Country overview: Finland
- Situation summary
- Drug use among the general population and young people
- High-risk drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-induced deaths and mortality among drug users
- 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 (28 countries)||Source|
|Population||2013||5 426 674||505 665 739||Eurostat|
|Population by age classes||15–24||2013||12.2 %||11.5 % ||Eurostat|
|25–49||31.6 %||35.0 % |
|50–64||21.0 %||19.7 % |
|GDP per capita in PPS (Purchasing Power Standards) 1||2012||115||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2011||30.0 %||29.0 % p||Eurostat|
|Unemployment rate 3||2013||8.2 %||10.8 %||Eurostat|
|Unemployment rate of population aged under 25 years||2013||19.9 %||23.4 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2012||59.2||:||Council of Europe, SPACE I-2012|
|At risk of poverty rate 5||2012||13.2 %||17.0 % e||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, 2012.
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 is 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 survey results indicate that almost one in six people 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. Some 29 % of respondents in this age group reported ever using cannabis in their life, while 11.2 % had used it in the last year and 3.3 % in the last month. Amphetamine was the second most prevalent substances used by this age group, but prevalence of recent use was below 2 %. Comparing these data with the results from the 2002 study, last year cannabis use shows a stabilising trend, 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 males and females who have used drugs is almost the same in younger age groups, but divergence occurs with ageing, with drug use sharply declining among females aged 25–34.
The most recent European School Survey Project on Alcohol and Other Drugs (ESPAD) results for 15- to 16-year-olds, 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. It 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 activities, 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. Substance abuse prevention is also embedded in general prevention programmes for young people, but manualised substance abuse prevention programmes in schools are rarely implemented, since the whole system is focused on offering a protective school climate.
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 guidebooks were published on the management of substance use problems and on the identification and screening of mental health and substance abuse problems. Risk prevention activities targeting school dropouts or young drug users are mainly implemented through health counselling centres, outreach youth work teams run by non-governmental organisations (NGOs), sheltered youth homes, rehabilitation units and workshops for young people. 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.
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. However, in 2012 a new definition of ‘high-risk drug use’ was adopted. The new definition includes ‘problem drug use’, but is broader (mainly in its inclusion of high-risk use of more substances). Details are available here.
The latest estimates of high-risk drug use populations using the capture-recapture method are available from 2005. Unlike many other European countries, where heroin is the main drug, amphetamines are the most commonly injected drug in Finland. Nearly 16 300 problem drug users used amphetamines (range: 12 000 to 22 000). It was estimated that some 0.43–0.74 % of 15- to 54-year-olds in Finland were problem amphetamine users. There were about 4 204 problem opioid users (range: 3 700 to 4 900), or 1.2 per 1 000 inhabitants aged 15–64 (range: 1.06 to 1.04). The opioids most commonly used were buprenorphine and methadone.
The prevalence of high-risk cannabis use was estimated based on 2010 general population survey data, which indicated that about 0.2 % of 15- to 64-year-olds used cannabis daily or almost daily.
In 2012 drug treatment information was collected by the National Institute for Health and Welfare from 79 treatment centres: 41 outpatient and 38 inpatient treatment centres. Data were collected on 1 486 clients admitted for treatment, of which 265 were new clients entering treatment for the first time.
As the drug treatment information system is voluntary and there is no official register of drug treatment centres, several treatment centres, in particular general health care centres, do not report data. Studies carried out to assess the data reporting coverage in specialised drug treatment centres indicated that it varies according to facility type. The Finish drug treatment reporting system is currently being reformed in order to enhance coverage and quality of data.
In 2012 some 62 % of all clients entered treatment due to opioid use (mainly injecting buprenorphine), followed by cannabis at 18 % and amphetamines at 12 %. The year 2012 was the first time that the largest proportion of treatment demands (43 %) reported that cannabis was their main problem drug, followed by opioids at 38 % , and amphetamines at 10 %. Injection rates remained high among all treatment clients (80 % for amphetamines and 81 % for opioids) and new treatment clients (68 % for amphetamines and 74 % for opioids). It should be noted that more than half of all treatment demand clients were polydrug users, as they reported using three or more substances before entering treatment services.
