Contemporary Drug Problems

Sweden has a long tradition of restrictive policies regarding both legal (such as alcohol and cigarettes) and illegal substances (such as cannabis and amphetamine). However, research is needed on how regulatory frameworks and cultural understandings of substance use play out in the lives of young adults. Utilizing the logics of critical explanation framework, I explore the different logics that young Swedes draw upon when they conceptualize legal and illegal substance use. The data included 30 interviews with 21/22-year-olds who had previously participated in a prospective cohort study. The analysis shows that substance use played a minor role in the participants’ lives. Overall, it represented an obstacle to becoming an adult with a good life. They drew on social logics related to responsibility, ambition, and health to make sense of substance use, regardless of its legal status. These social logics have been used to explain previous years’ decreased use of cigarettes and alcohol among young people, and this study shows that they may also elucidate why illegal substance use is still rare in this group in Sweden. The analysis further suggests that these social logics were naturalized through the political logics of risk and choice, which emphasize the ideal of always being vigilant and safe. To dig deeper into this discourse, I uncover the emotional and ideological dimensions of the participants’ conceptualizations by discussing how they articulate beatific or horrific futures. The beatific future holds a promise of a bright, independent, and productive life, which includes abstaining from substances or using them moderately and responsibly. The horrific, in turn, holds that careless substance use will lead to social exclusion, addiction, and death. The participants’ hopes and fears strengthened the neoliberal idea that a good life is achieved through choice, vigilance, and by avoiding risk.

Opioid dependence is a chronic health condition with significant public health implications. Opioid dependence treatment (ODT) has evolved considerably over time. In New South Wales, Australia, ODT prescribing has been available since 1970, managed by both state health services and private practitioners, mostly general practitioners (GPs). This study investigated how various health initiatives influenced GP engagement in ODT prescribing in New South Wales. The research employed a mixed-methods approach, combining document review, key informant interviews, and quantitative prescriber data analysis. Findings revealed a substantial increase in GPs prescribing ODT since the 1970s, with GPs providing care for half of the ODT-treated population by 2022. However, only a small percentage of GPs offered ODT, resulting in limited access and unmet treatment needs. The ODT structure remained vulnerable to potential disruptions in prescriber availability. These results highlight the complex interplay between policy initiatives and clinical practice in addressing opioid dependence. The study underscores the need for long-term, diverse strategies to improve ODT access and support GP involvement in providing comprehensive care for individuals with opioid dependence.

Public drinking practices among socially marginalized people remain highly stigmatized. Unlike public drinking practices among young people in Denmark, little attention has been put on the meanings and value attributed to such settings by people at the margins. In this paper, we examine public drinking practices of socially marginalized people with a Greenlandic background living in Denmark with attention to public squares where participants gathered. We introduce the concept of “squared drinking” to support a focus on emplaced public drinking that looks “beyond harm” and risk in understandings of stigmatized drinking practices. With “squared drinking” we seek to conceptualize public drinking as a particular socio-spatial phenomenon. With attention to the meanings attributed to such spaces by marginalized people with a Greenlandic background, we show how squared drinking practices serve to (1) anchor social connection in place and cultivate a space of belonging for individuals experiencing significant structural inequalities in the Danish welfare system. Moreover, (2) we approach public drinking squares as spatially confined settings where stigmatized populations process everyday experiences of marginalization and exclusion in the Danish welfare state and act upon emerging needs. Finally, (3) we show how, although public squares associated with drinking among marginalized communities are often portrayed as wild and unregulated settings beyond the reach of the welfare state, such settings simultaneously function as spatially bounded but excessively targeted sites of control and care. In conclusion, we thus suggest that it makes sense to understand “squared drinking” spaces as emerging not in spite of welfare regulation. Instead, such spaces might be understood as co-constituted by welfare practices, both as a result of excessive regulation and due to the interstices in Danish welfare provision to marginalized citizens.

Access to cannabis for medicinal purposes in Brazil faces many restrictions. The country does not have a law establishing clear regulation for this issue, creating a context characterized as a “weak legal governance.” This allowed social actors to build their own dynamics of access to the plant and its products, often on the fringes of the law, by using strategic mechanisms of action. The most expressive case is the creation and functioning of non-profit cannabis patient associations (CPAs), whose activities have redefined the policy design “space” of cannabis medicinal use in the country. The specialized literature still lacks an analysis of these cases and their contribution to the new governance of cannabis regulations. The article intends to address this gap. To this end, a literature review in the field of public policy and related areas, as well as a qualitative analysis of secondary data, was conducted. To complement this information, primary data was collected through five semi-structured interviews with key representatives from CPAs and with the Legal Network for Drug Policy Reform. The conclusion is that Brazil has an alternative bottom-up cannabis regulation model created by a “leadership configuration” in which CPAs are protagonists. They assume this role by acting based on the idea of civil disobedience to the drug law and functioning as social devices for politicizing medical cannabis use. This alternative regulation promotes more democratic access to cannabis-based medicines but remains embedded in Brazil's racist and classist prohibitionist framework, adding a new layer to it rather than replacing it..