Country overview: Finland
- Drug use among the general population and young people
- Problem drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-related deaths
- Treatment responses
- Harm reduction responses
- Drug markets and drug-law offences
- National drug laws
- National drug strategy
- Coordination mechanism in the field of drugs
- Public expenditure
- Drug-related research
|Year||EU (27 countries)||Source|
|Population||2012||5 401 267||503 663 601 b p||Eurostat|
|Population by age classes||15–24||2012||12.2 %||11.7 % b p||Eurostat|
|25–49||31.9 %||35.4 % b p|
|50–64||21.3 %||19.5 % b p|
|GDP per capita in PPS (Purchasing Power Standards) 1||2011||114||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2010||30.6 %||29.4 % p||Eurostat|
|Unemployment rate 3||2012||7.7 %||10.5 %||Eurostat|
|Unemployment rate of population aged under 25 years||2012||19.0 %||22.8 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2011||60.7||:||Council of Europe, SPACE I-2011|
|At risk of poverty rate 5||2011||13.7 %||16.9 % e||SILC |
p Eurostat provisional value.
b Break in series.
1 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
2 Expenditure on social protection contains: benefits, which consist of transfers, in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.
3 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.
4 Situation of penal institutions on 1 September, 2011.
5 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold, which is set at 60 % of the national median equivalised disposable income (after social transfers).
A general population survey on drug use has been carried out in Finland every two years since 1996 among people aged 15–69. It was conducted via an online (since 2010) or a postal questionnaire, with the exception of the survey carried out in 2000, when a face-to-face interview method was used. The 2010 results indicate that almost every sixth person aged 15–64 reported trying illicit drugs at least once during their lifetime, which is a slight increase compared with 2006. In the 15–64 age group, 18.3 % reported that they had used cannabis at least once in their life. Lifetime prevalence of amphetamines was reported by 2.3 % of respondents, ecstasy by 1.8 %, cocaine by 1.7 % and LSD by 1.0 %. Last year prevalence of cannabis use was 4.6 % and last month prevalence was 1.4 %. For all other substances, last year and last month prevalence was lower than 1 %. The highest rate of drug use was recorded among 15- to 34-year-olds. Comparing these with the results from the 2002 study, the trend shows a stabilisation in last year cannabis use, especially in the 15–24 age group, while among those aged 25–34 it has almost tripled. It is interesting to note that the proportion of men and women who have used drugs is almost the same in younger age groups, but divergence occurs with ageing, with drug use sharply declining among women aged 25–34.
The most recent European School Survey Project on Alcohol and Other Drugs (ESPAD) results, for 2011, indicate that 11 % of respondents had ever tried marijuana or hashish (8 % in 2007; 11 % in 2003; 10 % in 1999). The reported lifetime prevalence of cannabis use was 12 % for males and 10 % for females. In 2011 the lifetime prevalence of inhalants use was the same as in the previous study (10 % in 2011; 10 % in 2007; 8 % in 2003; 5 % in 1999). Lifetime prevalence of ecstasy and other drugs was reported by 1 % of the sample. Last year prevalence of cannabis use was 9 % (6 % in 2007; 8 % in 2003) and last month prevalence was 3 % (2 % in 2007; 3 % in 2003).
Since the first ESPAD survey was carried out in 1995, drug experimentation has increased in Finland. The surveys indicate that pupils who are doing well in school use substances of any kind less than do pupils who are performing poorly. By contrast, the educational background of the pupil’s family does not significantly influence experimentation.
Substance use prevention in Finland is part of the wider concept of the promotion of well-being and health, and falls under the responsibility of both central and local governments, with local government focusing on practical measures and coordination of activities. It is recommended that local authorities have in place strategies for mental health and substance use services at health centres, but a 2008 survey of health centres showed that about one-third of centres do not have such a strategy in place. Quality criteria have now been determined for substance use prevention. Substance use prevention also includes prevention of smoking and functional dependencies.
