Endorsed as integral part of the treatment and health services for people who use drugs in 1996, the harm reduction goals within Norway’s comprehensive alcohol and drug policy have been defined more recently in the white paper ‘See me! A comprehensive drugs and alcohol policy’ and were confirmed in the current national action plan. The aim of harm reduction measures is to improve health and a more dignified life for substance users, including the prevention of overdoses and drug-related infectious diseases, such as HCV infection. Moreover, a national overdose strategy for 2014-17 calls for the scaling-up of activities to prevent overdose risks and promotes emergency assistance and treatment for drug users. In Norway, the municipalities are responsible for the organisation of harm reduction measures on the basis of local needs and challenges. While cooperation between local public health and social services constitutes the backbone of service provision, private non-profit organisations are important partners in the implementation of harm reduction in the municipalities.
Low-threshold facilities already offer a broad range of services, such as health checks, treatment of sores, vaccinations (including the provision of free hepatitis A and B vaccines), distribution of injecting equipment, nutritional and hygiene guidance, prevention of overdoses, general advice and guidance, and follow-up and referral to other parts of the health service on a longterm basis.
In 2015, an estimated 2.5 million syringes were distributed through low-threshold facilities to PWID; about half of these were provided in Oslo. This estimate does not include all syringe providers in the country and is, therefore, lower than the total number of syringes distributed in 2015.
Prevention of drug-related overdoses is among current national priorities. In this context, several municipalities have adopted local action plans and measures, and a trial project combining the provision of training in overdose response with the distribution of naloxone (by nasal applicator) to peers and families of drug users was sponsored by the Ministry of Health and Care Services in Oslo and Bergen. In 2016, this take-home naloxone project was expanded to five other cities.
In 2009, the temporary law on supervised drug consumption facilities was made permanent and municipalities that want to establish those services now have a legal basis for doing so. Two injection rooms were operational in Norway by the end of 2016.
Availability of selected harm reduction responses
NB Year of data 2016.
Take-home naloxone projects are running in seven cities and injection rooms are operational in two cities by the end of 2016