Children Who Inject Drugs: Comparing Frontline Workers’ Responses in Sweden, Switzerland, and Wales

This paper presents findings from a cross-national study comparing frontline workers’ actual and potential responses to injecting drug use among minors (under 18) in Sweden, Switzerland, and Wales. We investigate if and how distinct drug policy contexts and child protection systems appear in front-line workers’ talk, and whether divergent policy settings might be associated with differential institutional responses. Attention is given to the different discourses which practitioners draw upon when depicting needs and suggesting appropriate measures. The data comprise six focus groups (two in each country) and vignettes serve as a basis for the discussion. Our analysis shows country differences and similarities; however, not always in line with policy expectations. Three country-specific patterns are identified: compulsory measures as default mode (Sweden), harm reduction as default mode (Switzerland), and drug use as secondary concern (Wales). A similarity across countries was a strong tendency to propose interventions that corresponded to already existing ones, originally developed for adults, whether these focused on abstinence or harm reduction. Our findings contribute to a limited empirically based knowledge regarding assessment processes and available services for children injecting drugs in Europe. It offers a starting point for reflection on how prevailing policy contexts influence everyday social welfare practices in the field of drug use.