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Harm reduction overview for Sweden

Map of Sweden

1. National context

The new National Action Plan on Drugs (2011–15), like its predecessor, endorses the visionary goal of a society free from narcotics, while one of its long-term objectives is to reduce the harm caused by the use of alcohol, narcotics, doping and tobacco. The evaluation of the 2006–10 National Action Plan on Drugs further suggested that county councils should broaden the range of evidence-based interventions targeting drug users, including needle and syringe exchange. To support the health promotion and prevention efforts among PWID implemented at the regional level, guidelines on the prevention of infectious diseases are currently being drawn up by the Public Health Agency, highlighting relevant research and knowledge.

The first needle and syringe programme (NSP) in Sweden began operation in 1986. In 2006, the Swedish government passed a law formally allowing the 21 counties (län) to introduce needle and syringe exchange programmes. Regulations concerning these programmes were drawn up by the National Board of Health and Welfare in February 2007 and define the procedures county councils have to follow. These include: a justification of need (e.g. an estimate of the number of potential service users); an assessment of available resources; and a provision plan for complementary and additional care services (e.g. detox, drug treatment and aftercare). The regulations also stipulate the obligation for NSPs to inform clients about injecting risks and to offer additional services, including vaccinations and testing for infectious diseases, and they define further quality management rules for the implementation of such services. Drug users are eligible to participate in a NSP when they offer proof of identity and are 20 years of age or older.

At the end of 2013 there were five NSP in place in Sweden. Approximately 230 000 syringes were given out and about 1 900 clients were served in 2013 in four NSPs; however, one of these NSPs had only been running for nine months and thus the numbers do not represent the full picture of Swedish NSPs’ activities in 2013. A sixth NSP site opened in October 2014.

The NSPs assist drug users with other medical/social support, offer free HIV, HBV and HCV testing and refer them to drug-free treatment within the social services. Pharmacies are not entitled to sell needles/syringes to people without a prescription for medical use, such as for diabetes care, etc.

To improve bystander response to opioid overdose events, a pilot study covering first aid training and the distribution of the opioid antagonist naloxone kits to those who are likely to witness overdoses is planned.

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2. Responses to prevent and reduce drug-related infectious diseases

Needle and syringe programmes Country  data
Availability of  NSP programmes  Limited
% NSP availability at NUTS3  14 %
Drug use equipment distributed at specialised drug agencies (standard prevention material)
availability of alcohol pads  Yes
availability of dry wipes  Yes
availability of containers  Yes
availability of water  No
availability of condoms  Yes
availability of foil  No

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
For an explanation of terms used, see the definitions of terms.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Testing, vaccination and treatment of infections Country  data
Availability of Hepatitis C testing in the community  Limited
Availability of universal hepatitis B immunization programme  No
Hepatitis B vaccination programme specific for high risk groups  :
ARV treatment of HIV infection  :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Health promotion responses Country  data
Availability of individual counselling programmes  :
Availability of programmes for practical advice and training on 'safer use/safer injecting'  Extensive
Involvement of peer educators in the response to infectious diseases prevention  :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.

Drug Treatment

See the country specific treatment profile.

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3. Responses to prevent and reduce drug-related deaths

Availability of drug-related death responses in the community Country  data
Availability of overdose information materials  Limited
Availability of individual overdose risk assessment (provided by trained drugs or health workers)  Limited
Availability of overdose response training  Limited

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Availability of drug consumption rooms Country  data
Number of facilities n.av.
Number of cities n.av.
Number of consumptions per year n.av.

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2011.
N.Av. stands for ‘The intervention is not available in the country’.

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4. Responses to prevent and reduce drug-related harms in recreational settings

Provision of specific responses implemented in night clubs and festivals Free, accessible, cold water Immediate First Aid ‘Chill out’ rooms Information material Outreach work Amnesty bins
Night clubs  : : : : : :
Festivals  : : : : : :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2011.
Provision expert rating scale:

  • Full – in nearly all night clubs/festivals.
  • Extensive – a majority of night clubs/festivals provide the intervention (but not nearly all of them).
  • Limited – more than a few night clubs/festivals provide the intervention (but not a majority of them).
  • Rare – just a few night clubs/festivals provide the intervention.

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5. References and links

Related EMCDDA resources

 

Page last updated: Wednesday, 03 June 2015