Elvebakken Upper Secondary School

Elise Harwiss from Elvebakken Upper Secondary School came in first place in the 2022 Holberg Prize Schoool Project with the research project: “The role of relatives in heroin assisted treatment”.

Elise Harwiss from Elvebakken Upper Secondary School came in first place in the 2022 Holberg Prize Schoool Project with the research project:  “The role of relatives in heroin assisted treatment“

HAB (heroinassistert behandling, or heroin assisted treatment) started as a trial study in Oslo and Bergen in Norway. The treatment is reserved for patients with severe opiate addictions and where opioid replacement therapy has been unsuccessful. The patients are offered safe and clean injections or pills with a predictable and safe dosage, all under supervision of medical staff in case of side effects. During treatment all patients are followed up by medical staff and social workers. 

What all these HAB patients have in common, as Harwiss points out, is that they all have next of kin  whose opinions and inputs are to be taken into consideration according to the study. Being the next of kin to someone with an opiate addiction can be experienced as shameful and characterised by hopelessness, as they watch their loved ones go through unsuccessful treatments and relapsing. This experience has a great impact on the lives of the relatives, although this side of the story is greatly underrepresented in the public debate on HAB . The problem statement of Harwiss research is as follows: What is the role of relatives in Herion Assisted Treatment and how does Heroin Assisted Treatment in Oslo factor in taking care next of kin during treatment?

Harwiss draws on available studies, both quantitative and qualitative, that deals with HAB and the role of relatives of the patients receiving treatment. The author has also conducted in-depth interviews. She takes ethics into strong consideration, and therefore chooses not to speak with any relatives herself but instead selects key informants holding knowledge about the topic. The key informants are all representatives of different organizations for relatives of addicts and associations promoting humane drug policies. Harwiss acknowledges that two of the informants are part of a user council and, thus, have impacted the design of HAB. Harwiss’ theoretical framework is based on Goffman´s (1993) theory of roleplaying in switching between public and private identity, as well as labeling theory.

In her research, Harwiss finds that in the national guidelines for HAB , next of kin of opiate addicts do have multiple rights that the national health service is obligated to fulfill, such as the right to sufficient information and education on the topic of HAB treatment. There are great variations in the social network of HAB patients, as well as how many, if any, of the next of kin the patient wishes that HABiO contacts. Crucially, inclusion of next of kin is determined by the patients, and there is no singular focus on them as an individual group. Just as a theater audience wishes to be invited backstage, next of kin can wish to be more included in the treatment of their loved ones.

 Harwiss concludes with the notion that whereas everyone agrees that the next of kin shall and must receive help, there is a general lack of assuming the responsibility for offering such help.