Universal school-based prevention is focused on all school levels and aims to create safe and risk-reducing environments for pupils. Drug education is a part of mandatory education. In addition, counselling and support in drug-related problems are offered by health and social services in schools. All schools have a drug strategy as part of their student welfare plan, comprising guidelines for drug prevention and drug-related problems, together with information on cooperation and networking with local stakeholders. Individual schools can decide independently about other school-based drug prevention programmes, but these activities are not systematically reported. The most popular approaches are knowledge transfer, experimental pedagogy, life-skills education, affective education and alternatives to drug use.
With regard to selective and indicated prevention, the National Institute for Health and Welfare has published a guide for social welfare and healthcare professionals on the early identification of mental health and substance abuse problems. In 2009 a guidebook was published for parents and professionals working with young people on the management of substance use problems. Risk prevention activities targeting school dropouts or young drug users are mainly implemented through health counselling centres and outreach youth work teams run by non-governmental organisations (NGOs). Drug testing has been introduced in workplace settings to facilitate early interventions and referral to support services for those who may need it. A low-threshold web service Addiction is an additional tool to provide information and self-help for high-risk populations.
View ‘Prevention profile’ for additional information.
Unlike many other European countries, where heroin is the main drug, amphetamines are the most commonly injected drug in Finland. Following an increase in problem drug use at the end of the 1990s, recent estimates from 2002 and 2005 suggest that the situation seems to have stabilised. In 2005 there were an estimated 4 500–19 100 problem drug users, including problem amphetamine and opioid users (with 16 600 as a central estimate and a rate 4.8 per 1 000 inhabitants aged 15–54, with a 95 % confidence interval of 4.2–5.5). Nearly four-fifths of problem drug users used amphetamines. The opioid most commonly abused is buprenorphine, and polydrug use is very common among problem drug users.
Up to 2012 the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) defined problem drug use as injecting drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis were not included in this category. Details are available here.
In 2011 the drug treatment information system included data from 72 treatment centres, and 1 443 clients were reported, of which 249 were new treatment clients.
In 2011 some 62.2 % of all clients entered treatment due to opioid use (mainly injecting buprenorphine), followed by amphetamines at 14.1 % and cannabis at 13.4 %. Among new treatment clients, 43.8 % reported that opioids were their main problem drug, 32.9 % reported cannabis use and 11.6 % reported amphetamines. It should be noted that more than half of all treatment clients were polydrug users, as they reported using three or more substances before entering treatment services.
In 2011 some 28 % of all clients entering treatment were under the age of 25. A higher percentage of younger clients was reported among new treatment clients, with 49 % under the age of 25. With regard to gender distribution, around 64 % of all clients entering treatment were male and 36 % were female. The proportion of females among all treatment clients is increasing steadily, year by year. A similar gender distribution was reported among new treatment clients, with 66 % male and 34 % female.
The National Institute for Health and Welfare in Finland operates the national HIV registry. In 2011 the registry recorded 176 new cases of HIV infection (187 in 2010; 178 in 2009). In 2011 eight cases (1.5 per million of the population) were attributed to injecting drug use. In 1997 only two cases of diagnosed HIV infection were attributed to injecting drug use (0.2 per million of the population), increasing to 85 in 1999 (16.5 per million of the population). The number of cases has decreased significantly since then. The national prevalence rate of HIV infection among injecting drug users for 2007 was estimated at 1.2 %, based on a sample of 722 people. In 2009 HIV prevalence based on a sample of 679 current injecting drug users in nine needle and syringe programmes indicate HIV prevalence at 0.7 %.
In 2010 some 1 160 new cases of hepatitis C virus (HCV) were diagnosed (1 132 in 2010; 1 061 in 2009) and approximately half of the cases had been contracted through intravenous drug use. HCV prevalence among 682 clients of nine needle and syringe programme sites was 60.5 % in 2009. In 2010 some 24 cases of acute hepatitis B virus (HBV) infections were diagnosed; the means of transmission was identified in 10 of the cases, but none had contracted acute infection through injecting drug use.
In general, there has been significant decline in HIV and HBV infections linked to injecting drug use over the past decade, which is largely attributed to the work of health counselling centres, including the exchange of used needles and syringes for clean ones and provision of the HBV vaccination free of charge to risk groups.
