Country overview: Finland
- Situation summary
- Data sheet
- Barometer
Contents
- Drug use among the general population and young people
- Prevention
- Problem drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-related deaths
- Treatment responses
- Harm reduction responses
- Drug markets and drug-related offences
- National drug laws
- National drug strategy
- Coordination mechanism in the field of drugs
- Drug-related research
| Year | Finland | EU (27 countries) | Source | ||
|---|---|---|---|---|---|
| Population | 2010 | 5 351 427 | 501 105 661 p | Eurostat | |
| Population by age classes | 15–24 | 2010 | 12.3 % | 12.1 % p | Eurostat |
| 25–49 | 32.3 % | 35.8 % p | |||
| 50–64 | 21.7 % | 19.1 % p | |||
| GDP per capita in PPS (Purchasing Power Standards) 1 | 2009 | 113 | 100 | Eurostat | |
| Total expenditure on social protection (% of GDP) 2 | 2008 | 26.3 % | 26.4 % p | Eurostat | |
| Unemployment rate 3 | 2010 | 8.4 % | 9.6 % | Eurostat | |
| Unemployment rate of population aged under 25 years | 2010 | 21.4 % | 20.9 % | Eurostat | |
| Prison population rate (per 100 000 of national population) 4 | 2009 | 67.4 | Council of Europe, SPACE I-2009 | ||
| At risk of poverty rate 5 | 2009 | 13.8 % | 16.3 % | SILC | |
p Eurostat provisional value.
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, 2009.
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).
Drug use among the general population and young people
Since 1996, a general population survey on drug use has been carried out in Finland every two years, among persons aged 15–69 by means of a postal questionnaire, with the exception of the year 2000 when a face-to-face interview method was used. The 2006 results indicate that 14.8 % aged 15–64 reported lifetime prevalence of at least one drug. Among persons aged 15–64, 14.3 % reported that they had used cannabis at least once in their life. Lifetime prevalence of amphetamines was reported by 2.2 % of respondents, ‘solvents-inhalants’ by 1.9 %, ecstasy by 1.6 %, cocaine by 1.1 % and LSD by 1.1 %. Last year prevalence of cannabis use was 3.6 % and the last month prevalence of cannabis, 1.6 %. For all other substances, last year prevalence was lower than 2 % and last month prevalence was even lower. Comparing these with the results of the 2002 study, the trend shows a stabilisation in cannabis use, the most important increase was seen for the last year prevalence in the 25–34 year old men group, their proportion almost doubled between 2002 and 2006.
The most recent results of ESPAD 2007 indicate that 8 % had ever tried marijuana or hashish (11 % in 2003 and 10 % in 1999). In addition, the reported lifetime prevalence of cannabis use among males was 8 % and 7 % among females. In 2007, inhalants lifetime prevalence was reported by 10 % of the students (8 % in 2003 and 5 % in 1999). Lifetime prevalence of ecstasy was reported by 2 % of the sample (1 % both in 2003 and 1999). Results also indicated 6 % for the last year prevalence of cannabis use (in 2003 it was 8 %) and 2 % for the last month prevalence of cannabis (3 % in 2003).
Throughout the history of the ESPAD survey (since 1995), drug experimentation has risen in Finland. Yet, ESPAD surveys indicate that pupils doing well in school use substances of any kind less than those performing poorly. By contrast, the educational background of the pupil’s family does not significantly influence experimentation.
Prevention
Preventive substance abuse work in Finland is part of the wider concept of promotion of well-being and health. Local authorities are recommended to have a mental health and substance abuse service strategies in place. The 2008 survey of health centres showed, that about one third of centres do not have such strategy. Quality criteria have now been determined for substance abuse prevention.
Preventive substance abuse work also includes prevention of smoking and functional dependencies. Universal school-based prevention is focused on all school levels, and drug education is a part of mandatory health 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 on methods to achieve nationally-set objectives on drug education and prevention. However, they do not systematically report their activities. The most popular approaches are knowledge transfer, experimental pedagogy, life skills education, affective education and alternatives to drug use. Available data on school-based prevention is limited mainly to those prevention programmes offered by external parties, which are regularly evaluated.
With regard to selected prevention, the National Institute for Health and Welfare has published a guide on early identification of mental health and substance abuse problems intended for social welfare and health care professionals. The NGOs and other third-sector actors play a central role in the practical work of substance use prevention. Risk prevention activities targeting school dropouts or drug users are mainly implemented through NGO based health counselling centres low-threshold web service Addiction link is additional tool to provide information as well as self-help tools for high risk populations.
