How should substance use problems be handled? Popular views in Sweden, Finland, and Canada

Although the way in which, for example, substance use problems are conceived and reacted to (by experts and treatment professionals but also by the environment), can have vast consequences for those directly or indirectly concerned, there is little systematic knowledge about how various preferred approaches differ between types of problems and sociocultural settings. In an ambition to at least partly mend this gap, this paper aims to compare how the general public in Sweden, Finland, and Canada appraise four generically different approaches to dealing with substance use problems, as these are applied to problem use of alcohol, cannabis, heroin, and cigarettes.

The paper uses data from three national surveys, aimed at uncovering how representative population samples from Sweden, Finland, and Canada perceive and understand the character of, and the proper way of handling, various addictive problems. Data from these surveys have been used to discern and operationalize four basic “models of helping and coping” as these have been outlined by Brickman et al. (1982). The analysis has aimed at investigating how the popular preferences for either of these models vary with type of addiction (to cigarettes, alcohol, cannabis, and other (“hard”) drugs, national setting, and potentially important respondent characteristics.

The results point to large differences between the ways in which the general public understands the proper way of handling the four types of addiction, and shows, for example, that addiction to “hard” drugs is predominantly perceived as a matter for expert treatment, whereas smoking, or addiction to cigarettes, is more often perceived as a bad habit which the user is able to break on her/his own. In addition, the popularity of different handling models is found to vary between countries, and with personal characteristics such as gender, age, and substance use experiences.

The study is one of few that have systematically tried to find out how various forms of substance use problems, or addiction, are conceived and reacted to in various national and social settings.