■ Aims The aim of this article is to investigate the problem formulations – the preconceptions about causes and effects and the possible solutions to the problems of alcohol abuse – that characterized the compulsory institutional care of alcohol abusers in Sweden in the 20th century. The article focuses on problem formulations that actually were practised in the institutions. ■ Methods & Data The main source material is to be found in the archives of four institutionalized care establishments and consists of official reports, correspondence, supply estimates, circulars for consideration and – above all – patient records. From this material you can learn about the institutions' struggle for autonomy, expansion and legitimacy, and also about the clients' characteristics and how the clients were viewed. The study of the archives allows you to form a picture of the problem formulations that affected the activities in the institutions directly, a picture that goes beyond the more abstract expectations preferred by official reports and legislation. ■ Results Within the compulsory institutional care actually carried out, the problem formulations that were stipulated in the gender-neutral legislation and vague regulations became gender-specific and precise. The treatment of alcohol abusers was a class and gender related project, aiming not only at encouraging male diligence and the fulfilling of a man's maintenance obligation but also at female virtuousness and concern for the family. ■ Conclusions The history of alcohol abusers' treatment shows that alcohol itself has been a secondary factor in problem definitions which have let themselves be attached – via perceived links with either cause or effect – to more overarching social issues in Sweden. The concerns of emergent family policy in the 1940s, the developmental optimism and scientistic passions of the 1950s, and the systemically critical protest movements of the 1970s are all clearly reflected in trends within social care services for alcohol abusers – albeit much more often at the level of discourse than of praxis.