Bakgrund: Drogbruk är ett fortsatt växande folkhälsoproblem bland ungdomar och unga vuxna. Droger är skadligt för individen att bruka, framförallt med tanke på risken till beroende preparatet medför. Individens attityd kopplas ofta ihop med människans beteende och för att förstå personens handlingar är det angeläget att undersöka individens inställning till narkotika. Syftet: Studien syftar till att studera inställningen hos gymnasieelever i årskurs 3 och högskole-/universitetsstudenter gentemot narkotika samt om inställningen hos gymnasieeleverna och högskole-/universitetsstudenterna skiljer sig beroende på kön, kommun och utbildningsnivå i Örebro kommun och Västerås kommun. Metod: Studien är baserad på en kvantitativ ansats med tvärsnittsdesign. Den aktuella studiens enkät har inspirerats genom att tillämpa en tidigare använd skala. I urvalet är 17 årskurs 3 gymnasieelever och 145 högskole-/universitetsstudenter inkluderade. Resultat: Föreliggande studie visar att 79% av respondenterna inte ansåg att narkotika borde bli lagligt att använda sig av. Medelvärdet för negativa attityder blev slutligen 14 och för positiva attityder landade medelvärdet på 6. Det vill säga att majoriteten av respondenterna hade en negativ inställning till narkotika. Männen har en positivare inställning till narkotika jämfört med kvinnorna. Slutsats: Det finns märkbara könsskillnader bland ungdomar när det talas om attityden till narkotika där kvinnors inställning till narkotika är negativare jämfört med männen. Inga samband kunde hittas vad gäller utbildningsnivå eller kommun. Negativa attityder är vanligare än positiva attityder.

Bakgrund: Synen på narkotika har blivit mer liberal och frekvensen av substansbruk hos ungdomar har ökat. Ungdomar anser att narkotikaklassade preparat har blivit mer lättillgängliga. Ungdomsåren är en riskfaktor för både narkotikabruk och kriminalitet. Ungdomsbrottslighetens omfång har inte förändrats mycket sedan 70-talet, dock blir brotten allvarligare och vanligare i yngre ålder. Ungdomar är den mest brottsaktiva gruppen i samhället. Brottsligheten kan dock ofta ses som en övergående fas.  Syfte: Syftet med denna litteraturstudie är att beskriva ungdomars erfarenheter av att lida av ett missbruk med samtidig kriminalitet. Metod: Studien är en litteraturöversikt. Datainsamlingen gjordes genom systematiska informationssökningar med bestämda inklusions- och exklusionskriterier. Analysmetoden som användes var Aveyards tematiska analysmodell. Nio artiklar ansågs ha ett relevant resultat som kunde besvara studiens syfte samt ha hög kvalitet.  Resultat: Resultatet presenteras utifrån fyra teman och nio subteman. De fyra temana som framkom var ”Från nöje till problem”, ”Den sociala arenans dubbla roll”, ”Förändrat beteende och psykisk ohälsa” samt ”Vård- och rättssystemets komplexitet”.  Slutsatser: Narkotikabruket gick från att bruka för nöjets skull till att problem skapades. Att bruka tyngre narkotika sker ofta i samband med brott i grupp och är ofta kopplat till grövre brottslighet. Det framkom att en trygg och säker miljö under uppväxten var en skyddsfaktor som minskade risken för narkotikabruk och kriminalitet i ungdomsåren. / Background: The view on drugs has become more liberal and the frequency of substance use among youth has increased. Adolescents also believe that illegal drugs are more easily accessible. The adolescent years are a risk factor for drug use and criminality. The extent of juvenile delinquency has not changed much since the 1970s, however, the crimes have become more serious and more common in younger ages. Adolescents are the most criminally active group in society. However, crime can often be seen as a transient phase. Aim: The aim of this literature review is to describe adolescents experiences of substance abuse with co-occurring criminality. Method: The method used in this study was a literature review. Data was collected through systematic information searches with specific inclusion and exclusion criteria. The method used to analyse the articles was Aveyard's thematic analysis model. Nine articles were considered to have a result that could answer the aim of the study and to be of high quality. Findings: The results are presented based on four themes and nine sub-themes. The four themes that emerged were “From recreational use to problems”, “The dual role of the social arena”, “Changed behaviour and mental health” and “The complexity of the care- and justice system”. Conclusion: The use of narcotics went from using for the sake of fun to creating problems. Heavier drugs were often associated with committing crimes in groups as well as committing more serious crimes. The importance of a safe and secure environment during childhood were a protective factor which could reduce the risk of drug use and criminality in adolescence.

