Läkemedelsassisterad behandling vid opiatberoende - En kritisk diskursanalys av behandlingsformens utvecklingsläge från central till lokal nivå

Sammanfattning: Author: Terese Farkas Title: Medication-assisted treatment for opiate dependence - A critical discourse analysis Supervisor: Leili Laanemets Assessor: Håkan Jönson och Torbjörn Hjort The aim of this study was to analyze how the medication-assisted treatment for opiate dependence textually constructed and constituted through language in a number of text documents produced partly by the National Board of Health and in part by Region Skåne. The essay has a social constructionist stand with a view on language as access to the empirical reality which is the basis for the discourse analytical approach. The analysis was conducted using a so-called critical discourse analysis (CDA) inspired by Norman Faircloughs model. The main questions dealt with how medication-assisted treatment for opiate dependence was produced in writing through a selection of text documents describing the treatment method. Furthermore the dominant discourses were examined. The study has been based in manifest intertextuality where the intertextual chain was studied. It was possible to discern a number of links between text documents made in practice and National Board documents. The most significant and clearly observation were two competing discourses that both existed in the discursive practice simultaneously. At the end of the intertextual chain, at the local level, the implementers discourse ruled. There is indication that that implementers discourse advocates primarily a medical solution to opiate addiction. A disciplinary language appears in the implementers discourse where permission for medical privileges and punishment of rule violations should discipline the patients. Key words: opiate dependence, critical discourse analysis, Foucault