Alcohol dependence profoundly affects the family and social network of the afflicted person. The most frequent difficulties in activities and participation have to do with interpersonal interactions, economic and work life, dealing with aggression and legal problems. Problems with high-risk behaviours and in seeking appropriate treatment are also common. Treatment targeted at reduction or cessation of alcohol use is effective in reducing these psychosocial difficulties. The ICF offers a structure for systematic evaluation of the wide range of difficulties encountered in alcohol dependence.

Prison-based drug treatment (PDT) has increased markedly in the Nordic countries over the last 15 years. Based on data from Denmark, Finland, Norway and Sweden, we outline the historical development of PDT and analyse the rationales employed in the political discourse in the Nordic countries legitimizing this development. These rationales relate to the reduction of criminality, zero tolerance, rights and the modern welfare state, and managerialism. Though these rationales may appear dissimilar, they have been combined with relative ease in the political discourse. Actually, this elasticity may partly explain the popularity of PDT. We discuss whether the increased use of PDT reflects a criminalization of social problems and signals a rebirth of the treatment ideology in Nordic prisons.

Aims This article describes and analyses prisoners' experiences of drug treatment in prison in four Nordic countries: Denmark, Finland, Norway and Sweden. The article examines how prisoners experience drug treatment, control and sanctions as related to three main topics, namely motivation; the content of the measure and relations to staff; and control and sanctions. Methods & DATA – The article is based on data from twelve prisons, three in each of the four countries; 91 interviews with prisoners; and around six months of observation. The two main kinds of drug treatment measures are drug treatment units and day programmes. Results – Prisoners described several motives to participate in drug treatment measures: to leave drugs and crime; to renew relations with family and friends; to solve health problems; and to improve their prison conditions. Prisoners found that drug treatment measures offered possibilities to acquire new ways of being. Staff behaviour seemed to be more important to prisoners than the methods used, and some prisoners seemed more positive to staff involved with the drug treatment than to other staff. A surprising finding was the prisoners' limited critique of controls and sanctions. We see this as embedded in the situation of being a prisoner, and also in relation to contexts outside prison. Conclusion In discussing their experiences in the treatment units, prisoners are not so concerned about the rehabilitative features or the controls and sanctions. They evaluate their present situation in light of a future, which is their real concern. This is in line with a main task for staff, which is to prepare prisoners for release.

Emotional problems, work and sleep problems should be addressed in all the treatments of neuropsychiatric disorders regardless of their specific diagnosis, etiology and severity. Personality issues should be targeted in the treatment for neurological disorders, whereas communication skill training may also be useful for mental disorders. The effects of medication and social environment on patient's daily life should be considered in all the neuropsychiatric conditions.

Aim The article outlines, at the level of political discourse, changes in drug and criminal policy that may have influenced the penal system as a backdrop to the rise of prison-based drug treatment programmes (PBDT) in Finland. Methods and Data Our perspective is historical. The article is based on historical and political documents, scholarly research and white papers. Results The history of PBDT in Finland is characterised by an absence of drug treatment programmes until the 1980s, first initiatives at the end of the 1980s, enthusiastic programme development from the mid-1990s, and decreasing interest during recent years. Unlike the National Drug Strategy, the Prison Drug Strategy aimed at a drug-free environment (zero tolerance) and implemented harm-reduction measures only to a limited extent. Conclusion The development of PBDT represents the new way of performing treatment in prisons, with features of managerialism. PBDT is also affected by an organisational segregation of rehabilitation and medical treatment, which prevents integration of harm-reduction measures with rehabilitative treatment, and is in conflict with general aims of integrating substance abuse treatment to mental and healthcare services in Finland. In the spirit of a new kind of Penal Welfarism, the role of documented individual risk and needs assessment in defining an offender's sentence has increased.

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