Problem drug use
As opposed to many other European countries where heroin is the main drug, amphetamines are the most commonly injected drug in Finland. After an increase at the end of the 1990s, the recent estimates (2002 and 2005) suggest that the situation with the problem drug use seems to have stabilised. Estimates on the number of problem drug users including problem amphetamine and opiate users come to 14 500 –19 100 in 2005 (with 16 600 as a central estimate and 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 use amphetamines. The opiate most commonly abused is buprenorphine and polydrug use is very common among the problem drug users.
The EMCDDA defines problem drug use as intravenous drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis are not included in this category. The Finnish data may include also occasional users due to registration practices of data sources.
Treatment demand
In 2009, the drug treatment information system included data from 83 treatment centres and in total 1 907 all treatment demand and 303 first time treatment clients were reported.
In terms of primary substances, the majority of all treatment clients reported that opioids (mainly buprenorphine) were the main drug, at 60.0 %, followed by 17.2 % for amphetamines and 12.2 % for cannabis. Among first time treatment clients, a slightly different distribution was reported with 37.7 % reported opioids as the main drug followed by 33.3 % for cannabis and 18.8 % for amphetamines.
In 2009, 30 % of all clients entering treatment were aged less than 25 years. A higher percentage in age distribution was reported among new treatment clients, with 55 % being under 25. As far as gender distribution is concerned, 69 % of all clients entering treatment were male whereas 31 % were female, and the proportion of females among the all time clients has increased if compared with 2008 data. A similar gender distribution was reported among first time treatment clients: 68 % were male and 32 % female.
Drug-related infectious diseases
The National Institute for Health and Welfare in Finland operates the national HIV registry. In 2009, the registry recorded 178 new cases of HIV infection (compared to 148 cases in 2008 and 188 cases in 2007). In 2009 the 7 % were attributed to injecting drug use (5 % in 2008). In 1997, this proportion was 1 % of HIV infection diagnosed in the country, rising to 58 % in 1999, and the proportion has decreased significantly since then due to the activities of the health counselling points, including e.g. exchange of used needles and syringes for clean ones. It is estimated that the national prevalence rate of HIV infection among injecting drug users for 2007 is around 1.2 % of infected persons for a sample of 722 tested persons. In 2009, HIV prevalence from testing a sample of 679 current injecting drug users in nine needle and syringe programs indicate HIV prevalence at 0.7 %.
In 2009, 1 061 (1 144 in 2008 and 1 157 in 2007) hepatitis C new cases were diagnosed, and in about half of the cases the means of transmission was reported. Out of these cases, 81.2 % are estimated to have been contracted through intravenous drug use. HCV prevalence among 682 clients of nine needle and syringe program sites was 60.5 %. In 2009, 34 hepatitis B new cases were diagnosed, and the means of transmission was identified in 23. No new acute infection had been contracted through injecting drug use.
Drug-related deaths
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 case of an unexpected or sudden death. The data from both registries on drug-related deaths are also available as drug-related death standards, a standard protocol for extracting data on drug-related deaths from registers in EU Member States.
According to the DRD standard definition for the general mortality registries, there were 175 drug-related deaths in 2009 (169 in 2008, 143 in 2007, 138 in 2006 and 126 in 2005).
Compared to previous years (e.g. 97 in 2002), the number of deaths have generally decreased since 2000, yet increased from 2003 to 2009. In particular, the number of heroin-related deaths increased in the late 1990s, especially among young people, but heroin-related deaths have since decreased rapidly, although 88.2 % of DRD involves opiates — mainly opioid-containing medications. An increase has been observed with regard to buprenorphine-related deaths, which was the most common opiate found in forensic autopsies in 2007. According to the General Mortality Register, 40 % of drug-related deaths in 2000 involved people under 25 years. This trend has since levelled off and in 2009, the proportion of drug-related deaths which involved persons under the age of 25 years decreased to 17.1 %.
Treatment responses
The provision of drug treatment falls under the responsibility of the regions and municipalities. More than half of drug treatment is delivered by NGOs, 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.
A description of drug treatment in Finland should take into account that problem alcohol use is a much greater problem in Finland than illicit drug problems. 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, namely: outpatient clinics, short-term inpatient care, long-term rehabilitation units, support services and peer support activities. Outpatient treatment covers outpatient treatment for all kinds of addictions, youth outpatient services, and outpatient services for problem drug users. 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. However, a trend to move drug treatment to primary health is increasingly noticeable.
