The making of the chronic addict

Inspired by social problems theory, this article analyzes the "formula story" of harm reduction in a Danish addiction-treatment context. In Denmark, very few opiate addicts are in drug-free therapeutic treatment. Instead, they are offered methadone (often on a permanent basis) accompanied by practical help in tackling the negative social, economic, and health-related consequences of their drug use. The aim of this article is to show how the formula story of harm reduction-and first and foremost the idea that opiate addiction is an incurable condition-tends to work as a self-fulfilling prophesy. Opiate addicts entering the treatment system risk being "made up" as chronic addicts regardless of how they themselves look upon their own addiction problem and notwithstanding that many of them have not given up their hope of becoming drug-free. The article is based on two types of data: (1) file records (gathered in 2007) describing the addiction problems and treatment careers of clients enrolled at outpatient treatment centers in Copenhagen, and (2) qualitative interviews (conducted in 2006) with 30 methadone-program participants at the centers. The analysis is qualitative and the empirical results cannot necessarily be generalized to other methadone-maintenance programs. Yet the theoretical message of the article is applicable to all treatment institutions and social problems work in general. Definitions and categorizations of clients are not innocent, and naming people and their problems is the same as changing them.