Evidence Production for Psychosocial Treatment of Substance Use Problems

Aims: In the article at hand we intend to discuss to what extent hitherto efforts towards standardization and quality assurance have been able to achieve stability concerning the production of evidence, and whether an actual evidence-based practice for psychosocial interventions for alcohol and drug problems is anywhere truly in the making. Methods: To explain several methodological inadequacies we make use of a perspective commonly referred to as the actor-network theory (ANT). This is characterized by a strong interest in detailed analysis of how an innovation or an idea is transformed due to interaction with its situated and specific conditions. The empirical material is taken from four earlier studies of our own hands. Results: We have given examples of how an unsystematic handling of different control group designs can lead to serious misinterpretations of intervention effects. The same goes for researcher allegiance, the use of different types of criteria in order to rank different types of evidence, unmotivated restrictions on the inclusion of evidence in a given systematic review, or as in the case of several US clearinghouses, to use extremely weak criteria when discriminating between what is evidence-based and what is not. Conclusions: We suggest that all of these shortcomings are directly or indirectly related to translations, modifications or neglect to adhere to methodological rules intended to produce a reduction of biases and increase standardization