Konsumtionen av både alkohol och narkotika orsakar idag stora folkhälsoproblem och står för en betydande del av sjukdomsbördan i Sverige. Sverige har idag en hög dödlighet och det är mer vanligt än ovanligt att personer efter behandling återfaller. Syftet med studien är att med semistrukturerade intervjuer undersöka behandlares upplevelser av vilka inre och yttre faktorer som mest påverkar klienter under missbruksbehandling. Avsikten är att få en större förståelse för hur man når störst framgång med behandlingen.  Resultatet visar att av de yttre faktorerna ansågs konsekvenser vara en drivkraft för att komma till behandling. Under behandlingen ansågs även goda relationer till både behandlare och behandlingsgrupp vara av betydelse för att stanna kvar. Det ansågs viktigt med ett nyktert nätverk som gav stöd i individens drogfrihet. Den sista yttre faktorn som var av betydelse var att individen fick sociala stödinsatser även efter behandling för att bibehålla nykterheten. Bland de inre faktorerna framkom inre motivation som någonting avgörande för att framför allt stanna kvar i behandling, detta kunde främjas av behandlingspersonalen. Den andra inre faktorn som kunde påverka behandlingsutfallet var samsjuklighet, där samverkan mellan de olika instanserna var central. / The consumption of both alcohol and drugs is currently causing major public health problems and accounts for a significant proportion of the burden of disease in Sweden. Sweden currently has a high mortality rate and it is more common than not for people to relapse after treatment. The aim of this study is to use semi-structured interviews to explore therapists' perceptions of which internal and external factors most influence clients in addiction treatment. The intention is to gain a greater understanding of how to achieve the greatest success in treatment.  The results show that of the external factors, consequences were considered a driving force for entering treatment. During treatment, good relationships with both therapists and the treatment group were also considered important for staying in treatment. A sober network that supported the individual's drug-free life was considered important. The last external factor that was important was that the individual received social support even after treatment to maintain sobriety. Among the internal factors, internal motivation emerged as something essential for staying in treatment in particular, this could be promoted by the treatment staff. The second internal factor that could influence treatment outcome was co-morbidity, where interaction between the different agencies was central.

Bakgrund: Statistik visar att narkotikaanvändningen bland tjejer i åk 2 på gymnasiet på Gotland ligger 5% över riksgenomsnittet i Sverige. Mot denna bakgrund tog Region Gotland fram ett medborgarlöfte år 2020 med målet att ta fram ett proaktivt och förebyggande samverkansarbete gällande gymnasietjejers narkotikabruk. Syfte: Studiens syfte var att inom ramen för Region Gotlands utvecklingsarbete undersöka unga kvinnors uppfattning och erfarenhet av narkotikaanvändning på Gotland. Metod: Studiens design var kvalitativ med induktiv ansats. Semi-strukturerade fokusgrupper genomfördes för att samla in data. Tre fokusgrupper genomfördes, där vardera gruppen intervjuades vid två tillfällen, cirka 120 minuter per tillfälle. Sammanlagt deltog 22 tjejer i gymnasieåldern i intervjuerna. Systematisk textkondensering användes för genomförande av analysen som mynnade ut i fyra teman med tillhörande underkategorier: 1) Narkotikan finns överallt och när den träder in förändras spelreglerna, 2) Se oss, hör oss respektera oss, 3) Kille och tjej på olika villkor, 4) Vi bor alla på en liten ö. Resultat: Det sammantagna resultatet visade att tjejerna efterfrågar närvarande vuxna som visar förståelse och engagemang att vilja lära sig om de problem och utmaningar som unga tjejer stöter på i sin vardag. Tjejerna efterfrågade engagemang från vuxna i balanserade samtal om droger, både som föräldrar och i professionella situationer. Slutsats: Tjejerna gav flera förslag för att minska riskfaktorer och öka skyddsfaktorer som i hög grad stämmer överens med de åtgärder som återfinns i den så kallade Islandsmodellen. / Background: Statistics show that drug use among girls