Treating equivalent cases differently: A comparative analysis of substance use disorder and type 2 diabetes in Norwegian treatment guidelines

Abstract

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) definitionof 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 theT2D guideline reflects the WHO's conceptualization of chronic illnesses. We arguethat this discrepancy implies that SUD is understood as a moral and legal problem,whileT2D is conceptualized as a somatic illness. We discuss how social, political andhistorical conditions of the possibility for understanding SUD are interwoven withnormative presumptions about the clinician, patient, treatment guidelines and drugpolicies in a way that may impede the development of continuing care. Conclusion:The paper concludes that the delivery of treatment services isinequitable as SUD is not treated as a chronic illness.