PDF(Pubmed)
Abstract：
BACKGROUND: Policies to address substance use differ greatly between settings, where goals may range from zero-tolerance to harm reduction. Different approaches impact formats of care, policing, and even interpersonal interactions, and may play a role in the labelling and stigmatization of people who use drugs (PWUD). Where Sweden has a more restrictive policy, aiming to have a society free from drugs, Denmark has embraced harm reduction principles. The aim of this study was to explore PWUDs\' experiences of interpersonal interactions, policing, and service formats in the two countries.
METHODS: The data consists of 17 qualitative semi-structured interviews with Swedish PWUD who have been in both Sweden and Denmark. Recruitment took place at harm reduction sites in both countries, and through snowball sampling.
RESULTS: Participants reflected on how they were perceived by those in public spaces, and received by care systems and personnel. In public settings in Sweden, participants felt they were ignored, rendered invisible, and lost their humanity. In Denmark, they were perceived and acknowledged, valued as people. This was simultaneously linked to being embodied by the availability of differing service offerings and policing practices, which solidified their \"right to be out\" in public. Reflecting on their reception in the treatment system, strict formatting in Sweden caused participants to feel that an identity was projected upon them, limiting their opportunities or growth of new facets of identity. Care relations in Denmark fostered more opportunity for autonomy and trust.
CONCLUSIONS: A zero-tolerance policy and associated public discourses could solidify and universalize stigmatizing categorizations as a central feature of PWUD identity and reception from those around them, exacerbating social exclusion. Conversely, harm reduction-centered policies fostered positive interactions between individuals with care providers, public, and police, which may promote inclusion, empowerment, and wellbeing.
METHODS: The data consists of 17 qualitative semi-structured interviews with Swedish PWUD who have been in both Sweden and Denmark. Recruitment took place at harm reduction sites in both countries, and through snowball sampling.
RESULTS: Participants reflected on how they were perceived by those in public spaces, and received by care systems and personnel. In public settings in Sweden, participants felt they were ignored, rendered invisible, and lost their humanity. In Denmark, they were perceived and acknowledged, valued as people. This was simultaneously linked to being embodied by the availability of differing service offerings and policing practices, which solidified their \"right to be out\" in public. Reflecting on their reception in the treatment system, strict formatting in Sweden caused participants to feel that an identity was projected upon them, limiting their opportunities or growth of new facets of identity. Care relations in Denmark fostered more opportunity for autonomy and trust.
CONCLUSIONS: A zero-tolerance policy and associated public discourses could solidify and universalize stigmatizing categorizations as a central feature of PWUD identity and reception from those around them, exacerbating social exclusion. Conversely, harm reduction-centered policies fostered positive interactions between individuals with care providers, public, and police, which may promote inclusion, empowerment, and wellbeing.
摘要：
背景：解决物质使用的政策在设置之间差异很大，目标可能从零容忍到减少伤害。不同的方法会影响护理形式，治安,甚至是人际互动，并可能在吸毒人员（PWUD）的标签和污名化方面发挥作用。瑞典有更严格的政策，旨在建立一个没有毒品的社会，丹麦接受了减少伤害的原则。这项研究的目的是探索残疾人的人际互动体验，治安,和两国的服务形式。
方法：数据包括对瑞典和丹麦的瑞典PWUD进行的17次定性半结构化访谈。在两国的减少伤害地点进行了招募，通过滚雪球采样。
结果：参与者反映了他们在公共场所的感受，并由护理系统和人员接收。在瑞典的公共场合,参与者觉得他们被忽视了，呈现不可见，失去了他们的人性。在丹麦,他们被感知和承认，作为人的价值。这同时与不同服务产品和警务实践的可用性有关，这巩固了他们在公共场合的“权利”。反思他们在治疗系统中的接待，瑞典的严格格式化使参与者感到身份投射在他们身上，限制他们的机会或身份新方面的增长。丹麦的关怀关系为自治和信任提供了更多机会。
结论：零容忍政策和相关的公共话语可以巩固和普及污名化分类，将其作为PWUD认同和接受周围人群的中心特征，加剧社会排斥。相反，以减少伤害为中心的政策促进了个人与护理提供者之间的积极互动，public,和警察,这可能会促进包容，赋权，和幸福。
方法：数据包括对瑞典和丹麦的瑞典PWUD进行的17次定性半结构化访谈。在两国的减少伤害地点进行了招募，通过滚雪球采样。
结果：参与者反映了他们在公共场所的感受，并由护理系统和人员接收。在瑞典的公共场合,参与者觉得他们被忽视了，呈现不可见，失去了他们的人性。在丹麦,他们被感知和承认，作为人的价值。这同时与不同服务产品和警务实践的可用性有关，这巩固了他们在公共场合的“权利”。反思他们在治疗系统中的接待，瑞典的严格格式化使参与者感到身份投射在他们身上，限制他们的机会或身份新方面的增长。丹麦的关怀关系为自治和信任提供了更多机会。
结论：零容忍政策和相关的公共话语可以巩固和普及污名化分类，将其作为PWUD认同和接受周围人群的中心特征，加剧社会排斥。相反，以减少伤害为中心的政策促进了个人与护理提供者之间的积极互动，public,和警察,这可能会促进包容，赋权，和幸福。
