Along with the efforts to classify the problem, the institutions also had to find ways to handle it. This is where the real challenge and need for accom- modation appeared. The initial response to the challenge was for all three institutions – prisons, psychiatry and child and youth care – to try to ‘inte- grate’ young drug users into the existing populations and as far as possible to
use the existing methods and technologies. This strategy failed for them all, but in different ways and for different reasons, and naturally the interesting thing is what they did as a consequence of this.
The prison service
When the Directorate for the Prison Service was asked by the Committee on Adolescent Drug Abuse to account for its immediate response to the new drug problem in 1968, it made it clear that it did not consider prisons to be the right place to conduct drug treatment. The Directorate suggested that only drug abusers whose delinquency was due very little to drugs should be put in (youth) prisons:
[…] people for whom drug abuse is only a random part of an anti-social pattern, and for whom the crime pattern is heterogeneous, … and … young drug abusers who have no criminal record and where it is assessed that the drug abuse is not too severe, especially because they are not deeply involved in the drug sub-culture. (Kriminalforsorgen 1968: 5).
People with more serious drug problems were to receive treatment instead of imprisonment, for instance after a suspended sentence. The number of drug abusers placed in prison should represent no more than one-fifth of the total prison population. Furthermore, with the exception of a special ward for drug abusers with hepatitis, they should be placed among other prisoners in the hope that these prisoners would have a positive influence on the drug abus- ers. This policy of mixing prisoners with drug problems with other prisoners was called the ‘dilution policy’ (Kontaktudvalget 1969: 225; Sylvestersen 1970: 3; Kriminalforsorgen 1971: 3). Even without major new measures, the Prison Service did expect that handling the drug problem would require extra resources. The hope was that these ‘acute’ measures would accommodate the problem. They failed to do so. In November 1971 the prisons receiving the largest number of drug users had a proportion of drug abusers which in some cases far exceeded one-fifth of the total population (Vestre Prison in Copenhagen: 25 %; Nyborg Youth Prison: 65 %; Søbysøgård Youth Prison: 75 %) (Kriminalforsorgen 1971: 1).
The psychiatric system
The immediate response of the psychiatric system to young drug abusers was to place them among other patients. Until the 1960s the psychiatric system had been used to provide treatment for ‘medicine abuse’, involving individuals who primarily had an unauthorised consumption of prescription medicine. This condition was seen as a symptom of mental and/or emotional problems, and it was treated by withdrawal from the drugs involved and psychiatric treatment of the problems causing the abuse of medicine. In contrast to this, as I have already shown, it soon became clear that the drug problems of the young drug users were of a social and psychosocial nature, and did not necessarily involve a bona fide mental illness. Whereas the ‘mixing’ strategy in the prison system was made difficult because there were too many young drug users who were too entrenched in a drug-using lifestyle, the problem for the psychiatric institutions was that the drug abusers were too young and that they constituted a sub-culture. The drug abusers were younger than most of the other patients, and this led to tensions and conflicts in the wards even when efforts were made to make the environment attractive to young patients.
Most of them think the wards are old-fashioned and inappropriately or- ganised. They don’t like them and are critical about being placed with much older psychiatric patients. They are bored most of the time on the wards, and they miss adequate activities and entertainment, the chance to play their special music. (Jørgensen in Pedersen 1981: 24).
At one hospital such problems led to the placement of young drug users in special wards, but still among other categories of patients. But even without the generation problem, it was a problem that the young drug users belonged to a sub-culture, which they brought with them into the hospitals. This sub- culture – like any sub-culture within a total institution (Goffman 1967) – represented a threat to the normative system, the hierarchy and the social roles, not least the ‘patient role’ and the patient-doctor relationship upon which the system rested (Goffman 1967; Jørgensen & Ulff-Møller 1972).
First of all a number of difficulties are associated with treatment of drug abusers in the hospital. They stand apart from the other patients and the staff both with regard to clothes and behaviour and because they constitute a sub-culture with all the conflicts that follow from this. (Groth 1970: 222).
The child and youth care system
By 1968 it was estimated that 10 % of the clients at reform schools11 in the child and youth care system were drug users (Nielsen 1970); although about one-fifth of the clients at some schools were drug users (Perch 1969). These clients turned out to be different from the other clients, and caused a number of problems. One of these problems was that they were a source of ‘infection’ because they took drugs with them into the institutions, where other clients might pick up the habit. This led to discussions about establish- ing special closed institutions for drug users (Jørgensen 1969; Perch 1969; Nielsen 1970). But in 1968 the three reform schools, which had the largest number of drug users presented their experiences of the new clients, and one of these schools stated:
Experience has shown that in the treatment work it has been necessary to try to let the young people talk about their sometimes very well-defined motives for choosing an anti-social existence, and the best results have been reached by using arguments instead of prohibition and restrictions. (Sund- hedsstyrelsen 1968: 169).
In the end one closed unit which had been established before the emergence of the new drug problem was used for a while (Nielsen 1970). But in order to handle the problem four reform schools were given the special task of provid- ing drug treatment, one of the aims being to keep drugs and drug users out of the other schools. This did not happen, and in 1969 it was recognised that a large proportion of the clients at reform schools had tried or were using marihuana, and the four schools were given the task of providing treatment for the most severe cases (Kontaktudvalget 1970). The problems involved in integrating young drug users into reform schools cannot be dissociated from the more fundamental institutional challenge which the young drug
users posed not only for the reform schools, but also for the prison system and the psychiatric system.