ABSTRACT
Ideally, public policy is guided by strong scientific evidence pointing toward a specific form of implementation. However, most policy cannot be decided in this way. Diverging evidence points in different directions, the same evidence can be taken as argument for opposing interpretations and sometimes policy must be formulated with scarce or even absent evidence. Different frameworks for science-based decision-making approach these issues in various ways. The authors argue that the explanatory approach is the superior approach for science-based decision-making when facing either diverging evidence, diverging interpretations and/or scarce evidence. As an illustration of their argument, they examine the current Norwegian guideline for treatment and rehabilitation of substance use disorders and addiction. Substance use and substance use disorders is a particularly interesting field since within it there is contestation concerning a wide variety of issues, such as legality, treatment, the nature of the disease, the quality of evidence and the general ideology of treatment. The authors argue that the explanatory approach, with its focus on transparency, consistency and rigor, can direct future guidelines in a direction that accommodates legitimate criticisms while counteracting illegitimate accusations, thus improving the quality of arguments within future guidelines and elevating the willingness of clinicians to implement them.
