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AbstractBackgroundMethodsResultsConclusionThe COVID-19 pandemic had many serious consequences for vulnerable populations, but it also gave rise to innovations and changes of established ways of providing services for such populations. In Copenhagen, Denmark outreach opioid agonist therapy (OAT) was such an innovation.Based on qualitative interviews with 15 individuals who received outreach OAT this article describes this new service and presents OAT clients’ experiences of previous OAT and outreach OAT. Analytically the article draws on literature about people who use drugs’ experiences of barriers when wanting to access drug treatment and other services.The participants had experienced significant systemic and social barriers in relation to outreach OAT. Outreach OAT helped to minimize both types of barriers. It also created new opportunities for providing care because treatment took place in participants’ own environments.Outreach OAT has the potential to minimize treatment barriers for some of the most vulnerable people who use drugs. It is however also important to review and possibly change system design, guidelines, and practices of the existing system to better accommodate the program to the needs of vulnerable people. [ABSTRACT FROM AUTHOR]

This research note reports on five online workshops by an international team of scholars, the authors, with shared interests in drug (mis)use. The workshops comprise a novel form of collective international qualitative secondary analysis (iQSA) exploring the possibilities for, and value of, qualitative data reuse across international contexts. These preparatory workshops comprise the preliminary stages of a longer programme of methodological development of iQSA, and we used them to identify what challenges there may be for translating evidence across international contexts, what strategies might be best placed to support or facilitate analytical engagement in this direction, and if possible, what empirical value such exchange might have. We discuss how working across international contexts involved the authors in new 'translational' work to address the challenges of establishing and sharing meaning. Such 'translation' entailed a modest degree of empirical engagement, namely, the casing of empirical examples from our datasets that supported an articulation of our various research studies, a collective interrogation of how, why and which such cases could be used for best translational effect and a collective reflexive engagement with how these cases generated new and novel questions that in turn re-engaged us with our own data in new ways. Descriptions of our datasets, therefore, emerged as multifaceted assemblages of 'expertise' and comprised the evidential bases for new empirical insights, research questions and directions. [ABSTRACT FROM AUTHOR]

AIM - To present a historical account of how addiction has been conceptualized and handled in Denmark from the 1870s to the 1980s. DESIGN - Analytically the account is inspired by elements from Michel Foucaults archeology of knowledge by focusing on how established ways of thinking, talking and acting in relation to drugs and drug use from time to time were challenged by changes with regard to which drugs were used, how they were used and by whom they were used. FINDINGS - The account is structured in four parts that covers the dominating ways of conceptualizing and handling drug related problems in four different periods. These periods are: (1) the era of ‘chronic morphinism’, (2) the era of ‘euphomania’ and the emergence of drug use as a criminological issue, (3) the era of ‘youth-euphomania’ and (4) the emergence of harm reduction as a way to conceptualize and handle drug related problems.

Although the association between substance use and violence has been well established, knowledge on predictors for violent victimization of individuals treated for alcohol use disorder (AUD) or drug use disorder (DUD) is lacking. Using Goldstein's tripartite conceptual framework, this study examines the relationship between substance use and violent victimization. Data were derived from national registers on persons aged between 15 and 75 years, living in Denmark, and admitted for AUD or DUD treatment during 2006-2016 (n = 82,767). Rates of new incidence of violent victimization were estimated per 10,000 person years for the patient cohort, and for an age- and gender-matched control group of 492,397 people with no history of treatment for drug and alcohol problems. The incidence of victimization for the AUD/DUD sample was 145.6 per 10,000 person years and 5.4 per 10,000 person years for the comparison cohort. Results of multivariate Cox regression on specific types of substance use supported Goldstein's psychopharmacological and economic compulsive models of victimization, but not the systemic model. Gender-stratified results showed that the use of cannabis and methadone was associated with victimization in women treated for AUD and DUD. Patients with a non-Western background were more likely to experience victimization than Danish patients. The study highlights the strong association between substance use disorder and victimization, and the important role that service providers play in addressing the high levels of victimization experienced by patients with AUD or DUD. [ABSTRACT FROM AUTHOR]

In 2004 the Danish Parliament re-penalized possession of illegal drugs for personal consumption after 35 years of de-penalization. This article presents an analysis of this shift away from a relatively fiberal drug policy and towards a more repressive drug policy and places it in a context of the shifting balances between control and welfare in Danish drug policy since 1955. The article analyzes the background for the first penalization of possession in 1955, de-penalization in 1969 and repenalization in 2004, focusing particularly on how the drug using subject was constructed at these three important moments in the history of Danish drug policy. The article furthermore analyzes the changes in 1969 and 2004 as part of more general changes of welfare policy and penal policy in Denmark. The article is based on analyses of Danish drug legislation and policy documents.

