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Article Excerpt
For decades, restrictive and universal measures have dominated alcohol policies in Sweden and other Scandinavian countries. How far the dismantling of such policies has reached is subject to dispute, but no one questions that alcohol policies inspired by the total-consumption model are currently in retreat (Tigerstedt, 2001). What the final outcome of this process will be is uncertain, but a number of patterns or characteristics are becoming discernible. Besides the fact that the doctrine of total consumption is losing ground as an integrating principle, alcohol policy is increasingly targeted at selected groups and arenas, such as youths, pregnant women, travel and the workplace (Sulkunen, Sutton, Tigerstedt and Warpenius, 2000).
These shifting perceptions of alcohol problems and policies in Sweden are also reflected in the way that the overall goal of national alcohol policy has been rephrased. Between the late 1970s and the mid-1990s, this goal was to "... achieve a reduction in the total level of alcohol consumption such as to contribute to holding back the level of alcohol addiction and with this also to counteract alcohol-related harms" (Statens offentliga utredningar [SOU] 1994:25, p. 32). In the most recent governmental bill (Regeringens proposition, 2000, p. 39), the priorities of the goals of reducing total alcohol consumption and holding back alcohol addiction are reversed. Now the ambition is formulated as "to reduce total alcohol consumption in the country by 2005. This goal will be achieved by preventing people from becoming heavy drinkers and by trying to influence the habits of heavy drinkers." The most recent formulation of the goal of public alcohol policy has been drafted by a new committee appointed to implement the current bill. According to this committee, the task is "to work for a better alcohol culture. The goal is to reduce drinking that results in intoxication. We will also work to reduce harms to the individual, within the family, as well as in society at large" (Alkoholkommitten, 2001, p. 1). Their action plan prioritizes five subtasks, of which the first is that "alcohol should not be consumed in connection with transport, in workplaces or during pregnancy" (Alkoholkommitten, 2001, p. 1). The remaining four tasks also focus on certain groups or arenas, or on drinking to intoxication, but no mention is made of reducing total consumption levels.
The process by which the focus has been shifted from total consumption, with universal and restrictive measures, to risk groups and individualized strategies has now continued for over ten years. The major concern is to find "compensatory" measures as the opportunities for maintaining high prices and restricting availability disappear. Prevention in the workplace is consistently referred to as being among the most important and promising of these measures.
A number of motives for the use of prevention in the workplace recur frequently in the discourse. These include consideration for the working environment (addiction and problematic drinking have negative consequences for physical and psychosocial conditions at work); security reasons (many working operations are associated with risks and therefore require sobriety); quality-related considerations (being under the influence of alcohol or other drugs reduces the efficiency and quality of work, and absences due to illness increase); and humanitarian reasons (early interventions and treatment minimize the risk for social maladjustment among workmates).
The literature on prevention in the workplace is sparse in Sweden, particularly research reports that focus on preventive strategies. The theoretical basis of such preventive efforts is said to be "still in its infancy" (Ahlberg, Allebeck and Leissner, 1998, p. 180). Whenever the literature mentions prevention, the primary concern is with preventing people from increasing their levels of abuse and providing them with timely assistance. This is a common feature; what is really being discussed is secondary, not primary, prevention (e.g., Hermansson, 2002; Creutzer, 1997). Another issue that is frequently discussed, particularly in the media, is the use of alcohol and drug testing. Drug tests are often referred to as a way of preventing employees from using drugs both in and away from the workplace. Alcohol tests are more often used to provide evidence in support of an employer's suspicion that a certain employee is intoxicated. Providing the tests work, then, alcohol testing constitutes more of a secondary prevention method, and drug testing a method of primary prevention. The effectiveness of alcohol and drug tests is rarely discussed, however (Eriksson and Olsson, 2001).
Swedish research into alcohol, drugs and the workplace has mainly focused on the question of which factors in the working environment and the corporate culture might influence employees' drinking habits (Axnas and Olsson, 2000; Linden-Bostrom, 1990; Eskilsson, 2001; Edsbrand and Ohlin, 2001a, 2001b). A research project currently under way at the University of Gothenburg aims to develop methods and instruments for the evaluation of preventive measures in the workplace. One conclusion reached thus far is that it is difficult to register the effects and changes resulting from primary prevention and to isolate these effects from other changes taking place in society (Leissner, Ahlberg and Allebeck, 1996).
Besides research, there are numerous other sources of information on alcohol and drug problems in the workplace. The ALNA council, an organization set up in 1960 by national employers' and workers' organizations, is the largest body that actually works with primary as well as secondary and tertiary prevention. The council offers counseling and guidance to workplaces on formulating alcohol and drug policies and action plans. It also offers general alcohol and drug information and education to employees and employers alike. In addition, a small number of private organizations that serve the same function as ALNA. (1)
Other sources of written information on alcohol and drugs in the workplace include the trade unions and employers' organizations. This literature focuses on what to do when problems arise and on the legal responsibilities of employers. It also deals with the issue of early intervention and provides advice on signs that indicate abuse. The unions and employers' organizations primarily provide advice to their own membership. They also discuss the importance of the working environment in relation to preventive measures; alcohol and drug issues, it is felt, should be integrated into the wider context of the working environment (e.g., Wikander, 1992; Wibell, 1991).
The international literature is far more extensive, especially in the U.S., but here...
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