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The Drug Situation in Norway 2012

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The Drug Situation in Norway 2012 The Drug Situation in Norway 2012 Annual report to the European Monitoring Centre for Drugs and Drug Addiction – EMCDDA SIRUSIRUSS Norwegian Institute for Alcohol and Drug Research 2 The Drug Situation in Norway 2012 Foreword As in previous years, this 12thth national report reduction and policy. SIRUS wishes to express its on the drug situation in Norway has been drawn gratitude to all public institutions that have pro- up in accordance with the reporting guidelines vided relevant information. Our thanks go in common to all member states in the EMCDDA. particular to the co-authors who have made tex- In addition to the annual report, we submit sepa- tual contributions and to the authors of the se- rately a number of standardised tables, mainly lected topics, Chapters 11 and 12. epidemiological data, as well as several compre- hensive questionnaires in the fields of demand Oslo, December 2012 Odd Hordvin Head of Focal Point Annual report to the European Monitoring Centre for Drugs and Drug Addiction – EMCDDA 3 Authors Editor: Translation: Odd Hordvin, SIRUS Allegro Language Services, Bergen With the assistance of: Astrid Skretting and Pål Kraft, SIRUS. Co-authors: Chapter 1: Torbjørn Brekke, Ministry of Health and Care Services Chapter 3: Maj Berger Sæther, Directorate of Health Chapter 4.1: Ellen J. Amundsen, SIRUS Chapter 5.2: Grethe Lauritzen, SIRUS Chapter 6.1: Hans Blystad, Norwegian Institute of Public health Chapter 6.2: Thomas Clausen, Norwegian Centre for Addiction Research Chapter 10.1: Ola Røed Bilgrei, SIRUS Authors: Chapter 11: Astrid Skretting, SIRUS Chapter 12: Arne Schanche Andresen, The municipality of Oslo, Agency for Welfare 4 The Drug Situation in Norway 2012 Contents Foreword . 2 5 . Drug-related treatment: treatment Authors . 3 demand and treatment availability . 28 Summary . Main findings – Part A . 6 5.1 General description of systems ........28 5.2 Access to treatment .................29 PART A: New developments and trends . 11 5.2.1 Waiting times......................29 1 . Drug policy: legislation, strategies and 5.2.2 Treatment demand.................30 economic analysis . 12 5.2.3 About patients in OST in particular ...30 1.1 Legal framework ....................12 1.2 National action plan 6 . Health correlates and consequences . 32 and/or strategy......................12 6.1 Drug-related infectious diseases ......32 1.2.1 White paper on drug and alcohol 6.1.1 HIV and Aids . 32 policy . 12 6.1.2 Hepatitis..........................32 1.2.2 Implementation and evaluation of the national action plan 2007–2012 ...14 6.1.3 Bacterial infections.................33 1.2.3 Grant schemes . 15 6.2 Drug-related deaths and mortality of drug users . .33 1.3 Economic analysis ...................16 6.2.1 Drug-related deaths................33 2 . Drug use in the general population 6.2.2 Death and poisoning related and specific target groups . 18 to PMMA .........................36 2.1 Drug use in the general population.....18 6.2.3 Mortality among OST patients .......37 2.2 Drug use among young adults.........18 6.2.4 Hepatitis C as the cause of death 2.2.1 Data . .18 among injecting drug users .........37 3 . Prevention . 20 7 . Responses to health correlates and consequences . 38 3.1 Universal prevention . .20 7.1 Prevention of drug-related 3.1.1 Community . .20 emergencies and reduction of 3.1.2 Family............................22 drug-related deaths .................38 3.1.3 School ...........................22 7.1.1 Emergency assistance ..............38 3.2 Selective prevention 7.1.2 Reduction in overdoses and overdose – at-risk groups and settings..........22 fatalities ..........................39 3.2.1 At-risk groups .....................23 7.2 Responses to other health correlates among drug users ...................40 3.2.2 At-risk families ....................24 7.2.1 Psychiatric and somatic co-morbidity..40 3.3 Recreational settings ................25 7.2.3 Needle exchange programmes ......42 4 . Problem drug use . 27 8 . Social reintegration . 43 4.1 Prevalence and incidence estimates of problem drug use .................27 8.1 Housing............................43 8.2 Employment ........................44 Annual report to the European Monitoring Centre for Drugs and Drug Addiction – EMCDDA 5 9 . Drug-related crime, prevention PART B: Selected issues . 65 of drug-related crime and prison . 46 11 . Residential treatment for drug users . 64 9.1 Drug law offences ...................46 11.1 History and policy frameworks .......64 9.1.1 Legal basis and type of statistics .....46 11.1.1The history of residential treatment ..64 9.1.2 Statistics . .47 11.2 Strategy and policy frameworks for 9.2 Interventions in the criminal residential treatment................66 justice system.......................48 11.3 Availability and characteristics .......67 9.2.1 Alternatives to prison ...............49 11.4 Types and characteristics of 9.2.2 Units for mastering drug and residential treatment units...........68 alcohol problems ..................50 11.5 Quality management................68 9.3 Driving offences .....................51 11.6 Discussion and outlook..............69 10 . Drug markets . 