Denmark Country Drug Report 2017

Drug harms

Drug-related infectious diseases

In Denmark, notifications of human immunodeficiency virus (HIV) infection, which are based on diagnostic reporting following voluntary testing, are registered by the Statens Serum Institut. The number of newly diagnosed HIV cases that can be attributed to drug injecting is relatively low (approximately 3 % of all newly notified HIV infections in Denmark in 2015) and has remained stable over recent years.

Drug-related infectious diseases may be under-diagnosed in Denmark, since drug users are not regularly tested. The latest data on HIV prevalence among PWID are from 2004- 08, when a special study indicated that the HIV prevalence rate among PWID was 2.1 %

Cases of hepatitis C virus (HCV) infection are frequently linked to injecting drug use, and HCV remains the most common drug-related infectious disease among PWID. In contrast, hepatitis B virus (HBV) infection is less frequently linked to drug injecting. The proportion of chronic HBV cases that can be attributed to injecting drug use has varied between 2 % and 7 %, whereas, for chronic HCV, this proportion has varied between 56 % and 75 % in the last decade. The proportion of acute HBV cases linked to injecting drug use has varied between 4 % and 42 %, and acute HCV cases have varied between 0 and 86 %.

The latest data on the prevalence of HCV among PWID date back to a 2008 study that reported a rate of around 52.5 %. It is estimated that approximately one quarter of drug users are infected with HBV.

Drug-related emergencies

Drug-related emergency data originate from the National Patient Register and refer, from 2014, to patients contacting acute outpatient facilities.

In 2015, a total of 2 484 case of poisoning with illicit substances were reported (up from 2 280 cases in 2014). Opioids remain the main cause of non-fatal poisoning in Denmark in 2015; however, the number of emergency cases linked to heroin has fallen, whereas the number of poisonings as a result of other opioids (mainly methadone) has increased. In 2015, there were 510 cases related to ‘other opioids’ and 498 cases related to ‘polydrug use and unspecified’. Those who experience non-fatal overdoses from opioid use are older than those who require emergency care as a result of synthetic stimulants (mainly amphetamines). In 2015, more than one third of drug- related poisonings were among those under 25.

Newly diagnosed HIV cases attributed to injecting drug use

NBNB: Year of data 2015, or latest available year.
Source: ECDC.

Prevalence of HIV and HCV antibodies among people who inject drugs in Denmark

NBYear of data for HIV is 2006, for HCV is 2008.

An emergency room in a Roskilde hospital participates in the European Drug Emergencies Network (Euro-DEN) project, which was established in 2013 to monitor acute drug toxicity in sentinel centres across Europe.

 

Characteristics of and trends in drug-induced deaths in Denmark
 

NBYear of data 2014.

Drug-induced deaths and mortality

Drug-induced deaths are deaths directly attributable to the use of illicit drugs (i.e. poisonings and overdoses).

In Denmark, drug-induced deaths are recorded in the National Police Register and the Cause of Deaths Register of the Statens Serum Institut. The data extracted from the Cause of Deaths Register are in line with the EMCDDA recommendations and are used for the European comparisons. The number of drug-induced deaths recorded in the Cause of Deaths Register was slightly higher in 2014, compared with 2013. The toxicological results show that opioids were the principal drug involved in drug-induced deaths. The victims are generally older than the average age of victims of drug-induced death in Europe. Some of the fatal overdoses reported among people over 64 years may relate to opioid-related deaths in the context of cancer/chronic pain treatment, rather than in the context of problem drug use.

The latest European average of drug-induced mortality rate among adults (aged 15-64 years) was 20.3 deaths per million. In Finland, this rate was 57.6 deaths per million in 2014. Comparison between countries should be undertaken with caution. Reasons include systematic under-reporting in some countries, different reporting systems and case definition and registration processes.

The National Police Register collates information on all reported deaths for the purpose of post-mortem examination. It constitutes an essential source of information and includes specific information on poisonings that cannot be retrieved from the Cause of Death Register.

A total of 167 direct drug poisonings out of a total 245 drug-related deaths (including deaths due to other causes) were recorded in 2015. The number of direct drug poisonings has been stable over the last 10 years. The majority of the poisoning deaths reported through the National Police Register involved more than one psychoactive substance, which indicates that polydrug use is a common cause of death in Denmark. Nevertheless, the presence of opioids (heroin, morphine or methadone) was detected in most cases

Drug-induced mortality rates among adults (15-64 years)

NBYear of data 2015, or latest available year. Comparison between the countries should be undertaken with caution.


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