This article examines how the issue of alcohol use has been problematized using past and current World Health Organization reports and associated publications as illustrations. The 2010 Global Stra...

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Problematizations in Alcohol Policy: WHO’s “Alcohol Problems”

Public Drinking and Popular Culture in Eighteenth-Century Paris

Medical doctors have been interested in the individual and societal problems and consequences due to heavy drinking during the last three centuries (Heather & Robertson, 1989; Levine, 1978). The first sociologists exploring this topic, were the research group directed by Jellinek at Yale University during the 1940s, followed by Seldon Bacon at the Center of Alcohol Studies. Bacon placed the role of sociology into the discussion about alcohol studies, asking for broader attention be paid both to drinking and not drinking habits, and on how their cultural aspects influence institutional responses (Bacon, 1943). But it was especially thanks to the anthropologists Dwight Heath, Mary Douglas, and Edgerton that cultural aspects of drinking were investigated; helping to develop the concept of a drinking culture. Heath (1999), by comparing the meanings of alcohol consumption in traditional societies and in Western societies revealed that in contemporary Western societies the emphasis on alcohol focuses mainly on drinking as a social problem, a concept that was completely unknown in traditional societies even if negative consequences of drinking were also present. Since the 1970s, other alcohol drinking-related problems in addition to the health consequences today called ‘harm to others’—such as car and work accidents, violence, family problems, and so forth—attracted the attention of the scientific community, which found the total consumption model—elaborated by Sully Ledermann (1956)—to be a good tool for interpretation and for developing political strategies. Ledermann found a rather strong connection between total alcoholic beverage consumption in a population and mortality due to alcohol drinking-related pathologies. He showed that the number of heavy consumers and the total number of consumers are related, so that an increase in the number of alcohol consumers corresponds to an increase in problematic drinkers and consequently in alcohol consumption-related

The Public Health Dilemma in the Alcohol Intervention Area: Unfinished Business Between Limits and Freedom.

What in this article is called ‘the policing of alcoholics’ was a process involving several agents and institutional bodies, including but not limited to, officials and at the alcoholics’ institutions, regional and local temperance boards, police authorities and local poor-law boards as well and several others. For the welfare state in the making, the recalcitrant and morally depraved alcoholic represented an anomaly, someone who did not really belong to society. Policing was in the last instance legitimated by the role it played in the process of creating a new social order. The early welfare state should not mainly be seen as a form of ‘liberal’ governance but as a state formation where a continuity with older forms of governance, i. e. policing, existed. The empirical material for this article is taken from the alcoholics’ institution at Svartsjö in the late 1930s and early 1940s. By being subjected to the workings of the power apparatuses in institutions like these, an undifferentiated mass of vagrants, beggars, drunkards, petty criminals, and unruly and socially troublesome people were transformed into a new welfare category, the alcohol abusers. Importantly, this was a process to which the alcohol abusers, through their resistance, also contributed. 

The policing of alcoholics: Power and resistance in early welfare-state Sweden

The moral problem of heavy drinking has become medicalised However, when taking into account the different levels of medicalisation, French alcohol policy and treatment organisation has traditionally gone further than Finnish policy, although physicians in both countries are now becoming more important in the treatment of alcoholism General practitioners (GPs) are often the first to diagnose alcoholism and they are expected to apply brief interventions, which have been proven effective in reducing heavy alcohol consumption Focus-group interviews were conducted in Finland and France using three film clips as a stimulus for discussion The short vignettes show incidences of alcohol problems from scenes in international fictional movies, with themes of loss of control, harm of loved ones and cue dependency Interviews were analysed for GPs’ narratives about alcohol problems and alcoholism, using the semiotic concept of focalisation The influence of historical approaches to alcohol problems was evident in

Alcoholism, brief intervention and the institutional context: a focus-group study with French and Finnish general practitioners

The alcohol policy doctrine that emerged during the era when modern welfare states were consolidated resulted from a battle between two options: the medical model and the epidemiological total consumption framework. This development was described and analysed in Alcohol, Society and the State. It saw the medical model as an alternative to and a competitor with alcohol control, meaning A any government measure to the purchase, production, or trade of alcoholic beverages @. Alcohol control as an instrument of prevention was grounded in what I here call the population argument — a public health theory that sets priority on rates of problems in a population rather than their individual determination. It further argues that rates of problems depend on rates of exposure, i.e. availability and consumption. Even if the practical implications of the population argument have nowhere been fully implemented, the argumentation became dominant among experts. This paper discusses the reasons why the epidemiological approach is compatible with welfare state thinking, and why its legitimacy depends on the social philosophy that underlies it, rather than technical or evidence-based considerations. This connection between the epidemiological approach and welfare state thinking is discussed in the context the changing Nordic ideas and power structures in Broken Spirits. The conclusion is that the epidemiological approach is experiencing difficulties to the extent to which the legitimacy of the welfare state is weakened.

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From “Alcohol, Society and the State” to “Broken Spirits” to...