Nils Bejerot - Bejerot On Factors That Increase The Risk of Abuse

Bejerot On Factors That Increase The Risk of Abuse

Before Bejerot began to participate in the debate on drugs in 1965, it was the dominant view in Sweden that drug abuse was a private health problem and that law enforcement measures should be aimed at drug dealers. Before 1968, the maximum offence for a grave drug crime was one year in prison. Bejerot objected to this and stressed the importance of measures against the demand for drugs, against users, and their importance in the spread of addiction to new addicts.

Bejerot did not accept unemployment and poor private economy as explanations for increased use of illegal drugs. He pointed out, that alcohol abuse in the 1930s was comparatively limited in Sweden, despite high unemployment and economic depression.

Nils Bejerot stressed five main factors that cause increased risk of an individual of becoming a drug abuser:

• Availability of the addictive substance
• Money to acquire the substance
• Time to use the substance
• Example of use of the substance in the immediate environment
• A permissive ideology in relation to the use of the substance.

Bejerot advanced the hypothesis that when addiction supervenes it is no longer a symptom but a morbid condition of its own. In the abuse stage one can willfully control their consumption and intoxicating themselves at will, but eventually - depending the product's addictive qualities, the dosage, the intensity of the abuse, individual factors etc. - the drug abuse can turn into drug dependency, the drug use receive the strength of an instinct. Then its development will not be affected by removal of the initiating factors, the drug dependency has the strength and character of a natural drive, even though it is artificially-induced.

He compared addiction with a very deep love, writing that addiction is "an emotional fixation (sentiment) acquired through learning, which intermittently or continually expresses itself in purposeful, stereotyped behavior with the character and force of a natural drive, aiming at a specific pleasure or the avoidance of a specific discomfort."

This would however not mean that drug addiction was impossible to treat. The abuse was learned, hence it is also possible to relearn, how to live without drugs, and treatment of drug addicts should have a drug-free goal, differing with others who aimed at reduction of adverse effects, also known as harm reduction. Bejerot thus criticized programs of long methadone treatment of opiate users in programs that were not aimed at drug freedom.