Staff Interpellation of Drug Testing in Youth Substance Use Treatment: Enactments of a complex Biotechnological Object

Drug testing through urinalysis is extensively used in the treatment system for youth substance use, in Sweden and elsewhere. Still, knowledge is scarce on how treatment staff understand the impact of this assessment method on disciplinary roles, work prioritizations, collaboration with other stakeholders, and meeting service users’ needs. This study aimed to examine assumptions about biotechnology, patients and interventions that professionals in Swedish youth treatment draw on to make drug testing meaningful in their clinical work. Twenty interviews were analyzed with a focus on how urinalysis was interpellated as an object by research participants, and on what subject-positions different interpellations enacted. By drawing on a wide range of narrative forms, the professionals interpellated urinalysis as a multiple and fluid object: it both was and was not: necessary, caring, compulsory, intrusive, a truth producer, and a means to determine treatment progress. These interpellations enacted professional-subjects who were both able and unable to break with clinical protocols and external expectations, but always capable of balancing care and control. They also enacted patient-subjects as vessels of information, youth in need, convicted offenders, citizens with rights, minors under paternal control, and untruthful drug users. The study demonstrates the complexity of urinalysis in youth treatment, and that it builds on and advances suspicion and zero-tolerance towards substance use. The deployment of drug testing appears as the least common denominator among diverse stakeholders with differing interests and ambitions in addressing youth substance use problems, and therefore as a stabilizer of a treatment system that could otherwise disintegrate. In staff interpellations, this biotechnology provides legitimacy as being evidence-based, encouraging between-agency collaboration and representing a shared push towards the same goal: drug-free adolescents. We, however, argue that the centrality of urinalysis in this treatment restrains productive discussions about other ways to address youth drug problems.