Substitution treatment is provided in inpatient and outpatient settings. It is typically provided through specialised units, although general practitioners are also allow to provide such treatment with only a few being 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, the first country in Europe were this substitution medication became available.
In 2009, it was estimated that approximately 1 800 clients were reported to be receiving opioid substitution treatment, 40 % of whom were on methadone and 60 % on buprenorphine.
Harm reduction responses
In 1998, when the HIV epidemic began among Finnish drug users, public attention focused on preventing diseases transmitted by injecting drug users. Current harm reduction responses in Finland include outreach work and health counselling centres. Outreach work mainly involves street patrols, with the aim of mediating between drug users and the official care system. 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, as well as testing of infectious diseases and vaccinations and small-scale healthcare. Free vaccination against viral hepatitis A and B is offered to injecting drug users, and the evaluation shows that approximately 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 in the past years, their number has increased further. However, there is some variation in service provision depending on the facilities. In 2009, there were 40 health counselling centres that exchanged needles and syringes to prevent infectious diseases, located mainly in cities with over 50 000 inhabitants. According to available data, the number of clients at health counselling centres increased from 2000 to 2004, and stabilised at approximately 12 000 in 2005 and 2006. At the same time, the number of syringes continued to increase (from 1.9 million in 2005 to 3.0 in 2009). Needle and syringes can also be purchased without medical prescription at most pharmacies in Finland.
Drug markets and drug-related offences
Due to the low supply of heroin from Afghanistan, in 2001 buprenorphine appeared on the illegal market in Finland and thus, heroin is still rare. Moreover, larger Subutex consignments have been smuggled into Finland from France, and smaller amounts have been brought mainly from diverted foreign prescriptions, primarily from Estonia. The joining of the Baltic States into the Schengen area seems to redirect to some extent both Subutex tourism and the smuggling of Subutex. The supply of hashish mainly originates from Morocco, reaching the Finnish market via Spain, the Nordic and Baltic countries. Amphetamine is smuggled to Finland mostly via Estonia, mainly from Russian, Estonian or Lithuanian sources. Increased availability of so-called ‘designer drugs’ 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 seized quantities of mCPP tablets indicated that the production was aimed for export.
In 2009, the quantity of cannabis resin seized increased almost ten-fold when compared to 2008, with a reported total of 440 kg; the number of seizures increased to a total of 1 940 seizures. The quantity of herbal cannabis seized increased when compared to 2008, with a reported total of 100 kg; the number of cannabis plants seized, however, declined, with a total of 12 500 plants reported. The quantity of amphetamine seized declined slightly to a total of 110 kg. Regarding the quantity and number of ecstasy seizures both declined significantly in 2009, with a reported total of 15 100 seized tablets and a total of 190 seizures when compared to 2008 (34 000 tablets corresponding to 250 seizures). The quantity of cocaine seized in 2009 was the same as in 2008, with a reported total quantity of 3 kg respectively.
In 2009, in total, 18 555 reports of drug law offences were reported which is the highest ever recorded number of the reports. More than 60 % of all reports are on use-related offences, while approximately 33 % are on both use- and supply-related offences.
National drug laws
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 maximum 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 the possession, manufacturing, growing, smuggling, selling and dealing of drugs. 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 organised for the extensive committing of such an offence. Aggravating circumstances will increase the penalty range to between one and 10 years’ imprisonment.
In 2010, the Narcotic Act was amended and MDPV was added to the list of controlled substances.
National drug strategy
Finland’s drug policy is based on its national drug strategy of 1997 and the Government Resolution on ‘Cooperation regarding national drug policy 2008–11’, which was adopted in November 2007 and is the continuation of a similar programme for the years 2004–07. Both the strategy and the resolution focus on illicit drugs and stress the importance of: continuing and developing long-term work; increasing cooperation between various actors; and establishing a uniform drug policy approach with balanced and compatible measures to reduce drug demand and supply. The measures under the resolution are related to: preventive work and early intervention; combating drug-related crime; treatment of drug addiction and reduction of harm from drug use; intensifying the treatment of drug misuse in connection with criminal sanctions; the EU’s drug policy and international cooperation; information collection and research regarding drug problems; and coordination of drug policies.
Coordination mechanism in the field of drugs
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.
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 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.
Drug-related research
Greater emphasis was first placed on drug-related research in the 1990s, along with increased experimentation and use of drugs and their related harm. During the past 10 years, drug-related research has evolved from: (i) a more global approach and setting up the basic indicators for monitoring the drug situation to (ii) more 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 2010 Finnish National report have focused on responses to and consequences of drug use, but determinant of drug use and supply and market issues have also been tackled.
