Prescription Drugs

opioids

Nordic countries struggle with a severe drug overdose problem - the drugs causing deaths differ among the five countries

 

THL.fi - May 2020

Despite the fact that the Nordic countries are often seen as ideal in practically every global ranking of quality of life and social equality, the number of drug-related deaths in these countries are among the highest in Europe. The Nordic countries are, however, far behind the United States in the number of fatal drug overdoses. Various measures to reduce drug-related harms have been introduced. Still hundreds of people die every year of fatal drug overdose.

Opioids were responsible for most of the overdose deaths
Heroin still causes a big portion of deaths in all Nordic countries except in Finland where buprenorphine continues to be the main drug causing overdose deaths. Heroin was the most common intoxicant in Sweden and Norway. In Denmark, heroin was the second most common drug, after methadone. 

 

“All in all, opioids such as heroin, methadone and buprenorphine were responsible for the majority of all overdose deaths in the Nordic countries”, Wiese Simonsen says.

 

Overall, deaths caused by an overdose by cocaine and MDMA increased, when compared to the previous study from 2012.

 

Sweden faced an epidemic of fentanyl derivatives in 2017, which caused an overall increase in the country’s overdose mortality rate. The epidemic inflicted some legislative changes in the country, which have later reduced the number of deaths related to fentanyl derivatives to a markedly lower level.

 

In addition to the extremely dangerous fentanyl derivatives, many other new psychoactive substances (NPS) were seen in the Nordic countries, especially stimulant drugs. Most of the deaths were poly-drug poisonings with 4-6 different substances contributing to the overdose.

EMCDDA - Overdose deaths, TRENDS

Source: EMCDDA

Sweden: In 2016 Sweden updated data since 2001 in order to include T40.4 cases.

National definitions usually refer to acute deaths directly related to drug consumption ("overdoses", "poisonings" or "drug-induced"). Note that, in a few countries, the figures might include also a limited number of cases of deaths indirectly related to drug use (e.g. accidents with positive toxicology). Note in addition that in some countries, statistics published at national level may differ from those presented here, owing to differences of case definition used at national level.

Comparisons between countries must be made with caution, because mortality rates and trends are influenced by factors such as practices of reporting, recording information and coding overdose cases that may vary across countries and time.

EMCDDA - Overdose deaths, Current situation > Toxicology > With opiates

The EMCDDA drug-related deaths (DRD) indicator focuses on deaths directly caused by illegal drugs (drug-induced deaths) and mortality among drug users.

The EMCDDA encourages countries to both harmonise their data collection and reporting. Nevertheless, differences in the availability of autopsies and in coding practices between countries will influence the interpretation and comparability of the results.

The number of drug-induced deaths provides one perspective on the drug situation and should be considered within the broader range of information available. Cross-referencing between data-sets provides both additional insights and a check of validity. The DRD indicator also considers mortality amongst drug users derived from cohort studies.

Learn more about EMCDDA methods and definitions

EMCDDA - Treatment demand > Current situation

* Percentage of patients whose main drug was opioid from all entrants.

Sweden: Data for clients entering treatment refer only to hospital-based and specialised outpatient care facilities.

Treatment demand > Current situation > Drug > All entrants > Opioids

Opioid substitution treatment > All clients

Legal framework > Initiation OST

Notes: 'Y' indicates whether a specific provider is involved in initiating opioid substitution treatment.

Specialized medical doctors' refers to specifically trained or accredited office-based medical doctors or general practitioners practicing outside specialised drug treatment centres.

'Any medical doctor' refers to office-based medical doctors practicing outside specialised drug treatment centres.

Where a specific provider is not allowed to initiate a specific treatment, the table entry is left empty. Exception for Sweden for which data were not available 

Needle and syringe programmes > Sites > Fixed

NSP (Needle and syringe programmes) site: The term ‘site’ is used to describe physically distinct outlets where syringes can be obtained for free or in exchange against used ones.

Norway: is based on a harm reduction equipment survey in Norwegian municipalities. This was carried out for the third time in 2019 with a response rate of 73%. 77 municipalities reported syringe delivery. 77 municipalities reported syringe delivery. Around 77 municipalities reported fixed NSP-locations. Due to the fact that not all of the municipalities who reported syringe delivery stated the type of NSP, this number should be treated as an estimate. Despite the high number of participating municipalities, some cities/villages with an NSP site are not represented in the survey.

Needle and syringe programmes > Sites > Outreach

Norway: The information provided is based on 2018 year's reporting (2017-data). Out of the 77 municipalities reporting syringe delivery in the survey, 18 reported outreach syringe provision. Due to some inconsistency in the reporting of type of NSP, this number should still be treated as a rough estimate.