Representations of alcohol and drug use in the Finnish reform of social and health care service users' rights.

BACKGROUND: A growing body of research has analysed the representations of alcohol and other drugs (AOD) in policy-making, but few studies have focused on the representations reproduced in law-making processes, especially in the context of the regulation of the rights of social and health care service users. This study examined what kind of representations of AOD use are reproduced in the legislative reform of social and health care service users' rights in Finland. The purpose of the reform is to strengthen social and health care service users' rights to self-determination and to reduce the use of restrictive measures. METHODS: As its data, the study used a draft of the bill and stakeholder opinions regarding the reform. 'What's the problem represented to be?' approach as a methodological framework. RESULTS: The study discovered three AOD-related discourses: the Control, Welfare, and Rights and Legality discourses. The Control discourse represented people who use AOD as risky individuals and called for ways to manage risks in treatment situations. The Welfare discourse portrayed people who use AOD as a vulnerable group whose problems should be addressed by the welfare system. The Rights and Legality discourse represented the vague legal definitions of AOD use as the main regulatory problem. The discourses differed in terms of their definitions of self-determination. CONCLUSIONS: The study illustrated how the right to self-determination as a legal concept is contested and can be interpreted in different ways depending on the representations of AOD use. The differing representations highlight the tensions involved in improving the rights of people who use AOD.

Night-time is the right time? Late-night drinking and assaults in Finnish public and private settings.

INTRODUCTION AND AIMS: The risk of alcohol-related injuries and violence increases in late-night settings. We analysed temporal patterns of drinking and assaults and present an event-level analysis of connections between night-time drinking, estimated blood alcohol level, location and drinkers' age and sex. DESIGN AND METHODS: Main data source is a Finnish general population (aged 18-69 years) survey carried out in 2016 (n = 1962), including event-level data on drinking occasions in the previous 7 days (n = 1891). Statistical analyses consisted of tabulations and logistic regression analyses. RESULTS: Finns' drinking peaked around 8-9 pm on most days, with the greatest peaks on Fridays and Saturdays. The main pattern was similar for drinking occasions occurring in home surroundings and in licensed premises, but a larger proportion of the latter occurred in later hours of the day. Assaults had a similar weekday distribution, but the peak occurred several hours later, around 3-5 am. One explanation is that the mean estimated blood alcohol concentration strongly increased as the ending time of the drinking occasion extended later into the night, and the proportion of late-night drinking was higher in licensed premises than home surroundings. DISCUSSION AND CONCLUSIONS: Peaks for assaults in public places temporally coincide with the late closing times of licensed premises and with high estimated blood alcohol concentrations among drinkers. The results underline a need to reduce harm from intoxication, which in public places could include restricted opening hours, increased law enforcement, improved responsible beverage service practices and other interventions to better manage aggression.

Change and continuity in Finnish drinking in the 21st century.

Aim: Alcohol consumption and policy in Finland have undergone a variety of changes in the two last decades. In several cases, trends in both consumption and policy have shifted direction when moving from the first decade of the 21st century to the second one. The aim of the overview is to summarise the trends. Data: The overview draws on results primarily from the cross-sectional Finnish Drinking Habits Survey (FDHS) in 2000, 2008 and 2016, and also from the whole series including altogether seven separate data collections carried out every eight years from 1968 to 2016 and mainly covering Finns aged 15-69 years. Response rates show a falling trend (78% in 2000, 74% in 2008 and 60% in 2016). The overview also makes use of data collected within the European School Survey Project on Alcohol and other Drugs (ESPAD) and, for the elderly, the National FinSote study carried out by the Finnish Institute for Health and Welfare (THL). Results: After an all-time high of 12.7 litres of pure alcohol per capita 15 years and over in 2007, total consumption of alcohol had decreased by 21% by the year 2019. Underage drinking has decreased ever since the millennium shift. Older people's drinking has continued increasing or levelled out. Along with reduced total consumption, heavy episodic drinking (HED) has also decreased, but the differences between manual and white-collar workers in HED have continued to grow. Drinking alcoholic beverages with meals has also declined since 2008. Liberal and restrictive alcohol policy measures have alternated. Conclusions: Finnish drinking culture seems to change at a slow pace; several typical drinking habits have remained unchanged.

The Finnish Drinking Habits Survey: Implications for alcohol policy and prevention.

Aims/materials: This reflection piece reviews some of the key results and conclusions from the book Näin Suomi juo (This is how Finns drink, 2018), based on the Finnish Drinking Habits Survey. Our aim was to go through the results taking the perspective of prevention workers and policymakers: how could they benefit from the scientific findings when tackling alcohol-related harm? Results/reflections: The reflections displayed in this article provide some useful arguments and justifications for population-level alcohol policy in the controversial alcohol policy debate. Harms do not only arise among the heaviest drinkers, and efficient methods to prevent harm may be found among the prevention efforts that apply to populations rather than only to the heaviest drinkers. The article also illustrates how the results from a population survey can be used in order to identify specific challenges and solutions for alcohol prevention in a given population. The results help in identifying the population groups and situations with an elevated risk of alcohol-related harm and in characterising the drinking patterns and social situations in which drinking takes place in these vulnerable parts of the population. Conclusions: The review illustrates that a many-sided understanding of alcohol consumption and the related harm, based on survey results, is more far-reaching in terms of prevention and policy than a knowledge base built solely on register data on the development of alcohol consumption and harm. For example, the respondents' drinking patterns are linked not only to their attitudes and risk perceptions but also to what people consider to be appropriate means to reduce alcohol use and the related harm in terms of alcohol policy, informal social control and people's life management.

Effects of a community intervention to reduce the serving of alcohol to intoxicated patrons.

AIMS: To assess the effects of an alcohol prevention programme to reduce the serving of alcoholic beverages to intoxicated clients on licensed premises. RESEARCH DESIGN: A controlled pre- (2004) and post-intervention study (2006) design. INTERVENTION: A community-based programme combining law enforcement, responsible beverage service training, information campaigns and policy initiatives in one Finnish town (Jyväskylä). PARTICIPANTS AND MEASUREMENTS: A male actor pretended to be clearly under the influence of alcohol and tried to buy a pint of beer at licensed premises. For the baseline measurement, every bar and nightclub was visited in the intervention and the control areas (94 licensed premises in total). Post-intervention data were gathered with the same principles (100 licensed premises in total). A researcher observed every visit and documented the results. RESULTS: In the post-intervention study there was a statistically significant increase in refusals to serve denials alcohol to the actor in the intervention area (from 23% to 42% of the licensed premises) compared to refusals in the control area (from 36% to 27% of the licensed premises). CONCLUSION: Previous research has documented that multi-component community-based interventions can have a significant impact on over-serving of alcohol when training and house policies are combined with effective law enforcement. The present findings also demonstrate that comprehensive Responsible Beverage Service (RBS) interventions applied at a local community level can be effective in decreasing service to intoxicated clients in a Nordic context.