WHEN YOU THINK of Norway, you think of welfare, oil-money, socialism and the privileged Scandinavian life. Surprisingly the capital, Oslo, struggles with an overwhelming number of heroin addicts – and deaths by overdose.
Walking out of Norway’s biggest train station in the heart of Oslo, a spot where many have their first proper glimpse of the country, tourists might be surprised. Walking straight into Oslo’s main street, you are likely to pass people either injecting a shot of, or being clearly affected by – heroin. This first impression, a concern that has caused heavy debate for years in Norway, might easily leave people with the impression that Norway has a huge drug problem, but the picture is far more complex than.
A report from SIRUS (Norwegian Institute for Alcohol and Drug Research) revealed that the number of people in Norway who have experimented with drugs, is lower than the European average. The number is also below the European average for “recreational” use on a regular basis, this includes cannabis, cocaine, ecstasy/MDMA. However, Norway has a relatively high number of intensive and more serious cases of drug abuse – actually above the European average. The report showed that within Norway’s 5 million inhabitants, there were between 7,300 and 10,300 injecting drug users in 2011 – a number that increased from 1970 to 2001, followed by a reduction until 2003, and which has been stable since. The drug addicts who inject constitute the majority of Norway’s problems with drug abuse, and these numbers offer part of the explanation to the many drug users outside Oslo Central Station, popularly referred to as “plata”.
The high numbers of users of such a heavy drug as heroine, might surprise those who first and foremost know the socialistic country for being one of the world’s richest nations. It is also known for its extensive social- and welfare system. Apparently, despite the oil money and welfare system, Norway is struggling with one of Europe’s most extensive heroin epidemics, something that reveals that drug addiction is a complex phenomenon which money and welfare have been unable to solve.
Numbers of deaths directly caused by drugs are hard to compare among European countries, but reports from EMCDDA (European Monitoring Centre for Drugs and Drug Addiction ) show that Norway has topped the European table concerning drug related deaths since 2007. From 2002- 2012 the average number of deaths in Oslo per year due to drugs was 60 people. 78 per cent of these deaths were due to opiates, but whether this was due to heroin, substances prescribed by doctors for rehabilitation, or a combination of the two, remains unclear. After 2009 the number of deaths due to heroin was reduced to half, but at the same time the numbers of deaths due to methadone provided by the state as a legal and rehabilitating substitute, increased and are now on the same level. These statistics clearly indicates how big a challenge the government is facing.
A culture of injection
In Norway, about 90 per cent of heroin users inject the drug, compared to only 15 per cent in the Netherlands. Injection of heroin is known as the most risky way to consume it, so why is it so common? Several explanations have been offered by SIRUS. One of them is, that it is more advantageous to inject the dose. The price of drugs has traditionally been higher in Norway, and not wasting drugs has been a bigger concern there. Despite the fact that prices are now on an average European level, such patterns in a culture take a long time to change and so far this trend has remained. Another explanation offered is that Norway or Nordic countries have an extreme culture of hard drinking and intoxication, which makes people seek the most extreme experience of the heroin effect.
An attempt at reduction
In recent years, effort has been made to encourage activities preventing overdose risk, promoting emergency assistance and the establishment of a field nursing service involving outreach activity of health checks, treatment of sores, free hepatitis A and B vaccinations, distribution of injection equipment, nutrition and hygiene guidance, follow-up and referral to other parts of health care system. Oslo started to hand out free needles in 1988 and a heroin- injecting room was also opened in the centre of Oslo temporarily in 2005 and made permanent in 2009. This room is available for “hardcore” injectors over the age of 18. Some critique has been made of these specific endeavours – especially on the issue that legal injection rooms and free needles might contribute to, and encourage this culture for injecting heroin.
In 2003 the police, the municipality of Oslo, and the central government made a plan aimed at breaking-up the groups of drug users gathering in central Oslo and to stop the drug market in these places. But the actual use or possession of heroin in the centre of Oslo rarely causes any reactions by the police due to a general softening of the drug policy.
Ten million Norwegian kroner was allocated in 2013-14 for the development of a five-year strategy, but there is a constant debate concerning what exactly should be Norway’s strategy for reducing the numbers of heroin abuse. Decriminalising heroin, and offering it to the heavy users for free; a strategy incorporated in several countries including Switzerland, Netherlands and Denmark, has been discussed, but so far Norwegian authorities have not agreed on trying this. Where several countries show good results, some of these numbers are based on the visible effect in the cities – effectively aesthetic improvements. Helge Waal from SERAF(Norwegian Centre for Addiction Research), who has been evaluating the project in Zürich claims that in Switzerland the strategy of free heroin for heavy users, was taken both to help the users as well as to “clean up” the city. That leaves the question of who exactly our strategies are aiming at helping; the heroin users or the reputation of the city?
While the debate about which strategy offers the best and most humane way to treat the heroin addicts goes on, the numbers of heroin users and deaths in Oslo due to overdoses remains steady.
By Ingunn Dorholt