In 2012 some 32 % of all clients entering treatment were under the age of 25. New treatment clients tended to be younger, with 61 % under the age of 25. With regard to gender distribution, around 66 % of all treatment clients were male and 34 % 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 67 % male and 33 % female.
The National Institute for Health and Welfare in Finland operates the National Infectious Diseases Register. In 2011 the registry recorded 176 new cases of human immunodeficiency virus (HIV) infection (187 in 2010; 178 in 2009). In 2011 eight and in 2012 seven cases of HIV were attributed to injecting drug use. In 1997 only two cases of diagnosed HIV infection were attributed to injecting drug use, increasing to 85 in 1999. The number of cases has decreased significantly since then. The national prevalence rate of HIV infection among people who inject drugs (PWID) for 2007 was estimated at 1.2 %, based on a sample of 722 people. In 2009 a sample of 684 current injecting drug users in nine needle and syringe programmes indicated HIV prevalence at 0.7 %.
In 2011 some 1 160 new cases of hepatitis C virus (HCV) were diagnosed (1 132 in 2010; 1 061 in 2009); approximately half of the cases had been contracted through injecting drug use. HCV prevalence among 682 clients of nine needle and syringe programme sites was 60.5 % in 2009. In 2011 some 24 cases of acute hepatitis B virus (HBV) infections were diagnosed; the means of transmission were identified in ten cases, and none had contracted the infection through injecting drug use. In 2012, out of 13 acute and chronic HBV cases with a known transmission route, one had contracted acute infection through injecting drug use.
In general, there has been a 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 prevalence of HCV, however, remained fairly stable.
The National Cause of Death Register (General Mortality Register — Statistics Finland) and the Special Registry provide data on drug-induced 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. Data extraction and reporting is in line with the EMCDDA definitions and recommendations.
A third indicative source is the Hjelt Institute, which provides data on the number of cases with positive chemical findings in forensic autopsies. The drug is not necessarily the direct cause of death for these cases.
According to the standard definition for the general mortality registries there were 213 drug-induced deaths in 2012, which is the highest annual number reported since 1996. Over the past 10 years the number of drug-induced deaths has generally increased and there was a fairly sharp increase in 2011 and 2012, mainly due to an increase in opioid- , amphetamine-, and cannabinoid-induced deaths. In 2012 a total of 170 deaths involved opioids — 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-induced deaths in 2000 involved people under the age of 25. This trend has since levelled off, and in 2012 the proportion of drug-induced deaths involving people under the age of 25 decreased to about 14 %. In 2012 the mean age of the victims was 37.7 years and the majority of the deceased were male (161). Some cases were related to new psychoactive drugs, of which MDPV was the most commonly found among the stimulant type of drugs.
The drug-induced mortality rate among adults (15–64) is 53.3 deaths per million, more than three times the European average of 17.1 deaths per million in 2012.
The provision of drug treatment falls under the responsibility of the regions and municipalities and is regulated by the Act on Welfare for Substance Abusers, the Social Welfare Act, the Mental Health Act and a Decree governing detoxification and substitution treatment for opioid addicts.
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 (OST) and detoxification. Drug treatment is mainly funded by the public budget of the communities; however, long waiting times, the attitude of primary health providers and the distance to a specialised service are mentioned as obstacles for accessibility of treatment services.
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 period 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; emergency care; pregnant women; OST for young people; and ADHD and intoxicants.
OST is provided in inpatient and outpatient settings. It is typically provided through specialised units, although general practitioners and pharmacies are increasingly involved in the provision of these services. 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 a total of 2 439 clients were reported to be receiving OST, of which 931 were on methadone and 1 508 were 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 among people who inject drugs. Based on the Communicable Diseases Decree of 1986, which stipulates that the local level (municipalities) is in charge of the prevention of infectious diseases, harm reduction services were established and are implemented by municipal bodies.
Current harm reduction responses in Finland include outreach work and local health counselling centres. In addition, some harm reduction activities are 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. It should be noted, that referral to treatment is a considered an integral component of harm reduction services in Finland. However, there is some variation in service provision, depending on the facilities. The health counselling centres that exchange needles and syringes to prevent infectious diseases are located mainly in cities of over 100 000 inhabitants, and are available at about 35 locations across Finland (27 fixed sites, two sites serviced by outreach workers and 13 sites serviced by needle and syringe programme vans).
