同等情况不同对待：挪威治疗指南中物质使用障碍和 2 型糖尿病的对比分析。
Treating equivalent cases differently: A comparative analysis of substance use disorder and type 2 diabetes in Norwegian treatment guidelines.
机构信息
Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.
出版信息
J Eval Clin Pract. 2022 Oct;28(5):721-728. doi: 10.1111/jep.13693. Epub 2022 Apr 28.
BACKGROUND
Substance use disorder (SUD) is often understood as a chronic illness.
AIMS
This paper investigates whether SUD is treated as a chronic illness.
METHOD
To this aim, we have used World Health Organizations (WHO's) definition of chronic illness to conduct a comparative analysis of SUD and type 2 diabetes (T2D), which is another chronic illness.
RESULTS
When analysing Norwegian treatment guidelines, we found that only the T2D guideline reflects the WHO's conceptualization of chronic illnesses. We argue that this discrepancy implies that SUD is understood as a moral and legal problem, while T2D is conceptualized as a somatic illness. We discuss how social, political and historical conditions of the possibility for understanding SUD are interwoven with normative presumptions about the clinician, patient, treatment guidelines and drug policies in a way that may impede the development of continuing care.
CONCLUSION
The paper concludes that the delivery of treatment services is inequitable as SUD is not treated as a chronic illness.
背景
物质使用障碍（SUD）通常被理解为一种慢性疾病。
目的
本文旨在探讨 SUD 是否被视为一种慢性疾病。
方法
为了达到这个目的，我们使用了世界卫生组织（WHO）对慢性疾病的定义，对 SUD 和 2 型糖尿病（T2D）进行了比较分析，T2D 也是另一种慢性疾病。
结果
在分析挪威的治疗指南时，我们发现只有 T2D 指南反映了 WHO 对慢性疾病的概念化。我们认为，这种差异意味着 SUD 被理解为一个道德和法律问题，而 T2D 则被概念化为一种躯体疾病。我们讨论了 SUD 的理解的可能性的社会、政治和历史条件如何与临床医生、患者、治疗指南和药物政策的规范假设交织在一起，这可能会阻碍持续护理的发展。
结论
本文的结论是，由于 SUD 没有被视为一种慢性疾病，因此治疗服务的提供是不平等的。
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