Drug consumption rooms (DCRs) have the potential to have a positive impact on the opioid overdose crisis. DCRs could also potentially change the political environment for public health because they can affect the distribution of responsibility for harm reduction between the individual and society by collectivizing responsibility for harm reduction through welfare regimes. The methodology is based on 2 case studies—1 in Copenhagen, Denmark, and 1 in Paris, France—about residents, people who inject drugs (PWID), and politicians' experiences of DCRs involving semidirective interviews. Denmark has a long history of harm-reduction policy, and the implementation of DCRs in Copenhagen has happened through close collaboration between local authorities and the local community. France is far more centralized and paternalistic in terms of the distribution of authority and decision-making in welfare and drug policy. Difficulties in cohabitation between local residents and PWID happened in both countries and can sometimes make public authorities hesitate to implement DCRs because of the NIMBY ("not in my backyard") phenomenon. However, the Danish and French case studies show that DCRs have the potential to become an instrument for civic cohabitation as well as to contribute to the destigmatization and health of PWID. (Am J Public Health. 2022;112(S2):S159–S165. https://doi.org/10.2105/AJPH.2022.306808) [ABSTRACT FROM AUTHOR]

Background : The aim of this study was to document employees' experiences of changes in service provision for substance use disorders (SUDs) during the first COVID-19 lockdown in Denmark (spring 2020), as well as to examine their relation to challenges in meeting the service users' needs. Methods: Employees (N = 373) working in SUD treatment and harm reduction services completed an online survey soon after the first national lockdown. The survey included questions about changes in service provision during the lockdown, perceived concerns of the service users, and challenges in meeting the users' emerging needs. Results: Employees reported some positive changes in service provisions, such as increased flexibility in appointments, administering medication-assisted treatment (MAT), and use of telehealth. Negative changes were related to reduced contact with practitioners and harm reduction facilities. Approximately one third of employees reported significant challenges in meeting the users' emerging needs. This was particularly so when users' concerns were about physical and mental well-being, and substance use. In regression models, negative changes in the access to practitioners and MAT administration (but not other changes) predicted difficulties meeting the users' needs. Conclusion: Employees in SUD treatment and harm reduction services in Denmark experienced both positive and negative changes as a result of the first lockdown. However, not all the provision changes were linked to challenges in meeting the users' needs. We discuss practical and research implications of our findings with a focus on the users' physical and mental health, use of telehealth, MAT, and overall service reorganisation. [ABSTRACT FROM AUTHOR]

The inner-city area of Inner Vesterbro in Copenhagen, Denmark, houses the largest open drug scene in Scandinavia. Since the 1980s, the area has been a gathering point for people who use, buy, and sell drugs. During the last two decades, urban redevelopments have resulted in marked demographic changes amid concerns about processes of gentrification. The drug scene, however, remains, and the last 7 years have seen the implementation of a new police strategy of "nonenforcement" of minor drug possession offences alongside the opening of two drug consumption rooms (DCRs) in the area. This article presents findings from a study of resident attitudes toward local DCRs and daily experiences of the open drug scene. Specifically, we draw on material generated via an online questionnaire distributed among residents in the area (N = 566) and qualitative interviewing of 33 residents. The article also proposes a change in perspective toward drug scene encounters, one that is not hinged exclusively on a narrow understanding of nuisances understood as negative affective states. This new approach is employed in an analysis of resident experiences of drug scene encounters. The analysis shows that rather than experiencing drug users and the drug scene exclusively as a nuisance or threat to community order, most residents are supportive of DCRs and generally accept the presence of a drug scene in the area. The article concludes with a brief discussion of results and their relation to current debates on urban coexistence, progressive harm reduction initiatives, and public space management. [ABSTRACT FROM AUTHOR]