A decree on vaccinations passed in 2004 recommends free vaccination against hepatitis A and B viruses for people who inject drugs (PWID), their sexual partners and individuals living in the same household as part of the general vaccination programme. The most recent data indicate that more than one-third of PWID in contact with the drug treatment system had received all three vaccine doses and more than half had received at least one.
According to available data, the number of clients using the needle and syringe programmes at health counselling centres has significantly increased during the period 2001–10, from 8 400 to more than 14 000 individual clients reached. In recent years, client numbers seem to be stabilising at around 11 000. The number of syringes given out increased year on year from 950 000 in 2001 to 3.5 million in 2012. Needles and syringes can also be purchased without medical prescription at most pharmacies in Finland, and pharmacies play a key role in needle and syringe provision in areas where there are no health counselling centres.
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 domestic 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 or eastern Europe and destined for Russia. Amphetamine is smuggled to Finland mostly via Estonia and Lithuania, primarily from western European sources, while some amphetamine and methamphetamine seized in Finland comes from Lithuania and Russia. 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, increased. Smaller amounts had 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 (NPS) 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 intended for export. NPS are mainly imported from the Netherlands, the United Kingdom, Poland and Germany. In 2012 the number of seizures of cannabis products continued to increase when compared to the previous years. A total of 714 kg of cannabis resin and herbal cannabis and 18 150 cannabis plants were seized in 2012. The quantity of amphetamine seized increased from 71 kg in 2011 to 124 kg in 2012, while the amount of seized methamphetamine dropped from 28 kg in 2011 to 15 kg in 2012. In 2012 a record number of ecstasy seizures (513) was recorded. Although the amount seized also increased (23 623 tablets in 2012), it remained below the figures reported annually until 2008 (range: 34 000 to 87 393) and in 2010 (27 000 tablets). The second largest quantity of 26 kg cocaine was seized in 2012 (39 kg in 2000), while 20 kg of cocaine destined for Sweden was seized in a single operation. As heroin has been largely replaced by illegally obtained Subutex, it is worth noting that 48 700 Subutex tablets were seized in Finland in 2012.
In 2012 more than 20 000 drug-law offences were reported, fewer than in 2011. More than 56 % of all reports were use-related offences, while approximately 39 % 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-use offence punishable by a fine or a maximum of six months’ imprisonment. Prosecution and punishment 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 (whether for personal use or supply), manufacturing, growing, smuggling, selling and dealing. There is no specific offence of dealing or trafficking. The penalties for a drug offence range from a fine to a maximum of two years’ imprisonment, while an aggravated drug offence is punishable by between one and 10 years’ imprisonment. 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.
The 2010–11 amendments to the Narcotics 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 the European Legal Database on Drugs (ELDD) 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 the Action Plan to Reduce Drug Use and Related Harm was adopted in August 2012. Covering the period 2012–15, 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 European Union’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 re-appointed 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 for 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 Finnish 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). The method used to estimate total drug related expenditure was updated in 2012, and data for that year is not comparable with previously reported data.
In 2011 total drug-related expenditure represented 0.2 % of gross domestic product (GDP), with 62.5 % spent on public order and safety, 20.7 % on transfers for social protection, and 16.8 % on healthcare.
Trend analysis shows that in 2011 total drug-related public expenditure increased by 10.5 % compared to the previous year, in nominal terms.
(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 Hein, R. and Salomaa, J. (1998), ‘Päihteiden käytön haittakustannukset Suomessa vuosina 1994–1995. Alkoholi ja huumeet’ [‘Harm-related costs of substance use in Finland 1994–1995: 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 harms were increasing. In 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 Finnish National Focal Point, the scientific journals that publish drug-related research and Internet portals. Recent drug-related studies mentioned in the 2013 Finnish National report have focused on responses to and consequences of drug use, but prevalence studies and supply and market issues as well as determinants of drug use have also been tackled.
View ‘Drug-related research’ for additional information.