The General Mortality Register and the special registry provide data on drug-related deaths in Finland. Data from the special registry are based on forensic toxicological examinations that must be conducted in cases where death is unexpected or sudden. The data on drug-related deaths from both registries are also available as drug-related death standards, a standard protocol for extracting data on drug-related deaths (DRDs) from registries in EU Member States.
According to the DRD standard definition for the general mortality registries, there were 197 drug-related deaths in 2011 (156 in 2010; 175 in 2009; 169 in 2008; 143 in 2007).
Over the past 10 years the number of drug related deaths has generally increased, and there was a fairly sharp increase in 2011, mainly due to an increase in opioid- and amphetamine-induced deaths. Although the number of heroin-related deaths has decreased rapidly since the late 1990s, some 81.7 % of DRDs involve opiates — mainly opioid-containing medications such as buprenorphine, usually in combination with other psychoactive substances, e.g. alcohol or benzodiazepines. According to the General Mortality Register, 40 % of drug-related deaths in 2000 involved people under the age of 25. This trend has since levelled off, and in 2011 the proportion of drug-related deaths involving people under the age of 25 decreased to 16.2 %.
The provision of drug treatment falls under the responsibility of the regions and municipalities. Specialised services are mainly provided by social welfare, while the health sector delivers primary care services. More than half of drug treatment is delivered by NGOs or foundations, and actively purchased by the public services of the municipalities. Public treatment agencies and NGOs — operating mostly regionally — provide opioid substitution treatment and detoxification. Drug treatment is mainly funded by the public budget of the communities.
Problem alcohol use is a much greater problem in Finland than is illicit drug use. Thus, there are more generic addiction treatment facilities than specific facilities, and this is the case for both outpatient and inpatient facilities. Drug treatment can be divided into five main categories: outpatient clinics; short-term inpatient care; long-term rehabilitation units; support services; and peer support activities. Outpatient services provide treatment for all kinds of addictions, youth outpatient services and outpatient services for problem drug users. They provide an assessment of mental and somatic status, counselling, individual, family or group therapy, referrals, detoxifications or opioid substitution treatment. Short-term inpatient care refers to inpatient detoxification treatment, which is usually arranged in rehabilitation units, detoxification units or specialised healthcare services. The duration of the detoxification periods varies from 24 hours to four weeks. Long-term rehabilitation includes residential psychosocial treatment for problem drug users, residential services for youth, and psychiatric services for problem drug users. Support services include rehabilitative day-care centres and housing services. However, a trend to move drug treatment to primary health is increasingly noticeable, while income-related activities, living and employment assistance are provided to facilitate treatment and recovery. It should be noted that available treatment is mainly focused on the needs of opioid users, while long-term treatment options for amphetamine users remain limited. The current care guidelines are being updated to incorporate the most advanced treatment methods for users of new psychoactive substances and cannabis, and for pregnant women.
Substitution treatment is provided in inpatient and outpatient settings. It is typically provided through specialised units, and although general practitioners are also allowed to provide such treatment only a few are reported to be involved. Methadone was introduced in Finland in 1974 and buprenorphine became available in 1997. The buprenorphine/naloxone combination was introduced in 2004, making Finland the first country in Europe where this substitution medication became available.
In 2011 approximately 2 000 clients were reported to be receiving opioid substitution treatment, 40 % of whom were on methadone and 60 % on buprenorphine-based medication.
View ‘Treatment profile’ for additional information.
In 1998, when the HIV epidemic began among Finnish drug users, public attention focused on preventing the disease being transmitted by injecting drug users. Current harm reduction responses in Finland include outreach work and health counselling centres, and some harm reduction activities are also carried out at treatment units. Outreach work mainly involves street patrols, with the aim of mediating between drug users and the official care system. Peer work is used in several locations and focuses on reaching the most excluded and hardest to reach groups of drug users. Health counselling centres are low-threshold facilities catering for problem drug users, offering: referral to treatment; case management; information on drug-related diseases and risks such as overdoses; needle exchange; testing of infectious diseases and vaccinations; and small-scale healthcare. Free vaccination against hepatitis A virus and HBV is offered to injecting drug users, and an evaluation found that more than half of IDUs in contact with the drug treatment system had received all three vaccine doses. Since 1997 health counselling centres have been established throughout the country, and their numbers have increased in recent years.
