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Drug treatment overview for Norway

Map of Norway

1. National context

Since the reform in drugs policy from January 2004 onwards, the Norwegian state, represented by four regional health authorities, has been responsible for the specialist treatment of drug and alcohol users, while municipalities bear overall responsibility for ensuring mental and somatic health services, outreach outpatient services/community teams, services for next of kin, low-threshold services, assessment and referral to treatment, and follow-up during and after treatment in the specialist health services or in prison. Treatment is mainly financed by public funds. In addition, the Ministry of Labour and Social Inclusion and the Ministry of Health and Care Services have extraordinary funds at their disposal for the development of special high-priority work in the areas of epidemiology, research, prevention and treatment.

The majority of treatment services available to drug users, whether outpatient or inpatient, treat addiction in general, and are not specifically designed for users of illicit drugs. The treatment and care programmes may be classified into four categories: (i) outpatient functions and assessment units; (ii) detoxification; (iii) inpatient treatment of less than six months; and (iv) inpatient treatment of more than six months. Inpatient treatment includes detoxification, stabilisation and assessment, short- and long-term inpatient treatment.

Opioid substitution treatment (OST) using methadone has been available through a nationwide programme since 1998, while buprenorphine has been available since 2001. In 2010 new national guidelines for OST came into force. These guidelines aim to increase nationwide access to OST as part of a comprehensive treatment and rehabilitation process. Following the guidelines, OST provision is now integrated into health trusts, the specialist care services under the auspices of the regional health authorities, and they have been given the authority to make an overall assessment of treatment need, initiate and follow up the treatment. The health trusts either organise the provision of OST by a unit with a separate management and a dedicated team, or integrate OST as part of an interdisciplinary specialist treatment without separate management. However, the guidelines retain the basic model of a tripartite collaboration comprising social security offices, general practitioners and the specialist health services, where the latter is given authority to assess the OST need, while general practitioners can only operate within strict shared care arrangements with specialised drug treatment centres. Nevertheless, general practitioners play a key role in the provision of OST as they prescribe the medication of about two-thirds of clients. In 2011, further guidance was provided on pregnant women in OST and the follow-up of families until children reach school age.

At the end of 2013 a total of 7 055 clients were in OST, about 43 % of whom were on methadone (3 034), while about 56 % received a buprenorphine/naloxone combination (3 951). The number of OST clients has been increasing steadily by around 500 from year to year, although some reductions in new admissions have been recorded since 2011.

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2. Treatment registries and monitoring systems

The national Focal Point SIRUS, in cooperation with the Bergen Clinics Foundation, operates a nationwide client registration system that covers all kinds of substance abuse treatment centres - both drug-free and MAT. It contains only aggregated data, which makes it impossible to extract information about the number of persons making a new treatment request or to separate the clients with primarily drug-related problems from those who seek treatment for their alcohol misuse.The Unit of Addiction Medicine at the University of Oslo is in charge of monitoring clients in medically-assisted treatment nationwide.

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3. Treatment demand

Table 1: Number of clients entering treatment in Norway by year
Clients in treatment 2009 2010 2012 2013
Number of all clients entering treatment N. Av. 8750 8891 8412
Number of all clients entering treatment with known primary drug   N.Av. 8891 8412
% of which for opioid use    31.5 33 26.9
% of which for cocaine use    0.9 1 0.9
% of which for cannabis use    15.9 19 20.3
% of which for stimulants use (other than cocaine)    13.2 12 13.1
Number of new clients entering treatment N. Av. N. Av. N.Av. N.Av
Number of new clients entering treatment with known primary drug        
% of which for opioid use        
% of which for cocaine use        
% of which for cannabis use        
% of which for stimulants use (other than cocaine)        
Notes:
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:

Reitox national reports 2014 and TDI tables.
EMCDDA Statistical Bulletin 2015.

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4. Treatment provision

Table 2: Opioid substitution treatment provision in Norway
Opioid substitution treatment 2009 2010 2012 2013
Number of clients in opioid substitution treatment 5383 6015 7038 7055
of which with methadone 2998 3122 3075 3034
of which with buprenorphine 2385 2827 3836 3951
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:
Standard Table 24 (ST24) on 'Treatment availability' submitted in 2014.
Table 3: Year of official introduction of opioid substitution treatment substances in Norway
Applied substances in opioid substitution treatment Officially introduced in
Methadone (MMT) 1998
Buprenorphine (HDBT) 2001
Heroin assisted treatment, including as trials N.App.
Slow-release morphine N.App.
Buprenorphine/naloxone combination N. Av.
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. App.’ stands for ‘Not applicable’.
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:
Reitox national reports.
Table 4: Legal framework of opioid substitution treatment in Norway
Legal framework of opioid substitution treatment Methadone Buprenorphine
Do office-based medical doctors have the right to initiate the prescription of substitution treatment? N.App. N.App.
Do specialised medical doctors have the right to initiate the prescription of substitution treatment? No No
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
For an explanation of terms used, see the definitions of terms.
'Specialised medical doctors' refers to specifically trained or accredited office-based medical doctors.
Sources:
Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2014.

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5. References and links

Related EMCDDA resources

 

External links

Please note that the EMCDDA is not responsible for the content of external sites.

Treatment inventories

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About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Friday, 22 May 2015