One of the long-term objectives of Sweden's Comprehensive Strategy for Alcohol, Narcotics, Doping and Tobacco (ANDT) 2016-20 is to reduce the harm caused by the use of alcohol, drugs, doping and tobacco. In 2015, the Public Health Agency of Sweden released the first national guidelines for health promotion and prevention of hepatitis and human immunodeficiency virus (HIV) infection among people who inject drugs (PWID), which included the recommendation that county councils should initiate low-threshold services and offer needle and syringe exchange programmes (NSPs) with the aim of preventing drug-related infectious diseases and promoting access to treatment and care services for PWID. By the end of 2017, eight councils reported operating a low-threshold service with a NSP, almost tripling the number of councils that reported running such services in 2015. In March 2017, the law concerning NSPs was changed making it easier to initiate a NSP.
Regulations drawn up by the National Board of Health and Welfare define the procedures that county councils should follow, which include, among others, a justification of need (e.g. an estimate of the number of potential service users); an assessment of available resources; a provision plan for complementary and additional care services (e.g. detoxification, drug treatment and aftercare), as well as service quality requirements. The offer of low-threshold services includes medical and social care and support, free testing for infectious diseases and vaccination for hepatitis B virus infection and referral.
Data from 9 of the 10 low-threshold centres show that the number of syringes distributed increased to nearly 387 000 in 2016 and that 3 049 individual clients were reached. Pharmacies in Sweden may sell needles or syringes only to people with a prescription for medical use.
|Country||Needle and syringe programmes||Take-home naloxone programmes||Drug consumption rooms||Heroin-assisted treatment|