In Norway, the prevention of drug and alcohol use is an important public health priority that is emphasised in the white paper ‘See me! A comprehensive drugs and alcohol policy’ and is further elaborated in the National Action Plan for the Alcohol and Drug Field (2016-20) and other policy documents that guide drug and alcohol prevention at the national level. The Norwegian drug prevention policy is based on the fundamental principle of the inclusive society, in which health promotion and prevention principles are embedded in all areas of society, and gives priority to early interventions. The municipal sector and the Ministry of Health and Care Services have agreed to establish a programme for public health work in the municipalities called the Public Health Programme (2017-2027), with the aim of integrating mental health and drug prevention as a part of public health work.
The Norwegian Directorate of Health contributes to the local implementation of prevention activities, while the municipalities are responsible for local drug and alcohol prevention and county councils have a statutory responsibility for public health work at a regional level. Seven regional competence centres are key partners in coordinating and improving local prevention in the municipalities. Prevention is funded by public funds, which are allocated to policies at a local level through various grant schemes.
An important aspect of the Norwegian prevention policy is the promotion of high-quality approaches and evaluations and a focus on the continuous development of the professional competencies of prevention workers.
Prevention interventions encompass a wide range of approaches, which are complementary. Environmental and universal strategies target entire populations, selective prevention targets vulnerable groups that may be at greater risk of developing substance use problems and indicated prevention focuses on at-risk individuals.
Environmental prevention measures in Norway focus primarily on regulating access to alcohol and medicines, with the municipalities having a key role in the area of controlling access to psychoactive substances, predominantly alcohol, at a local level. Collaboration between agencies, including the police and municipalities, to prevent crime in the licensed trade has strengthened.
In schools, priority is given to universal prevention activities that are comprehensively integrated into a learning environment, while the implementation of curricular school-based prevention programmes is decreasing.
Programmes to integrate parents into prevention activities are also supported. The ‘Love and limits’ programme, which is an adaptation of the ‘Strengthening families’ programme, is one of the most common in Norway and aims to enhance cooperation between school and home and to strengthen the social skills of adolescents. New target groups for universal prevention include students, employees and elderly people.
Selective prevention targets mainly young people outside the school environment, specifically, those who drop out of school early, through outreach work, integration of prevention activities into child welfare services and the promotion of early access to healthcare services. Specific programmes have concentrated on the needs of immigrants, asylum seekers, children with behavioural problems, young cannabis smokers and elderly people. More than 100 municipalities have established outreach services working with vulnerable young people. Training programmes developed for the staff of child welfare services and specialised health services focus on how to implement early interventions. Work has also been undertaken to develop tools and methods for early interventions that target pregnant women and their partners and parents of small children. Many municipalities and community associations carry out selective prevention activities in recreational settings, with a focus on health promotion, through peer approaches and the provision of alternative leisure activities.
While outreach work remains the most widely applied model for reaching vulnerable young people and the implementation of indicated prevention activities, innovative approaches are continuously being researched and introduced into practice. Programmes for disruptive children and their families, and children from families with problems resulting from drug dependence, are available.