However, there is some variation in service provision, depending on the facilities. The health counselling centres that exchanged needles and syringes to prevent infectious diseases are located mainly in cities of over 100 000 inhabitants, and are available in more than 35 locations across Finland. According to available data, the number of clients at health counselling centres has increased since 2002, and reached about 11 500 in 2011. At the same time, the number of syringes handed out continued to increase, from 1.9 million in 2005 to 3.5 million in 2011. Needles and syringes can also be purchased without medical prescription at most pharmacies in Finland.
Finland is not a prime target of the worldwide drug trade; however, the drug trade is professional and dominated by organised crime groups with strong international connections to the neighbouring countries of Estonia and Lithuania. Because of its location, Finland is increasingly seen as a route to Russia, for cocaine and hashish, for example.
While the Finnish drug market is fairly stable, there is concern over an increase in the cultivation of cannabis, and the smuggling of amphetamines, ecstasy and other synthetic psychoactive substances and narcotic pharmaceuticals. The supply of hashish mainly originates from Morocco, reaching the Finnish market from central Europe and destined for Russia. Amphetamine is smuggled to Finland mostly via Estonia and Lithuania, primarily from western European sources and Russia, while some amphetamine and methamphetamine seized in Finland comes from Lithuania. The availability of heroin in the Finnish market plummeted after 2001 and it was replaced by buprenorphine. The number of Subutex tablets seized, smuggled into Finland from France, has increased. Smaller amounts have been brought in mainly from diverted foreign prescriptions, primarily from Estonia. However, since it is no longer possible to import Subutex legally under prescriptions signed in Estonia, other countries like Sweden, the UK, Lithuania and countries in the Far East (via the Internet) have emerged as potential sources. The increased availability of new psychoactive substances is one of the emerging trends of the drug scene. In 2010, for the first time ever, police discovered a local production site of synthetic drugs and the quantities of mCPP tablets seized indicated that the production was aimed for export.
In 2011 the number of seizures of cannabis products was the highest ever recorded. A total of 860 kg of cannabis resin, 97 kg of herbal cannabis and 16 400 cannabis plants were seized. The quantity of amphetamine seized fell to 71 kg in 2011, and shortages in amphetamine in the market were most likely filled with metamphetamine. In 2011 some 29 kg of methamphetamine was seized in Finland. Regarding ecstasy, although the number of seizures increased when compared to the previous year, the quantity seized in 2011 (17 800 tablets) was less than in 2010. The quantity of cocaine seized in 2011 was 4 kg, the same as in 2010, which is more than in 2008 and 2009, when 3 kg of seized substance was reported annually. As heroin has been largely replaced by illegal Subutex, it is worthwhile to note that 31 700 Subutex tablets were seized in Finland in 2011.
In 2011 there were 20 469 drug-law offences reported, the most in any year. More than 59 % of all reports were use-related offences, while approximately 36 % were both use- and supply-related offences.
The central framework for drug legislation in Finland is based on the Narcotics Act. The provision of drug offences is laid down in Chapter 50 of the Penal Code. Use of drugs, as well as possession of small amounts of drugs for own use, constitutes a drug-user offence punishable by a fine or a maximum of six months’ imprisonment.
Prosecution and punishment for drug use and possession of small amounts of drugs can be waived if the offence is considered insignificant, or if the suspect has sought treatment specified by the Decree of the Ministry of Social Affairs and Health.
Drug offences include possession, manufacturing, growing, smuggling, selling and dealing. The penalties for a drug offence range from a fine to a maximum of two years’ imprisonment.
There is no specific offence of dealing or trafficking, but the type of offence may change from a drug offence to an aggravated drug offence. Aggravating circumstances for a drug offence include, for example, substances considered as ‘very dangerous’; large quantities of drugs; considerable financial profit; or if the offender acts as a member of a group that has been organised for the express purpose of committing such an offence. Aggravating circumstances will increase the penalty range to between one and 10 years’ imprisonment.
The 2010–11 amendments to the Narcotic Act stipulate that the Finnish Government may classify new psychoactive substances as narcotics on their own initiative, once the health hazards of such substances have been fully evaluated.
