Accepted Paper:

Social and cultural dimensions of case management - aspects of control in drug treatment  


Katrine Schepelern Johansen

Paper short abstract:

Case management has become a recommended treatment offer in much contemporary drug treatment. This paper shows how case management presents staff members in an out patient clinic for dual diagnosis with the possibility to follow the patients very close and give staff a certain type of control over patients’ lives.

Paper long abstract:

Within the drug treatment and research environment in Denmark the issue of what is treatment has been intensively debated throughout the last decade. This has resulted in several reports recommending how treatment of drug use should be organised. One of the recommendations is that people in treatment should have a case manager. A Campbell review has also recently pointed out that case management is effective in bringing people within the treatment system. It seems that case management is becoming one of the cornerstones in drug treatment in the first part of the twenty first century.

In this paper I will present an ongoing research project in an out patient clinic for people with a dual diagnosis (people with both a psychiatric disorder and a drug use). One of the treatment principles in this clinic is intensive case management (ratio: 1 case manager has 5 to 6 patients). I will focus on the benefits of case management as experienced by the staff. Case management seems to produce a very close relation to the patients that the staff uses to facilitate psychiatric treatment, to avoid and contain aggressive behaviour on part of the patients, to create a standing point in a moral difficult environment there patients talk and live with violence, prostitution and criminality, and last but not least where case management give a possibility for control in a treatment setting where former control through rules of methadone dispensing have been abandoned with reference to the principles of harm reduction.

Panel W020
The anthropology of drug policy: a way to diversify the field of drug studies?