"Att fortsätta vara ren, är svårare än att bli ren” Substitutionsbehandling ur ett etiskt perspektiv

Sammanfattning: Today, drug assisted treatment of Methadone and Subutex is well established in Swedish society. However, it has since the late 1960´s been differing perceptions of both the pros and cons on drug assisted therapy. The purpose and aim of this study was to explore and describe what kind of ethical attitudes social workers and representatives of the Swedish Drug Users Union (SDUU) usually have around maintenance treatment and what point of view they have concerning the constructed guidelines and directions from the Swedish National Board of Health and Welfare. In order to gather information in the subject, qualitative interviews with social workers, which have many years of experience of Methadone, buprenorphine or naloxone maintenance treatment, and representatives of the SDUU, were made. We used semi-structural lines of questions while interviewing six social workers and two representatives from SDUU. Three social workers have themselves experienced a long-standing opiate dependence .The analysis was based on teleological and deontological ethics around maintenance treatment. Our first conclusion was if you were, to judge what is right or wrong from an ethical perspective in relation to maintenance therapy we found that it is no easy task to face as professional or as a representative of a user association. The second conclusion we found was that the respondents, who personally experienced a long-standing opioid dependence, were also those who were most opposed to maintenance treatment in its entirety. The result of the study also showed that regardless if you are a professionals or representative of the SDUU, the ethical perspective around maintenance treatment is widely subjective. Finally it was concluded that most of the respondents put their clients in the first place, even though they have limited space and budget. The results showed that many of the respondents overlooked the constructed guidelines for Swedish National Board of Health and Welfare, to instead bring the client's best at centre