View ‘Legal profile’ for additional information.
The principles and objectives of Finland’s drug policy have been expressed in its 1997 National Drugs Strategy, and subsequent resolutions outline action for specific periods. Following resolutions for the periods 2004–07 and 2008–11, the Government Resolution on an Action Plan to Reduce Drug Use and Related Harm was adopted in August 2012. It is primarily concerned with illicit drugs and represents continuity with the approach set out in the 1997 strategy.
The 2012 Action Plan addresses five areas: (i) preventive work and early intervention; (ii) combating drug-related crime; (iii) treatment of drug addiction and reduction of harm from drug use; (iv) the EU’s drug policy and international cooperation; and (v) information collection and research regarding drug problems.
View ‘National drug strategies’ for additional information.
In 1999 the government set up the National Drug Policy Coordination Group, which is composed of representatives from all involved ministries and is reappointed every four years. This group has the task of coordinating national drug policy and intensifying collaboration between authorities in their effort to implement and monitor the Government Resolution on Cooperation regarding national drug policy 2008–11. It is coordinated by the Ministry of Social Affairs and Health and is attended by representatives from the Ministry of the Interior, the National Police Board, the Ministry of Justice, the Office of the Prosecutor General, the Ministry of Finance, the Customs authorities, the Ministry of Education and Culture, the National Board of Education, the Ministry for Foreign Affairs, the National Institute for Health and Welfare and Fimea.
In addition to the coordination group, the Advisory Committee on Intoxicant and Temperance Affairs acts as an advisory body and discussion forum on alcohol and drug issues. This Advisory Committee consists of politicians and members of NGOs.
Each municipality has a substance abuse worker who coordinates local actions, mainly in the field of prevention. These substance abuse workers are coordinated and supervised by the National Institute for Health and Welfare (THL). Provincial governments have cross-sectoral working groups for alcohol and drug issues, which coordinate and supervise the implementation of actions by the municipalities.
The government approves an annual drug budget that is in line with its drug strategy and action plan. Annual estimates of expenditures are also provided and include both labelled (1) and unlabelled expenditures. (2)
Total drug-related expenditure represented 0.07 % of GDP in 2009, with 54.5 % spent on public order and safety, 26 % transferred to municipalities (unidentified activities), 11.2 % on healthcare and 8.3 % on social security (sickness allowances and disability pensions). Labelled expenditures represented about 12 % of the total.
Trend analysis shows that between 2005 and 2009, total drug-related public expenditure remained stable at around 0.07 % of GDP.
(1) Some of the drug-related public expenditure is identified as such in the budget (‘labelled’). Often, however, the bulk of drug-related expenditure is not identified (‘unlabelled’) and must be estimated by modelling approaches. The total budget is the sum of labelled and unlabelled expenditures.
(2) Unlabelled expenditures are estimated on the basis of the method developed in R. Hein and J. Salomaa (1998), ‘Päihteiden käytön haittakustannukset Suomessa vuosina 1994–95. Alkoholi ja huumeet’ [Harm-related costs of substance use in Finland 1994–95: alcohol and drugs.], Tilastoraportti 4 Helsinki: Stakes.
View ‘Public expenditure profile’ for additional information.
Greater emphasis was first placed on drug-related research in the 1990s, as experimentation and use of drugs and their related harm were increasing. During the past 10 years, drug-related research has evolved from a global approach and setting up the basic indicators for monitoring the drug situation to detailed research based on the development of the drug situation. The current policy guidelines include a section on information collection and research. Major actors in this area include the National Institute for Health and Welfare (THL), the National Research Institute on Legal Policy and several university departments. The state budget and the Academy of Finland are the main funding sources of drug-related research. The Nordic Centre for Welfare and Social Issues (NVC), based in Helsinki, also plays an important role in promoting and supporting research cooperation amongst the Nordic countries. The main channels for disseminating research findings are the drug situation report, published online by the national focal point, the scientific journals that publish drug-related research and Internet portals. Recent drug-related studies mentioned in the 2012 Finnish National report have focused on responses to and consequences of drug use, but prevalence studies and supply and market issues have also been tackled.
View ‘Drug-related research’ for additional information.