Sweden Country Drug Report 2018

Harm reduction

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.

Harm reduction interventions

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.

Availablity of selected harm reduction responses in Europe
Country Needle and syringe programmes Take-home naloxone programmes Drug consumption rooms Heroin-assisted treatment
Austria Yes No No No
Belgium Yes No No No
Bulgaria Yes No No No
Croatia Yes No No No
Cyprus Yes No No No
Czech Republic Yes No No No
Denmark Yes Yes Yes Yes
Estonia Yes Yes No No
Finland Yes No No No
France Yes Yes Yes No
Germany Yes Yes Yes Yes
Greece Yes No No No
Hungary Yes No No No
Ireland Yes Yes No No
Italy Yes Yes No No
Latvia Yes No No No
Lithuania Yes Yes No No
Luxembourg Yes No Yes Yes
Malta Yes No No No
Netherlands Yes No Yes Yes
Norway Yes Yes Yes No
Poland Yes No No No
Portugal Yes No No No
Romania Yes No No No
Slovakia Yes No No No
Slovenia Yes No No No
Spain Yes Yes Yes No
Sweden Yes No No No
Turkey No No No No
United Kingdom Yes Yes No Yes

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.