Prison-based drug treatment in the Nordic countries

By/ PhD in anthropology associate professor Torsten Kolind and PhD in anthropology associate professor Vibeke Frank

This qualitative research project is financed for three years by the Joint Committee for Nordic Research Councils for the Humanities and Social Sciences (NOS-HS).  It is a collaborate project between: 

·        Center for Alcohol and Drug Research, Aarhus Universities, Denmark [project management]

 ·        School of law, psychology and social work, Örebro University, Sweden 

·        The Institute of criminology and sociology of law, Oslo University, Norway 

·        A-Clinic Foundation, Helsinki, Finland 

The project runs from 1th April 2011 to 31th March 2014.


During the last 15 years, prison-based drug treatment [PBDT] has increased enormously in all Nordic countries. This development can be seen as a response to the general increase in drug use among prison inmates, but also reflects growing political concern for drug-related issues in the same period. Despite this increase, the area has attracted very little research attention. Apparently, PBDT has become a self-evident response to drug problems, with no one questioning the political frameworks, institutional policies and strategies of inmates related to this growing industry; or questioning in what respect PBDT can be viewed as basically a new way of managing poverty and marginality.

The increase in PBDT reflects a general growth in late modern society of what has been termed ‘troubled identities’; that is, institutions devoted to identifying and managing personal troubles. In the Nordic countries, such institutions are generally cast under the auspices of the welfare state, characterized by their inherent contrast between control and rehabilitation. In the prison setting, this conflict is very manifest and pervades all aspects of prison life, especially in drug treatment programmes making PBDT a privileged site for studying general institutional classes of rationales.

Most studies of Nordic welfare institutions have focused on their constraining effects on client identity, looking at the explicit and the implicit workings of power. As a result, there has been a neglect of how clients themselves are involved in or resist the construction of social problems and client identities and develop strategies when facing constraining institutions. In addition, there has been a neglect of how institutional policy is turned into practice, hereby at times changing the stipulated objectives of the institutions. Our study will generate new knowledge on the workings of modern Nordic welfare institutions by studying the dilemma between control and rehabilitation combining different levels of research. 


The project aims to study and compare PBDT in the Nordic countries. We focus especially on three different modes of regulation: Penal, Moral and Medical. In an international context, Nordic prisons are exceptional because they are influenced by Nordic welfare state institutions, in addition to the penal tradition. Therefore, in order to understand Nordic PBDT, the project relates to perspectives on how troubled social identities are created in Nordic welfare institutions. In so doing, the project contributes theoretically not only to Nordic prison research but also to Nordic research into welfare institutions.


The project integrates three levels of analysis: Political discourses, Institutions, and Inmates. In our study, these levels integrate four central dimensions in social theory: context (prison drug policy), setting (the prisons), situated activity (interaction between inmates and drug treatment personnel), and self (experiences and narratives of inmates). Addressing the different levels brings the macro and micro analyses closer together and enables the project to be sensitive to the different timescales that are involved in social processes. In addition, it is our contention that drug users in prison occupy the locus of attention from three different and often conflicting modes of regulations: a) Penal: punishing, disciplining and controlling the criminal inmate; b) Moral: rehabilitating, empowering and offering drug treatment to the drug user;  and c) Medical: treating the addicted physical body. In all three levels of analysis, we will study how these conflicting modes of regulation are simultaneously formed by and inform social reality.

The first part of the project investigates the competing drug political discourses framing PBDT. In addition, we will historically outline and compare the rising of the concrete PBDT services in the Nordic countries. Looking at justifications for allowing or restricting different types of treatment not only tells about economy but also the penal, moral and medical paradigms inside Nordic Prison Services. The analytical backdrop for this part of the study will be discourse analysis investigating not how a discourse speaks about an object, but how it constitutes an object.

In the second part, we focus on how policy is put into practice in the selected Nordic prisons. The discourses identified in the first part frame the institutional practices in the individual prisons. However, these institutions have their own dynamics, agendas, and groups of professionals and inmates, together making the ‘translation’ of political discourses and objectives into practice rather dynamic. In this part we will among other things focus on several concrete drug treatment initiatives. The theoretical framework for this part of the study is firstly political anthropology which in recent years has focused on the relation between policy as an explicit normative system and policy as practiced. Secondly, we will lean on sociological role theories looking at how social identities are formed and renegotiated in interaction informed by the setting in which they are performed.

Thirdly, we focus on inmates’ experiences, strategies and situated activity. The penal, moral and medical discourses created in policy and transformed by local institutions’ interpretations and concrete initiatives are certainly constraining: they produce subject positions and prescribe visions of reality. On the other hand, discourses and troubled identities only enter an individual’s self through social interaction. That is, whatever the typification (criminal, drug user, sick, empowered), the connection between personal selves and troubled identities needs to be constructed. Individuals cannot transform discourses at will, and surely not inmates whose every movement is somehow surveiled, but they can relate themselves and their actions to them, thereby resisting, rejecting, reproducing or surrendering to them. In the study we will therefore look into the strategies and experiences of inmates in the selected treatment programmes. This part is inspired by practice theory, looking at the human ability to act upon and change the world, but avoids the trap of methodological individualism by seeing agency as a struggle to construct a life out of the cultural resources one’s social experience offers.

Methods and setting

The three levels of research will be pursued using observation studies, qualitative interviews, focus group interviews, document analysis, and analysis of statistical data from the Prison Services.

In each of the 4 Nordic countries, 3 prisons will be selected for the study. In each of these 12 prisons, 1 treatment programme will be selected. The following criteria will be used in the selection process: 

·       High security (closed)/low security (open) prisons. 

·       Treatment programmes in residential wings/day programmes for prisoners from different wings. 

·       Treatment programmes for men/women.