Norway Country Drug Report 2019

Harm reduction

The harm reduction goals within Norway’s alcohol and drug policy were defined in the 2011-12 white paper ‘See me! A comprehensive drugs and alcohol policy’ and are confirmed in the current national action plan. The aim of harm reduction measures is to improve health and allow people who use substances a more dignified life, including the prevention of harms such as overdoses and drug-related infectious diseases. The national overdose strategy for 2014-17 provided a background to scale up activities to prevent overdose risks and to promote emergency assistance and treatment for drug users. Low-threshold services and harm reduction are further addressed in the National Action Plan for the Alcohol and Drugs Field 2016-20. In November 2018, the government presented a revised national strategy on hepatitis that prioritises the prevention and treatment of the infection among vulnerable groups, including people who inject drugs (PWID). In Norway, the municipalities are responsible for the organisation of harm reduction measures on the basis of local needs. A 2017 national electronic survey among all Norwegian municipalities suggests that around 22 % currently provide syringes to PWID. While cooperation between local public health and social services constitutes the backbone of service provision, private non-profit organisations are important partners for municipalities in the implementation of harm reduction interventions.

Harm reduction interventions

Low-threshold facilities offer a broad range of services, such as health checks, vaccinations (including the provision of free hepatitis A and B vaccines), distribution of clean injecting equipment and foil, overdose prevention interventions, nutritional and hygiene guidance, and follow-up and referral to other parts of the health service.

A national survey estimated that 2.9 million syringes were distributed through low-threshold facilities in 2017, the majority being given out in Oslo, Bergen and Trondheim.

The 14 municipalities with the highest burden of drug-related deaths participated in the implementation of the national overdose strategy 2014-17, introducing overdose prevention programmes funded by dedicated grants from the Directorate of Health. The strategy is currently being re-drafted to be renewed for the period 2019-22, building on successful measures, addressing new challenges and aiming, among other things, to provide all municipalities with naloxone funded by the state. Several municipalities have also adopted local overdose action plans and measures. By the end of 2017, more than 6 300 naloxone kits had been distributed in the participating municipalities.

Two supervised injection rooms were operational in Norway by the end of 2017, in Oslo and Bergen. Since the one in Oslo was established, nearly 330 000 injections have been supervised in the supervised injection room, with no fatalities.

Availablity of selected harm reduction responses in Europe
Country Needle and syringe programmes Take-home naloxone programmes Drug consumption rooms Heroin-assisted treatment
Austria Yes No No No
Belgium Yes No Yes No
Bulgaria Yes No No No
Croatia Yes No No No
Cyprus Yes No No No
Czechia Yes No No No
Denmark Yes Yes Yes Yes
Estonia Yes Yes No No
Finland Yes No No No
France Yes Yes Yes No
Germany Yes Yes Yes Yes
Greece Yes No No No
Hungary Yes No No No
Ireland Yes Yes No No
Italy Yes Yes No No
Latvia Yes No No No
Lithuania Yes Yes No No
Luxembourg Yes No Yes Yes
Malta Yes No No No
Netherlands Yes No Yes Yes
Norway Yes Yes Yes No
Poland Yes No No No
Portugal Yes No No No
Romania Yes No No No
Slovakia Yes No No No
Slovenia Yes No No No
Spain Yes Yes Yes No
Sweden Yes No No No
Turkey No No No No
United Kingdom Yes Yes No Yes

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.