Results from a study of zero-tolerance drug policy in Denmark are presented. Database research shows that an increasing number of Danes are criminalized for possession of illicit drugs and that particular characteristics of offenders increase the chance of being criminalized. Qualitative case studies show ambiguous results. Criminal records do not indicate that particular people are singled out. Interviews with police officers indicate that appearance of persons and non-offending behavior can play a role in suspicion formation and legal action. The ambiguity of the results can be seen as a reflection of the differences in the data where some of the grounds for police intervention may be seen by police officers as not appropriate for official recording. To resolve these issues and provide better knowledge regarding drug policing in Denmark, further research is needed. [ABSTRACT FROM AUTHOR]

In Denmark, outpatient substitution treatment has traditionally been associated with a great deal of ambivalence and control. Until the late 1990s, a condition for entering substitution treatment was that the user ceased using illicit drugs. Failure to comply would in many cases mean expulsion from treatment. However, since the late 1990s/early 2000s, a more liberal substitution treatment policy has developed, which recognizes continued attachments to illicit drugs and drug scenes for many drug users. With this shift in treatment rationality, treatment encounters between social workers and drug users can be analyzed as experiments enacting new relations between legal and illegal drugs, bodies, and environments. Drawing analytical inspiration from material semiotics and actor-network theory, this article focuses on how “outside” relations are articulated and become visible “inside” outpatient treatment encounters. Against this backdrop, we analyze the trial and error involved in stabilization as a set of ongoing processes relating to configurations of heterogeneous material networks. The article presents by way of a case study a detailed analysis of these entanglements, drawing on data from two qualitative studies of outpatient substitution treatment in Denmark. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to map research communities related to heroin-assisted treatment (HAT) and the scientific network they are part of to determine their structure and content. Design/methodology/approach – Co-authorship as the basis for conducting social network analysis with regard to degree, weighted degree, betweenness centrality, and edge betweenness centrality. Findings – A number of central researchers were identified on the basis of the number of their collaborative relations. Central actors were also identified on the basis of their position in the research network. In total, 11 research communities were constructed with different scientific content. HAT research communities are closely connected to medical, psychiatric, and epidemiological research and very loosely connected to social research. Originality/value – The first mapping of the collaborative network HAT researchers using social network methodology. [ABSTRACT FROM AUTHOR]

The neighborhood of Vesterbro in Copenhagen has housed the largest open drug scene in Denmark since the 1980s. In recent years there has been a remarkable change in the police strategy towards this drug scene from zero tolerance to a non-enforcement strategy. This article presents a case study of this change in strategy and its implications for more general discussions about drug control and harm reduction. With inspiration from the governmentality literature, in particular how government involves the construction of governable spaces, and police research that emphasizes the territorial aspects of policing, the article seeks to characterize the difference between the two drug control strategies at Vesterbro. The analysis is based on original research and secondary literature. The article concludes that the non-enforcement strategy opens up the drug scene to new kinds of intervention by police and social welfare institutions, and that it changes the relationship between social welfare provision and policing. [ABSTRACT FROM AUTHOR]

The Centre for Alcohol and Drug Research (CRF) has since its foundation in 1991 had a strong tradition for research in drug control. However, researchers at CRF have also started to study drug policy not only from a control perspective but also from a perspective of health and welfare issues. From 2005, CRF has developed a particular interest in how welfare policies related to drug issues come into being and how they are implemented in practice in different welfare institutions. These studies, in opposition to more established drug policy studies based primarily on quantitative and statistical data, use a broader variety of empirical data collected using qualitative interviews and ethnographic observations. The article investigates the development of drug policy studies at CRF and discusses the theoretical and analytical implications of this development. The development is related to, first that the organization of the Danish drug field has changed and a variety of new social and health initiatives have emerged, necessitating a thorough investigation; and, second that more anthropologists and sociologists have been employed at CRF, complementing researchers trained primarily in legal studies. [ABSTRACT FROM AUTHOR]

This article discusses how opioid substitution treatment policy has developed from 2000 to 2011 in Denmark. Empirically, it takes its point of departure in a stakeholder analysis including 17 qualitative interviews with stakeholders who have played important roles in this field. Analytically, it is inspired by Kingdon's concepts of agenda and policy window. Three major shifts are identified: a shift from psychosocial to medical thinking and practice, from an abstinence driven ideology to health care, and from perceptions of passive clients to user involvement. These shifts are discussed in relation to the legal context of substitute prescribing medicine. [ABSTRACT FROM AUTHOR]

