Exit LARO

Sammanfattning: The aim of this study was to investigate the role of the counselor within the Swedish opioid maintenance program (LARO), considerations and experiences of patient processes as well as the treatment program. This in relation to the patient's possibility to initiate an exit process. The study was based on seven qualitative interviews with counselors within LARO. Furthermore, the study was based on the counselors’ reflections and experiences of the patient and the treatment program, which were analyzed with the help of the following concepts: categorization, discourse, power and exit theory. The results of the study showed that the counselor is within an area of tension between the medical and social science discourse. The tension contributes to the patient having a choice, the choice to continue or exit the treatment program. If the medical perspective dominates, it poses a challenge for the counselor to motivate an exit process. The study further showed that the counselors categorize the patient when enrolling the patient in the treatment program. The categorization contributes to an opportunity or limitation for the beginning of an exit process. This was because the counselor in their categorization process attributes to the patient different abilities and conditions for undergoing exit based on various situations and life choices. The conclusion was that the counselor plays an important role in the patient's ability to initiate an exit process as well as during the exit process. However, the counselor’s role in the organization, by its regulations and control measures, and an undervaluation of the social science discourse contributes to a limitation for an exit process.