A matter of craving–An archeology of relapse prevention in Swedish addiction treatment

The Model of Coaching Narcotics Prisoners in the Correctional Penitentiary

“…The availability of rehabilitation initiatives is the most crucial aspect of overcoming drug usage that law enforcement agents do not take into account. The existing development model for narcotics victims continues to classify them as criminals (perpetrators), hence rehabilitation attempts are frequently 19 One of the non-criminal punishments, such as fines or treatment requirements, or no criminal punishment. During "depenalization" efforts, the use of narcotics remains a criminal infraction, although imprisonment is no longer imposed for possession or use, despite the possibility of other criminal consequences such as fines, police records, and probation.…”

Self‐interpellation in narratives about craving: Multiple and unitary selves

“…This study is part of a research project on how craving and relapse are understood and handled in Swedish treatment for addiction problems. In addition to studying treatment manuals and pedagogical material related to RP (see Ekendahl & Karlsson, 2022 ), we have interviewed treatment staff (see Ekendahl & Karlsson, 2021a , b ) and service users who have engaged in RP in the Stockholm area. This analysis is based on 12 interviews with service users, carried out during 2019.…”

“…Erik, a man in his fifties with a history of polydrug use and who is now on opioid substitution treatment, gives his own self a similar centrality when explaining how craving develops and eventually leads to relapse. He defies the RP discourse by not seeing craving as an external object that can be understood and handled (Ekendahl & Karlsson, 2022), but narrates it as a situation he creates himself:

Well, it will start with a thought. Someone said something, a friend called and asked something or the like…then one starts to think about it and then one develops craving.

…”

“…Elin claims to get jealous of ordinary drinkers (referred to elsewhere as ‘those who can’), perhaps because they remind her that she is unlike them, and more similar to people who cannot drink alcohol without problems. But rather than sticking with the self that lacks control, she draws on the RP principle of treating thoughts as external forces that can be identified and extinguished (Ekendahl & Karlsson, 2022 ). The argument is that ‘I’ do not allow ‘myself’ to think specific thoughts, showing that identity multiplicity warrants some kind of control over cognition.…”

“…According to this narrative, evident in several other interviews too, the mere idea of craving becomes contradictory. Craving only surfaces for the inauthentic self, not for the authentic self that is cautious of risk situations and elides craving before it appears (see Ekendahl & Karlsson, 2022 ).…”