This article uses the concept of "political pharmacology" to show that drugs are complex and mutable entities, the constitution of which is as much a political (power) issue as it is a technical one. The article analyzes the negotiations and struggles that have been involved in the constitution of methadone and heroin as maintenance drugs in Denmark. Danish drug policy on medical-maintenance treatment was for many years dominated by a medico-administrative technocracy. But from the mid-1990s, this technocracy, and the way it defined maintenance treatment and maintenance drugs, was challenged by drug users and other actors. They were, among other things, dissatisfied with the medical constitution of maintenance drugs as "stabilizing medications" and demanded that the drugs should also be allowed to function as "intoxicating substances." [ABSTRACT FROM AUTHOR]

AIMS - To analyze how two youth alcohol prevention campaigns funded by the Danish alcohol industry articulate the relationship between alcohol, intoxication and pleasure. DESIGN - The two campaigns are first analyzed by applying an analytical model developed by Kartsson and Bergmark (2009) to analyze drug prevention campaigns in Sweden, After this a more detailed analysis of how the two campaigns articulate pleasure is done. RESULTS - Both campaigns recognize recreational motives for consuming alcohol. In both campaigns pleasure is central to the regulation of alcohol consumption among young people. Both campaigns aim to associate alcohol consumption with a disciplined pleasure that does not involve intoxication. In this way alcohol policy becomes a politics of pleasure. CONCLUSION - Alcohol prevention that aims to moderate alcohol consumption among young people by associating alcohol consumption with disciplined pleasure can be seen as a corporate social responsibility strategy by the alcohol industry. These strategies become relevant to include in order to understand prevention efforts within the national state. [ABSTRACT FROM AUTHOR]

AIMS -- This paper explores different approaches to quantify the human costs related to drug use. DATA AND METHODS -- The data come from a representative survey of 3092 respondents above the age of 18 in four Nordic capitals: Copenhagen, Heisinki, Oslo and Stockholm. RESULTS -- The results show that in most Nordic capitals more than half of the respondents at some time have known and worried about the drug use of somebody they know personally. Moreover, while the average reported harm was about 2 on a scale from 0 to 10, a significant minority (1074 of those knowing drug users indicated that the harm was above 5. CONCLUSIONS -- Many persons have at some time personally known somebody who uses drugs. This causes significant human harm and should be included in the estimate of the social cost of illegal drugs. These results are relevant in the debate on the size of the drug problem as well as for targeting groups that experience the highest costs. [ABSTRACT FROM AUTHOR]

The aim of this article is to understand the recent changes of Danish drug policy, which have changed both the balance between and the content of control and welfare. For this purpose, Danish drug policy is seen as a 'policy space' where different political rationalities are articulated and played out against each other. The political rationalities articulated within the realm of drug policy are furthermore seen to be influenced by the political rationalities that dominate penal policy and welfare policy more generally. To account for the policy space of Danish drug policy today the article builds on analyses of legislation, policy documents and research related to the policy process. The article is furthermore built on secondary literature about Danish drug policy. The article finds that Danish drug policy articulates a particular mix of neo-conservative and neo-liberal political rationalities that constitutes the basis for the balance between control and welfare in Danish drug policy today. [ABSTRACT FROM AUTHOR]

The article reviews the book "Drugs, Crime and Public Health: The Political Economy of Drug Policy," by Alex Stevens.

This article presents results from a study of clients' experiences of attending an opioid substitution treatment clinic in Copenhagen, Denmark. The study is part of a research project about the everyday lives of marginalized people who use drugs in Copenhagen, their risk environments, and their access to formal and informal resources. Thirty-eight clients participated in structured interviews, covering topics concerning drug use, income, housing, social relations, violence, and use of health and social services. A risk environment/enabling environment framework was developed to analyze the data. The study highlights the importance of including the drug scene that surrounds the clinic to understand the clinic as both an enabling, constraining, and risky environment affecting the clients' everyday lives, their safety, health, and well-being. The study shows that the clinic gives the clients access to different material, social and affective resources, but that access to resources often involves different trade-offs. For the clients, such trade-offs include balancing enabling and risky aspects of interaction with other clients or accepting constraints to get access to substitution medicine. Some clients accept such trade-offs, others do not and choose to find other ways to get resources, exposing themselves to potential harm. By paying particular attention to these trade-offs, this study provides a nuanced picture of the clinic's dual role in both being a source of stability and a place that many clients associate with feeling worried and insecure. [ABSTRACT FROM AUTHOR]