Representations of alcohol and drug use in the Finnish reform of social and health care service users' rights

Background: A growing body of research has analysed the representations of alcohol and other drugs (AOD) in policy -making, but few studies have focused on the representations reproduced in law -making processes, especially in the context of the regulation of the rights of social and health care service users. This study examined what kind of representations of AOD use are reproduced in the legislative reform of social and health care service users' rights in Finland. The purpose of the reform is to strengthen social and health care service users' rights to self-determination and to reduce the use of restrictive measures. Methods: As its data, the study used a draft of the bill and stakeholder opinions regarding the reform. 'What's the problem represented to be?' approach as a methodological framework. Results: The study discovered three AOD-related discourses: the Control, Welfare, and Rights and Legality discourses. The Control discourse represented people who use AOD as risky individuals and called for ways to manage risks in treatment situations. The Welfare discourse portrayed people who use AOD as a vulnerable group whose problems should be addressed by the welfare system. The Rights and Legality discourse represented the vague legal definitions of AOD use as the main regulatory problem. The discourses differed in terms of their definitions of self-determination. Conclusions: The study illustrated how the right to self-determination as a legal concept is contested and can be interpreted in different ways depending on the representations of AOD use. The differing representations highlight the tensions involved in improving the rights of people who use AOD.