in year 2 of Upper Secondary School on Gotland is 5 % above the national average in Sweden. Against this background, Region Gotland made a citizens’ pledge in 2020 with the goal of developing a proactive and preventive collaboration within Region Gotland, regarding high school girls’ drug use. Aim: The purpose of the study was to examine young women’s perceptions and experiences of drug use on Gotland within the framework of Region Gotland’s development work. Method: The design of the study was qualitative with an inductive approach. Semi-structured focus groups were conducted. Each group was interviewed on two occasions, with each session lasting about 120 minutes. Twenty two girls of high school age participated in the interviews. Systematic text condensation was used for the implementation of analysis that resulted in four themes with associated subcategories: 1) Drugs are everywhere and once introduced, the rules of the game change, 2) See us, hear us, respect us, 3) Boys and girls on different terms, 4) We all live on a small island. Results: The overall result showed that girls are actively looking for adults who show an understanding for their situation and who are committed to wanting to learn about the challenges that young girls face in their everyday lives. The girls expressed a call for adults, both parents and professionals, who were willing to engage in balanced conversations about drugs, both as parents and in professional situations. Conclusion: Several proposals on how to reduce risk factors and how to increase protection factors were brought forward by the girls. These were very much in line with the measures found in the so called Icelandic model.

Bakgrund: Hepatit C (HCV) är en virussjukdom som smittar via blodet. Personer sominjicerar droger (PSID) riskerar att drabbas av HCV till följd av injektionsrelateraderiskbeteenden. Idag finns det effektiv behandling mot HCV men det kräver viss följsamhet avden som behandlas. Syfte: Syftet var att undersöka sjuksköterskors upplevelser av följsamhet till behandling avhepatit C hos personer som injicerar droger. Metod: En kvalitativ intervjustudie genomfördes. Totalt intervjuades åtta sjuksköterskor frånfyra mottagningar. Datan analyserades sedan enligt Lundberg och Graneheims modell förkvalitativ innehållsanalys. Resultat: Resultatet sammanfattades under fyra huvudkategorier: Livssituation, Samverkan,Behandlingsrelaterade aspekter och Stigma. Totalt identifierades tretton subkategorier. Slutsats: Sjuksköterskor upplevde stora variationer i följsamhet till behandling hos PSID. Detupplevdes som positivt för följsamheten om PSID fick förutsättningar såsom en stabil tillvarooch regelbunden kontakt med en mottagning. I resultatet framkom att det var viktigt attvården var tillgänglig och att PSID fick ordentlig information om behandlingen. Det upplevdesäven som positivt om det fanns fungerande samverkan med både PSID och mellan deverksamheter som de kom i kontakt med. Stigmatiseringen av HCV och PSID upplevdessom ett centralt hinder för följsamhet. / Background: Hepatitis C (HCV) is a viral disease which is transmitted through blood. Peoplewho inject drugs (PWID) are at risk of developing HCV as a result of injection-related riskbehaviors. There is effective treatment for HCV, but it requires some degree of adherence. Aim: The aim was to investigate nurses’ experiences of adherence to treatment for hepatitisC in people who inject drugs. Method: A qualitative interview study was conducted. Eight nurses from four clinics wereinterviewed. The data was analyzed according to Lundberg and Graneheim's model forqualitative content analysis. Results: The results were summarized under four main categories: Life situation,Collaboration, Treatment-related factors and Stigma. Thirteen subcategories were identified. Conclusion: Nurses experienced large variations in adherence to treatment among PWID. Itwas perceived as positive for adherence if PWID had stable living conditions and regularcontact with a clinic. Availability and information about the treatment were important factors.It was also perceived as positive if there was functioning collaboration with PWID andbetween the institutions they came in contact with. The stigmatization of HCV and PWID wasperceived as a key obstacle to adherence.

