accomplished all four interventions they were in the range of a reference population. DISCUSSION: Decisive parental management of eating disturbed behaviors at the start of treatment of adolescents with ED promotes later clinical outcome. The finding supports the view that family based therapies are effective in adolescent ED. Results has to be followed up for evaluation of the long term effects of this type of intervention.

A dawning demand for a new cannabis policy: A study of Swedish online drug discussions.

BACKGROUND: This study examines how online discussions on drug policy are formulating an oppositional cannabis discourse in an otherwise prohibitionist country like Sweden. The focus of the paper is to identify demands for an alternative cannabis policy as well as analysing how these demands are linked to governance. METHODS: The empirical material is 56 discussion-threads from the online message-board Flashback Forum that were active during the first eight months of 2012. Discourse theory was used to locate the discourse, and governmentality theory was used to locate the political belonging of the discourse. RESULTS: On Flashback Forum demands for a new cannabis policy are articulated in opposition to Swedish prohibitionist discourse. The oppositional discourse is constructed around the nodal points cannabis, harm, state and freedom that fill legalisation/decriminalisation/liberalisation with meaning. The nodal points are surrounded by policy demands that get their meaning through the particular nodal. These demands originate from neo-liberal and welfarist political rationalities. Neo-liberal and welfarist demands are mixed, and participants are simultaneously asking for state and individual approaches to handle the cannabis issue. CONCLUSION: Swedish online discourse on cannabis widens the scope beyond the confines of drug policy to broader demands such as social justice, individual choice and increased welfare. These demands are not essentially linked together and many are politically contradictory. This is also significant for the discourse; it is not hegemonised by a political ideology. The discourse is negotiated between the neo-liberal version of an alternative policy demanding individual freedom, and the welfarist version demanding social responsibility. This implies the influence of the heritage from the social-democratic discourse, centred on state responsibility, which have been dominating Swedish politics in modern times. Consequently, this study refutes that the demand for a new cannabis policy is strictly neo-liberal.