Hard drug use in Norway

Abstract

BACKGROUND: Hard drug use has a variety of heavy personal, social and economic costs. Knowing the size of the hard drug use population, the types of drugs consumed and modes of consumption can help policy makers design better policies and facilitate decision making. Intravenous drug users constitute one subgroup of hard drug users. The aim of this article is to describe 1) how the prevalence of intravenous drug use is estimated in Norway and 2) how available data sources give insight about other types of hard drug use even though we can not estimate the true extent of such use. Some policy consequences are outlined. METHODS/MATERIALS: Overdose deaths and the mortality multiplier method were used to estimate the prevalence of intravenous drug users. Other materials were used to supply the picture of hard drug use in Norway. RESULTS/FINDINGS: The prevalence of intravenous drug users in Norway increased steadily from the early 1980s, peaked in 2001, decreased until 2003 and then stabilized. Heroin is the substance of choice of most hard drug users in Norway and injection is the preferred means of intake. Amphetamines are also injected or consumed in other ways, while heavy use of cocaine in the treatment population is low. The use of more than one substance is common. CONCLUSION: Preventing and reducing heroin injection is the main challenge facing Norwegian policy makers. Other drugs pose a problem as well. Wide availability of substitution treatment has a successful record of helping many former heroin users avoid heroin. The risk of relapsing remains high, however, and of dying after drop out or completion. Current knowledge of hard drug use is fragmented and improved monitoring of this high risk group should be prioritized.