Syftet med denna studie är att öka förståelsen av socialtjänstens perspektiv och insikter angående de bakomliggande faktorer som bidrar till utvecklingen av problematisk användning av alkohol och droger bland vuxna över 18 år. Uppsatsen ämnar undersöka och analysera de olika faktorer som kan spela en roll i utvecklingen av missbruk och beroende av substanser hos vuxna, samt återfall i sådana beteenden. Fokus ligger på de perspektiv och erfarenheter som socialarbetare och behandlare har när de arbetar med vuxna som kämpar med alkohol- och drogproblem inom ramen för Socialtjänsten. Studien syftar till att utvidga kunskapen inom kriminologisk forskning genom att undersöka vuxna med problematiskt substansbruk, vilket är en annan aspekt än den tidigare forskningen som främst har inriktat sig på ungdomar och deras substansanvändning. Studien genomförde sex kvalitativa semi-strukturerade intervjuer, varav två med socialarbetare och fyra med behandlingar från två kommuner i centrala Sverige. Resultaten visar att orsakerna till beroende varierar avsevärt mellan olika individer. Trots dessa variationer identifierades gemensamma mönster som ökar risken för utveckling av beroende eller återfall i beteenden. / The purpose of this study is to enhance understanding of the perspectives and insights of social services regarding the underlying factors contributing to the development of problematic alcohol and drug use in adults over 18 years of age. The paper aims to examine and analyze the various underlying factors that may play a role in the development of substance abuse and dependence in adults, as well as relapse. This paper focuses on the perspectives and experiences of social workers and therapists working with adults with alcohol and drug abuse within the Social Services. The study aims to extend criminological research by investigating adults with substance dependency issues, which differs from existing research predominantly focused on youth and their substance abuse problems. The study conducted 6 qualitative semi-structured interviews, two with social workers and four with therapists from two municipalities in central Sweden. The findings demonstrate that the underlying causes of dependence vary widely among different individuals. However, there are common patterns that increase the risk of developing addiction or experiencing relapse.

The aim of this essay was to describe how school social workers can help and support students with parents who abuse alcohol or other drugs. We wanted to see how school social workers room for action is presented and how it affects their work with students living with parents who are abusing. We used a qualitative method to elucidate how school social workers handle this issue in a more profound way. By conducting semistructured interviews with six school social workers in one province in southern Sweden we gained exhaustive and detailed answers. In the analysis we used street level bureaucracy and theory of recognition. The result showed that the school social workers regard their overarching room of action as very wide inside school but limited outside. At school the school social worker can support the students with supportive counseling and adapted school attendance. One important task of the school social worker is to help the student to get in contact with other organizations for example, support groups for children. We also found that cooperation is an important part as the school social workers describe themselves as “the spider in the web” with the task of connecting and sharing knowledge with other personnel and organizations. The relation with the student is important to be able to support the students or guide them further. School social workers also regard school as a good place to detect and identify these students, but that it can be difficult to know who these students are. If a specific plan for working with students whose parents abuse alcohol or drugs would affect the school social workers work is difficult to say since none that we interviewed in this study had experience of one.