52 12 . Case study: Oslo the capital city . 10.1 Availability.........................52 Key features of the city’s drugs policy . 71 10.1.1 The relationship between 12.1 The City of Oslo’s drugs and alcohol amphetamine and policy and most important agencies ...71 methamphetamine................52 12.2 Action plans for breaking up the drug 10.1.2 The internet as a market place for milieus in the city centre.............72 new, synthetic substances .........53 12.3 The city centre work and the 10.2 Supply . 54 responsibility of the city wards........75 10.2.1 Smuggling routes to Norway .......54 12.4 Local policing strategies against drug 10.3 Seizure statistics ...................55 scenes/drug trafficking..............76 10.3.1 Main features ....................55 12.5 Monitoring system..................77 10.3.2 Statistics for 2011 .................56 12.6 Low-threshold services for problem drug users . 78 10.4 Price of illicit drugs at retail level .....59 12.7 Current issues in Oslo 10.5 Purity/potency/composition of illegal – policy concerns ...................79 drugs and tablets...................60 12.8 Discussion ........................79 Appendix 1 . Legal limits for other drugs and alcohol . 81 Appendix 2 . Sales and licensing hours . 83 References . 84 Appendix: Lists . 86 6 The Drug Situation in Norway 2012 Summary. Main findings – Part A Legal framework paper, the Government presents targets and The Coordination Reform entered into force on 1 measures ranging from effective prevention, ear- January 2012. It will be gradually introduced ly intervention and help for people with exten- over the course of the next four years. As an sive drug and alcohol problems to measures tar- overriding framework, the reform is important geting next-of-kin and third parties affected by in relation to drug and alcohol policy. The goal is the harm caused by drug and alcohol use. The to achieve better and more coherent health ser- main topics in the report are challenges and poli- vices through improved coordination of the pri- cies relating to alcohol, which is the substance mary and specialist health services. The most that causes most harm, and drugs. important legislative amendments relating to the Coordination Reform are: The policy relating to doping as a social problem is integrated in the white paper. Based on the fact • A new Public Health Act, which gives the that doping can cause physical, mental and so- municipalities greater responsibility for cial problems, the Government advocates mobil- prevention and health-promoting work in all ising against doping through preventive, treat- sectors of society ment and crime-combating measures, and it • A new joint act relating to municipal health proposes criminalising possession and use of and care services doping. The white paper will be considered by the Storting in its spring session 2013. Drug driving limits set With effect from 1 February 2012, the Storting Implementation of the national action plan introduced ‘drug driving limits’ for 20 narcotic 2007–2012. Several challenges remain. substances and potentially intoxicating medici- The action plan expires in 2012. The white paper nal drugs. Norway thereby became the first states that the plan will be succeeded by strate- country in the world to set legal and sentencing gies in the following focus areas: public health, limits for substances other than alcohol. overdoses and competence. The amendments to the Road Traffic Act entered The Directorate of Health has reviewed the re- into force on 22 July 2012. Among other things, sults and use of policy instruments under the the amendments are intended to ensure greater Action Plan. The summary shows that, with a agreement between the Road Traffic Act’s provi- few exceptions, all 147 measures in the Action sions on drink driving and the regulation of Plan had been implemented or initiated, and that driving under the influence of other intoxicating many of the sub-goals in the plan had been or narcotic substances. achieved in whole or in part. White paper on drug and alcohol policy In addition, the Action Plan has led to a high level launched of activity, and the implementation rate has been On 22 June 2012, the Government presented a high. The county governors, research institutions, white paper on drugs and alcohol policy. This is expert milieus, user and next-of-kin organisa- the first white paper in Norway setting out a tions, voluntary and private players and others comprehensive drugs and alcohol policy that have contributed to many important results. covers alcohol, drugs, addictive medicinal drugs, Although the Action Plan has helped to increase and doping as a social problem. In the white the focus on prevention, competence and quality Annual report to the European Monitoring Centre for Drugs and Drug Addiction – EMCDDA 7 in the municipalities and in specialised interdisci- reported having used it during the last six plinary drug and alcohol treatment, much still re- months.
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