Reflections on the History of Medical Treatment of Opioid Addiction in Finland
Department of social sciences and philosophy University of Jyväskylä Jyväskylä, Finland
The Finnish drug addiction treatment system has experienced transformation from domination of psychosocial approach to drug addiction to a more medically-orientated approach during the past two decades. This is the case especially in relation to the treatment of opioid addiction and substitution treatments have become integral part of the treatment of opioid addiction. The prevailing explanations of this transformation have emphasised the process of medicalisation through which social problems are recoded as medical problems, the emergence and adoption of harm reduction policy alongside traditional Finnish control-orientated drug policy, and the progress of medical sciences with their new findings with regard to addiction. In this paper the aim is to problematise and contextualise these general explanations. This aim is attained through careful analysis of medical writings in two Finnish medical journals between 1965 and 2005. The analysis is based on the theoretical perspectives of genealogy and archaelogy of knowledge developed by Michel Foucault. From this perspective the focus of the analysis is on the different levels of change in the apparatus of addiction that consists of treatment techniques, ways of knowing and conceptualising addiction, and aims of addiction treatment. Starting point of the paper is that it is on these different levels of change that the causes contributing to the acceptance of substitution treatment can be found.