The Universal Declaration of Human Rights and Fundamental Freedoms and the International Covenant on Economic, Social and Cultural Rights state that everyone has the right to good health. According to the conventions, the states have obligations to prevent and combat disease, and if necessary, ensure that the conditions for treatment of the disease are appropriate (UDHR 1948, UNCESCR 1966). The broad wording in the conventions on the right to good health includes the right to care of substance use disorders. In the 1960ies the World Health Organization recommended, that people with such disorders should be seen as sick and that the legislation governing such care should be in accordance with special administrative legislations and not criminal legislation. The recommendation indicates WHO:s clear position that persons with substance use disorders primarily should be treated as persons suffering from disease and in need of care, and not primarily as disruptive individuals or criminals who should be disciplined or punished. This applies also to situations when treatment and care cannot be provided on a voluntary basis, but compulsorily. In Swedish context, the most commonly mentioned law in these cases is the social special legislation Law (1988: 870) on care of misusers, special provisions (LVM). Ever since the implementation of LVM in 1982, its legal position as well as application in institutional care has been subject of critical discussions within social work as well as in social science research. Such debate in the Nordic countries has until now mostly been marked by two important limitations. First, most comparisons are restricted to very few countries, e.g. four of the Nordic countries; secondly the notion of involuntary care is often limited to social legislation on compulsory care without taking criminal justice legislation or mental health legislation into account. The present dissertation studies legislations on compulsory commitment to care of persons with substance use problems (CCC), and compares these legislations from a larger number of countries, on global or European levels. This approach makes it possible to explore the great variation in CCC legislation between countries, i.e. type of law (criminal justice, mental health care and social or special legislation),  time limits (maximum duration) as well as levels of ambition, ethical grounds, criteria for admission, and adaption to human and civil rights.  In addition, the comparisons between many countries are used to investigate factors related to different national choices in legislations from country characteristics, e.g. historical and cultural background as well as economic and social conditions, including level and type of welfare distribution. Available datasets from different times permits trend analyses to investigate whether CCC or specific types of such are increasing or decreasing internationally.          Empirical materials: Article I is based on three reports from the WHO on existence of CCC legislation, before the millennium shift, in 90 countries and territories in all populated continents. Articles II and IV are based on own data collection from a survey in 38 European countries. Article III uses a combination of those data and additional information from country reports in scientific and institutional publications in three times of observation during more than 25 years, and including a total of 104 countries. Additional data for Articles I and II are information on various countries' characteristics obtained from different international databases.          Findings based on data from WHO reports at the eve of the millennium show that CCC legislation was very common in the world, since 82 per cent of the 90 countries and territories had such law. Special administrative (“civil”) legislation (mental health or social) was somewhat more prevalent (56 %), but CCC in criminal justice legislation was also frequent and present in half of the countries. The study shows that economically stronger countries in the western world and many of the former communist countries in Eastern Europe, the so-called "first and second worlds" in cold war rhetoric, more often had adapted to the recommendations made by WHO in the 1960ies, with CCC more often regulated in civil legislation. In the so-called "third world" countries, CCC in criminal justice legislation dominated. The new data collection from 38 European countries ten years later confirmed that legislation on CCC is very common, since 74 per cent of the explored countries have some type of legislation. The most common type was now CCC in criminal legislation (45%), although special administrative legislation (mental health or social) was almost equally common (37%). Special administrative legislation on CCC (both acute and rehabilitative), was more common in countries with historic experience of a strong influential temperance movement, and in countries with distribution of health and welfare more directed through the state, while countries with less direct government involvement in distribution of health and welfare and lacking former influence of a strong temperance movement more often had CCC in criminal justice legislation. During all the 25 years period from early 80ies up to 2009, it was more common for countries to have some type of law on CCC than not, although some reduction of CCC legislation is shown, especially during the last decade. But within countries having CCC, more cases are compulsorily committed and for longer time duration. This is related to a global shift from civil CCC to CCC in criminal justice legislation, directly in the opposite direction from what WHO recommended in the 60ies. Changes in CCC legislation are often preceded with national political debate on ethical considerations, and criticisms questioning the efficiency and content of the care provided. Such national debates are frequent with all types of CCC legislation, but ethical considerations seem to be far more common related to special administrative (civil) legislation. National legislations on CCC within Europe should conform to the human and civil rights stipulated in ECHR (1950). There seems, to be some limitations in the procedural rules that should protect persons with misuse or dependence problems from unlawful detentions, regardless type of law. The three types of law differ significantly in terms of criteria for CCC, i.e. the situations in which care may be ensured regardless of consent.        