(O)synliga namn och synliga nålar : En kvalitativ dokumentstudie om hur anonymitet och motivation formar sprututbytesverksamheter i Sverige och i Finland

Sammanfattning

Title: (In)visible names and visible needles – How anonymity and motivation forms needle exchange programs in Sweden and Finland. This study examines how policy documents in Sweden and Finland articulate and assign meaning to the concepts of anonymity and motivation within needle exchange services, and how the relationship between these concepts is constructed. The aim is to compare how the two Nordic countries frame anonymity and motivation in relation to needle exchange activities. The empirical material consists of national-level policy documents regulating or guiding needle exchange services in both countries. The analysis is conducted using critical discourse analysis, specifically Fairclough’s critical discourse analysis which is a three dimensional model which includes text analysis, discursive practice and social practice. The results show that although Sweden and Finland share similar welfare state structures, their implementation and framing of needle exchange services differ significantly. Swedish policy documents emphasize control, identification, and documentation, presenting motivation as a requirement for participation and positioning needle exchange primarily as an entry point to other forms of treatment. In contrast, Finnish policy documents highlight anonymity, internal motivation, and low-threshold access, constructing needle exchange as a harm reduction intervention and a form of care in its own right. While both countries aim to reduce the negative health consequences associated with drug use, their policy traditions lead to different discursive constructions of responsibility, access, and the role of needle exchange services. These findings illustrate how language in policy documents shapes both the understanding of harm reduction and the conditions under which individuals may access support.