In Sweden, data on drug-related infectious diseases are collected through the statutory surveillance system and notifications are submitted to the County Medical Officer of Communicable Disease Control (one in each of the 21 counties in Sweden) and to the Public Health Agency of Sweden.
Over the past decade, the total number of hepatitis C virus (HCV) infections reported to the national surveillance system has stabilised at around 2 000 cases annually. In 2015, 780 HCV infections were confirmed to be related to injecting drug use. However, in many HCV cases the route of transmission remained unknown. HCV continues to be the most common infection among PWID. Available data suggest that high-risk injection practices remain common among PWID.
The number of HIV notifications has been stable over the past five years, and only a few cases of new HIV infections notified are linked to injecting drug use. In 2015, out of a total of 15 new cases of HIV infection among PWID, two were linked to domestic infection. In the same year, the number of notified cases of hepatitis B virus (HBV) infection was higher than in previous years; however, the number of cases linked to drug injecting remained stable.
Information on drug-related acute emergencies is not routinely collected on a national basis in Sweden. Some data on telephone enquiries linked to NPS, which are reported by the Swedish Poisons Information Centre, provide insights into drug-related emergencies. In general, synthetic cannabinoids and synthetic cathinones remain the most commonly mentioned substances; however, in 2015, the number of enquiries involving these substances decreased, while the emergence of requests linked to benzodiazepines or fentanyl analogues was reported.
Newly diagnosed HIV cases attributed to injecting drug use
NB Year of data 2015, or latest available year. Source: ECDC.
Characteristics of and trends in drug-induced deaths in Sweden
NB Year of data 2015.
Drug-induced deaths are deaths directly attributable to the use of illicit drugs (i.e. poisonings and overdoses).
In 2015, an increased in drug-induced deaths was reported in Sweden, which continues the trend observed since 2003. The majority of victims were male. The mean age of victims was around 40 years, and has remained stable during the past decade. Toxicology reports indicate the presence of opioids in the majority of deaths. An increased number of toxicology examinations and improvements in analytical confirmation methods for suspected overdose deaths in the recent years have contributed to the increase in the numbers of the deaths reported; however, the increasing trend remains even if all these factors are corrected or controlled.
The latest European average of drug-induced mortality rate among adults (aged 15-64 years) was 20.3 deaths per million. In Sweden, this rate was 100.5 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.
Drug-induced mortality rates among adults (15-64)
NB Year of data 2015, or latest available year.