Conclusions: It is more common that societies have legislation on CCC, than not. This applies internationally – in all parts of the world as well as over time, for a period of 25 years, at least. Sweden’s legislative position is not internationally unique; on the contrary, it is quite common. Law on CCC tend to be introduced in times of drug epidemics or when drug-related problems are increasing in a society. Changes in CCC legislation are often preceded by national debates on ethics, content and benefits of such care. These findings here discussed may reflect different concurrent processes. A shift from welfare logic to a moral logic may be understood as more moralization, perhaps due to relative awaking of traditionalism related to religious movements in various parts of the world (Christian, Hindu, Muslim or other). But it may also be understood from more libertarianism that stresses both individual responsibility for one’s welfare and the state´s responsibility to discipline behaviours that inflict negatively on the lives of others. Possibly do these two tendencies work in conjunction to one another. At the same time, however, there is a stronger emphasis on care content within criminal justice CCC, especially in the Anglo-Saxon drug court system. Some shift within Civil CCC is also noticed, i.e. from social to mental health legislation. Thus drug abuse and dependence is increasingly more recognized and managed in the same way as other diseases, i.e. an increased normalization. Since social CCC has been more in focus of research and debates, this may also result in CCC turning into a more hidden praxis, which from ethical perspectives is problematic. The thesis shows that there are examples of focus on humanity and care in all three of the law types, but there are also examples of passive care, sometimes even inhumane and repressive, in all types. Thus, type of law cannot be said to in general correspond to a specific content of care. Although CCC can be delivered in accordance with human and civil rights, there is still a dissatisfying situation concerning the procedural rights that should ensure the misuser his/her rights to freedom from unlawful detention. The possibility to appeal to a higher instance is missing in about 20 percent of European CCC laws, although not differentiating one type of legislation from the others. A clear difference between the three law types concerns criteria that form the basis for who will be provided care according to the laws. This is of major importance for which persons of the needy who will receive care: addicted offenders, out-acting persons or the most vulnerable. The criteria for selecting these relate to the implicit ambitions of CCC – correction, protection, or for support to those in greatest need for care. The question is what ambition a society should have concerning care without consent in case of substance abuse and addiction problems. The trend that CCC according to special administrative legislation is declining and criminal legislation increases in the world should therefore be noticed.     Keywords: Alcohol, drugs, substance misuse, coercive care, compulsory commitment to care, involuntary care, mandatory care, legislation, human and civil rights, comparative analysis, prediction models, and trend analysis / <p>Vid tidpunkten för disputationen var följande delarbeten opublicerade: delarbete 4 inskickat.</p><p>At the time of the doctoral defence the following papers were unpublished: paper 4 submitted.</p>

Den här uppsatsen fokuserar på autenticitet inom rapp: hur den skapas och bibehålls. Först introduceras genren ”gangsterrapp” och därefter analyseras en uppsättning av låtar inom genren både text-, ljud- och bildmässigt. Därefter följer en diskussion om mina undersökningsresultat och slutsatsen att svenska gangsterrappare skapar autenticitet genom att vara kriminella. Oavsett var de kommer från eller vilka de känner presenterar gangsterrapparna sig som frontfigurer för stora kriminella nätverk och använder sina texter som en slags ”gangsters dagbok”. Teman såsom polishat, drogförsäljning och kallblodigt mord förekommer ofta och är till och med förväntade. / This paper focuses on authenticity in rap: how it is created and maintained. First, I introduce the subgenre of “gangsta rap” and how it is defined. Then, I continue by analyzing a set of songs both lyrically, audibly and visually, and while direct audible differences are included, they are deemed less important than the social aspect of said songs. Subsequently follows a discussion of my findings and the conclusion that Swedish gangster rappers create authenticity by being criminals. No matter where they come from, or who they know they will always present themselves as the front figure of vast criminal networks and use their lyrics as a form of “gangster diary.” Themes such as hating the police, selling drugs and killing in cold blood are commonplace and are even expected.

