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*AIM The aim of the paper is to study how the Addiction Severity interview (ASI) is integrated in the ordinary work of social services in two Swedish towns that use ASI regularly, According to an ideal model for using ASI, it should fulfil three functions: to be a structured tool for assessing client problems, to facilitate the follow-up of treatment measures for each client, and to form a basis for the systematic follow-up of treatment units. This paper asks specifically how ASI is used compared to this ideal ASI model, how ASI is viewed by the different hierarchical levels within the social service organisation, how the social worker's tasks are perceived, and how the use of ASI is followed up. * METHODS Qualitative interviews were undertaken with staff at different levels within the social service organization in the two towns, which were chosen from a county known for its extensive use of ASI. * RESULTS Although rhetorically the social workers have adopted the use of ASI, in practice, however, the use of ASI seemed rather far from ideal. The foremost advantage the social workers perceived with ASI was that it supplied basic information in an initial investigation of client needs. The problems connected to the use of ASI were that it is not suitable for all clients and that some clients are subjected to too many ASIs. Other problems were that it was hard to maintain sufficient quality in the use of ASI due to too high staff turnover and too few opportunities to conduct interviews, in spite of the well-known obstacles for efficient use of ASI, little control was undertaken to monitor use or how information from the interviews is used. *CONCLUSIONS The demand on social work to meet politician's expectations for service development can be in direct conflict with the practical considerations of the social service work, which may explain the shortfall between rhetoric and practice. From a political legitimacy point of view, it is more important that the social service organization is supported by the political funding sources than to meet demands for treatment efficiency. A Loose coupling between rhetoric and practice allows for ASI to be adopted only rhetorically. white the regular work can continue to meet the practical considerations. The use of ASI cannot therefore be seen as a simple solution to the problems that the Swedish treatment system is struggling with. [ABSTRACT FROM AUTHOR]

AIMS - The purpose of this article is to demonstrate how Swedish authorities and politicians have related to syringe exchange in Sweden during the last 25 years. As the syringe exchange in Sweden still is very limited, this study focuses on the arguments for and against syringe exchange. and how the question has been formulated in the political proposals during the period studied. METHODS AND DATA - Since 1988 the National Board of Health and Welfare conducted three major studies on the effects and relevance of syringe exchange. These studies, and the policy documents that followed, are qualitatively analyzed in this paper. RESULTS - The processes have all looked the same; NBHW has proposed syringe exchange programs, which are a mix of drug policy and infection control aspects. During the political process the proposals have changed so that the infections control aspects has been downgraded on behalf of drug-policy interests. The arguments for this change have to their nature been abstract. CONCLUSIONS - Even though Sweden established its first experiments with syringe exchange already in the mid-1980s. it is not before the year 2006 that the country's all counties by law are allowed to provide clean syringes to their drug users. However, the law is modeled on a fear of harmful effects of drug use, and a will to rather encourage drug treatment than other measures. Thereby the importance of the infections control aspect is heavily undermined. [ABSTRACT FROM AUTHOR]

There has been an increasing interest in drinking among older people in Sweden in recent years as today's older people drink more than previous generations and also constitute a larger part of the population. This paper examines survey data on drinking habits in combination with register data on alcohol-related harms to obtain a clearer picture of the importance of alcohol among older people in Sweden today. A clear majority older people in Sweden drink alcohol at least on a monthly basis: in 2007, the differences when compared to younger age groups were quite small Still, as regards levels of drinking and frequency of binge drinking, older people drank less than younger age groups. In contrast to younger age groups who reported less drinking between 2002 and 2007, older age groups tended to have stable or increasing consumption. In addition, alcohol-related mortality and hospitatisation as well as drink-driving, have increased among older people in recent years but not among younger groups. Cohort effects and media reports of the beneficial effects of alcohol are brought up as plausible explanations for the results. Implications for the total consumption model and the theory of collectivity of drinking culture are also discussed. [ABSTRACT FROM AUTHOR]

AIMS AND METHODS The purpose of the present paper is to investigate the ways in which women who inject heroin or amphetamines procure drugs and finance their drug use. The results are based on standardised interviews conducted at the needle exchange programme in Maimö between 1 July 2005 and 30 September 2006. In total, 188 out of the 232 women who visited the programme during this period were interviewed. RESULTS A vast majority of the women (93%) buy most of the drugs they use themselves. Among the women interviewed, the most common sources of income were: social benefits (45%), dealing (23%), prostitution (22%). theft (21%) and paid work (16%). A majority of the women (53%) reported use of both formal, and informal, incomes to finance their drug use over the last two weeks, just over a third of the women (36%) reported only formal incomes. and a small minority (12%) reported only informal incomes. A majority of the women also reported to have been provided with drugs by others. In most cases, the provider was a man (p>.01). Women with heroin as their principal. drug more frequently reported multiple sources of income (p>.01). income through prostitution (p>.001). dealing (p>.01) or theft (p>.05). whereas women with amphetamines as their principal drug more frequently reported income through paid work (p>.05) or pensions (p>.01). CONCLUSIONS Few women correspond to the stereotypical image of the homeless and outcast street addict who supports her drug habit mainly through prostitution and illegal activities or by contacts with mate addicts. The majority of the women in this study have a relatively stable housing situation, the vast majority (93%) are active actors on the drug market who buy most of the drugs they use themselves, and most of the women use incomes from both formal/illegal and informal/illegal sources. For most of the women, drugs provided by others only constituted a complement to those obtained by the women themselves. A few women, however, who did not report any personal income. seem to be highly dependent on others to secure a safe supply of drugs. Some women also reported that they had had to perform sexual, services in order to get access to drugs from male suppliers. For women with heroin as their principal drug. it seemed much more difficult to finance their drug use by legal incomes only. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate howcare managerswent about in theirwork with older people living at homeand having alcohol abuse problems. Method: Six focus group interviews and one interview with two participants were carried out. In total, 23 care managers from five different municipalities participated. Results: The care managers all stressed the fact that within home care, no addiction treatment was conducted. The role of home care was to provide good care helping older people in their everyday lives irrespective of their problems. The care managers had to push the limits for the available services to be able to help older people with alcohol abuse problems. The services offered are however strictly regulated in guidelines. Many older people with alcohol abuse problems were not interested in receiving home care, and they were seldom interested in having contact with the addiction unit. The self-determination of older people in need of home care is strongly stressed in legislation. If the older person did not want any help, there was not much the care managers could do. Conclusions: Since older people today drink more alcohol than earlier generations, there is a need for services and addiction treatment specifically directed at older people with alcohol abuse problems suitable for their needs. [ABSTRACT FROM AUTHOR]