Nordic Studies on Alcohol and Drugs

Alcoholics Anonymous's non-hierarchical and non-bureaucratic organisation structure and its ability to maintain its unity is unique. AA has a “formal” level of decision-making – the AA service structure. The main activity for most members, however, is the grass-root activity in individual AA groups. There are certain tensions between these two. This case study analyses a conflict around the movement's decision-making structure in Finland in the late 1990's. The disagreements led eventually to the founding of a new AA service structure which led in fact to 2 parallel service structures. The study also looks at the consequences the conflict had on the Finnish AA movement and its vitality.

The data is qualitative and consists primarily of taped interviews with 26 AA members. In addition, textual material written by AA members was analysed.

The analysis of the interviewees' accounts revealed that the conflict was rooted in the movement's concrete decision-making practices as well as collective identities entwined with the members' social position. The grass-root activity of AA groups remained active despite the disputes on the movement's organisational level and a majority of the members remained uninterested in the dispute. The conflict did, however, affect the movement's ability to hold on to old members and attract new ones. Furthermore, it caused hurtful feelings to many and questioned the members' feeling of belonging together.

It is suggested that the fact that the conflict resulted in the founding of a new AA service structure – instead of for example further specialisation on the group level – reflects the Finnish society and its organisational traditions.

This paper focuses on one part of a sample from a large follow-up study on substance abusers in residential treatment. The aim of the paper is to describe the abstinent group prior to and in the first two years following residential treatment in Denmark.

The present paper is based on data collected in a follow-up study on substance abusers in residential treatment. The data were collected in the initial phase of treatment and twice in follow up interviews, respectively half a year and two years after termination of treatment, primarily through the use of a Danish version of EuropASI.

The study shows that few differences are found in the comparison of data prior to treatment, and that major differences appear in the years following treatment. In comparison to the non-abstinent groups the abstinent group has to a greater extent established itself in the labour market or in the educational system, and managed to establish and maintain a network of drug free friends and family, including contact with self-help organizations as the NA. The problem severity as measured with the EuropASI is found to have some shortcomings when it comes to evaluating and describing subjects with a very low degree of problem severity.

The aim of this study is to discuss the frame of action within which the alcohol and drug prevention work by non-profit organizations in Sweden is performed. What activities or methods are emphasized as preventive work? How are the goals formulated? What kind of organizations are financed for preventive work? Concepts such as actors, legitimacy versus efficiency and technology are discussed.

The empirical material consists of project applications and evaluations from the 150 non-profit organizations that during 1998 and 1999 received financial support from the National Institute of Public Health for preventive alcohol and drug work among adolescents, and scattered data from projects applying for but not receiving funding. The data was analyzed by grouping the projects according to type of applying organization, goals of the project, measures and target group.

A great variety of organizations receive funds for preventive work. Some of them, the temperance organizations and church-related organizations, have traditionally a strong position in Swedish prevention work, albeit recently weakened. Others, such as sports organizations, do not have preventive work in this field as their prime activity. The explicit overall goal of all projects is to prevent alcohol and drug consumption among adolescents but the operational goals and activities vary a lot and not all of them are clearly alcohol or drug related. Preventive work seems to have quite undefined borders. 1/3 of the projects could not keep the time limits. This could be related to short time financing.

In times when evaluation of social and health policy is emphasized, the relation between legitimacy and efficiency becomes central. The challenge will be to incorporate knowledge from the field in the creation of new and efficient tools and methods and to invite new organizations to take part in this work.