Before the regulation of opium as a “narcotic” in Sweden in 1923, opium was not regulated for its intoxicating properties and was freely available. But not in any kind of shop. Opium was legally available only through the pharmacies. This thesis explores how this free availability of a narcotic was understood by its traders, the pharmacists. The title of this thesis – The Value of Poison – indicates how opium could be conceptualized both as a safe, everyday remedy essential to keep freely available and as a drug of intoxication. As a poison it could be articulated as a matter of primarily pharmacological, not moral or medical, concern. This also gave the pharmacists, with their special knowledge of pharmaka (drugs, poisons), an autonomous space of knowledge free from the ever more intruding “medical gaze”. But, in order to articulate this kind of understanding of opium, another kind of knowledge was needed to be acknowledged: that of the user. In this articulation a “sensus communis” was tied in with a broader cultural knowledge of drugs. Problems with opium were focused on the danger of acute poisoning, not recreational intoxication. Concepts that could have problematized this kind of use were rearticulated as problems either of illegitimate trade, unregulated markets and advertising or of draconian regulation by greedy or sloppy doctors. These rather opposite elements were made equivalent through the articulation of ignorance in both cases, thus further emphasizing the special knowledge of the pharmacist. The thesis locates a process of contradiction that contributes to the eventual diminishing of the discourse of poison towards the end of the period. The pharmaceutical knowledge that guaranteed the discourse was based on a “pharmaceutical gaze” on pharmaka. It pierced through the drug to identify its constituent parts. In this process it was promised that the different effects of opium would be separated. “Narcotic” could be a by-product, to be discarded or controlled, without dispensing of other therapeutic effects. With this ever deeper knowledge of opium, knowledge in the pharmacies was made insufficient for the full understanding or opium, and so too was that of the traditional user. The era of opium as a poison was over. / Före den första särlagstiftningen om narkotika i Sverige 1923 reglerades inte opiumets rusgivande egenskaper. Drogen var fritt tillgänglig i handeln. Men inte i vilken butik som helst. Opium kunde bara köpas lagligt på landets apotek. Den här avhandlingen undersöker hur denna fria tillgänglighet av narkotika förstods av droghandlarna själva, apotekarna. Titeln pekar på hur opium på en och samma gång kunde tänkas som en säker husmedicin vars tillgänglighet var avgörande för folkhälsan och som en rusgivande drog. Som ”gift” artikulerades det som en i första hand farmakologisk angelägenhet, inte en moralisk eller medicinsk. När de talade på detta sätt upprättade apotekarna, genom sin särskilda kunskap om farmaka, ett eget rum för sitt vetande, fritt från läkarnas allt mer genomträngande ”kliniska blick”. Men för att kunna artikulera denna förståelse av opium krävdes också att en annan typ av kunskap vidkändes: brukarens. Genom denna artikulation knöts brukarnas ”sensus communis” samman med en bredare kulturell kunskap om droger. De av opiumets problem som lyftes fram handlade om akut förgiftning, inte rekreationellt rusbruk. De begrepp som hade varit möjliga att användas för att problematisera denna senare form av bruk reartikulerades: antingen förpassades de till den olagliga handeln, de oreglerade marknaderna och reklamen, eller också till de drakoniska regleringarna som giriga och slarviga läkare stod bakom. Apotekarna artikulerade dessa båda helt motstående element som ekvivalenta genom en brist på kunskap, vilket i sin tur ytterligare stärkte deras egen kunskapsmakt. Avhandlingen lokaliserar även en processande motsägelse som sker när giftets diskurs tynar bort vid slutet av den undersökta perioden. Den farmaceutiska kunskap som underbyggde diskursen vilade på en ”farmaceutisk blick” på farmaka. Denna genomborrade drogämnet för att avslöja dess beståndsdelar. Genom denna process utlovades att opiumets olika effekter skulle kunna skiljas från varandra. ”Narkotikan” kunde ses som en bieffekt, som kunde kastas åt sidan eller kontrolleras separat, utan att opiumets kvarvarande terapeutiska effekter minskade. Denna allt djupare kunskap medförde att de enskilda apotekarnas eget vetande på apoteken inte räckte till för att fullt ut förstå opium, och därmed bröts även samartikulationen med brukarnas kunskap. Tidseran när opium var ett gift tog därmed slut under mellankrigsperioden.