AUTHOR=Flyger Julie , Larsen Christina Viskum Lytken , Jensen Else , Niclasen Birgit , Nielsen Anette Søgaard 

TITLE=A qualitative study of the implementation and organization of the national Greenlandic addiction treatment service

JOURNAL=Frontiers in Health Services

VOLUME=Volume 4 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/health-services/articles/10.3389/frhs.2024.1219787

DOI=10.3389/frhs.2024.1219787

ISSN=2813-0146

ABSTRACT=Background: Alcohol and cannabis use constitute major public health problems in Greenland, and thus it is of importance to assess if Allorfik, a new national outpatient addiction treatment service introduced in 2016, was implemented successfully and how it is perceived. Allorfik introduced local treatment centers offering a treatment methodology (Motivational Interviewing and Cognitive therapy) new to addiction treatment in Greenland and with limited evidence from indigenous populations like the Greenlandic. The present study investigates the implementation of Allorfik from the perspective of those engaged in the process and in the field.Methods: Data consists of transcribed interviews with 23 individuals from both Allorfik and organizations collaborating with or supposed to collaborate with Allorfik. The theme of the interviews were their perspectives of the implementation process, enablers, and obstacles in the process as well as how Allorfik was performing at the time of the interview. The interview guide was informed by implementation theory. The transcribed material was analyzed using a general inductive approach.Results: the analysis resulted in three overall and interconnected themes: implementation, collaborations, and challenges. The implementation was overall considered a success by the interviewees as all components were implemented as planned with a few adaptions e.g., a treatment guideline update. Collaborations are considered challenging but important to all interviewees. Collaboration seems to rely on the personal commitment as opposed to well-defined structures, making it unstable and vulnerable to changes of staff. One of the main challenges highlighted by the interviewees is the number of problems other than addiction among people in treatment, which makes addiction treatment and recovery difficult to achieve. Nevertheless, the high levels of other problems being treated in Allorfik highlights the need of easily accessible therapy as many find that Allorfik is the only place to turn to in times of crisis.  Conclusion: Allorfik seems to have been implemented in accordance with original intentions and plans for addiction treatment service but have also become more than just a service for addiction treatment with easy access in country with vast distances and limited resources.