Myhre Linda Pettersen, Fineide Mona Jerndahl
Managing director, Lukra veiledning AS, Askim, Norway.
Professor, Department of Welfare, Management and Organisation, Østfold University College, Halden, Norway.
Nordisk Alkohol Nark. 2025 Feb;42(1):39-56. doi: 10.1177/14550725241295458. Epub 2024 Dec 19.
Research has identified the use of anabolic-androgenic steroids (AAS) as a gap between treatment needs and available facilities for substance use disorder (SUD) treatment in Norway. State policy emphasizes the need for measures to ensure coordinated treatment services. This study aims to explore whether clinical pathways of mental health and substance abuse and team-based organisation function as intended in the treatment of patients with AAS use. A qualitative research design was used. Individual semi-structured in-depth interviews were conducted with eight professionals who we assumed had experience with this patient group. The participants were asked about the clarification process regarding assessment and treatment for AAS and internal and external cooperation. Everyday work, roles and task distribution, structure and routines, and knowledge of AAS were topics that were addressed. We analysed by interpreting the data considering relevant theoretical perspectives of organisational- and sociology of profession perspective. We found that it was arbitrary whether AAS use was discovered, which may indicate a lack of attention to this form of abuse. Organisation in teams seems to as an adequate horizontal coordination mechanism within SUD treatment. However, the teams lacked both knowledge of AAS as well medical expertise, which may lead to a lack of a treatment programme that is in line with the patient's needs. There still seems to be a need for increased awareness of AAS among the professionals and organisations involved. Team-based organisation within SUD seemed to function well, however loss of coordination between SUD and local services may indicate that the clinical pathway for mental health and substance abuse do not function as intended.
研究发现，在挪威，合成代谢雄激素类固醇（AAS）的使用揭示了物质使用障碍（SUD）治疗的需求与可用设施之间的差距。国家政策强调需要采取措施确保治疗服务的协调。本研究旨在探讨心理健康与药物滥用的临床路径以及基于团队的组织在治疗使用AAS的患者时是否按预期发挥作用。采用了定性研究设计。对八位我们认为有该患者群体治疗经验的专业人员进行了个人半结构化深度访谈。参与者被问及关于AAS评估和治疗的澄清过程以及内部和外部合作。日常工作、角色和任务分配、结构和常规以及对AAS的了解都是讨论的话题。我们通过从组织和职业社会学的相关理论视角解读数据进行分析。我们发现，AAS的使用是否被发现具有随意性，这可能表明对这种滥用形式缺乏关注。团队组织似乎是SUD治疗中一种适当的横向协调机制。然而，这些团队既缺乏对AAS的了解，也缺乏医学专业知识，这可能导致缺乏符合患者需求的治疗方案。在参与的专业人员和组织中，似乎仍需要提高对AAS的认识。SUD中的团队组织似乎运作良好，然而SUD与当地服务之间的协调缺失可能表明心理健康与药物滥用的临床路径并未按预期发挥作用。
