Prevalence of "High Risk" Opioid Use in Norway

"High-risk opioid users are a heterogeneous group that includes marginalised drug users with long-standing ‘careers’ of heroin use, as well as socially included persons who became addicted to opioids through excessive consumption of prescribed pharmaceuticals. The description of high-risk opioid use does not include stable patients in opioid substitution treatment (OST) or others using pharmaceutical opioids in accordance with a doctor’s prescription. Patients in OST who misuse prescribed drugs or other opioids than the prescribed one(s) shall be included, however.

Drugged Driving Law

(Drugged Driving Law) "For 20 intoxicating substances, it has been documented that use entails an increased risk of a road accident. Concentration limits corresponding to a blood alcohol level of 0.2 mg/ml have been adopted for these substances.
"Sentencing limits corresponding to 0.5 mg/ml and 1.2 mg/ml

Avaibility and Use of Syringe Exchange Programs

(Avaibility and Use of Syringe Exchange Programs) "The primary objective of needle exchange programmes is to reduce the risk of infectious diseases associated with the sharing of injection equipment. Approximately 3.3 million syringes were handed out in Norway in 2007, largely through low-threshold services. In a follow-up survey carried out by SIRUS, 14 towns/municipalities reported that almost 3.1 million syringes were handed out in 2009. Of these, 85 per cent or 2,635 million were distributed in the three biggest cities Oslo, Bergen and Trondheim.

Norwegian National Strategy to Reduce Overdose

(Norwegian National Strategy to Reduce Overdose) "The Government will task the Directorate of Health with drawing up a separate national strategy for reducing overdoses in collaboration with relevant agencies, such as user and next-of-kin organisations and the municipalities. The goal is an annual reduction of the number of overdose fatalities. The purpose is to stimulate the development of more local strategies for municipalities that have registered overdose fatalities. The local strategies should have concrete targets and measures in the following areas:

Mortality Among Patients In Opioid Substitution Treatment (OST)

(Mortality Among Patients In Opioid Substitution Treatment (OST)) "Of the 6,640 patients in the OST programme in Norway at the end of 2011, 54 deaths from various causes were reported by the centres during 2011, indicating a total mortality rate of about 0.8 per 100 patient-years while in OST. This is on par with the previous year (Table 4). The majority of deaths in OST were due to somatic causes and injuries.

Drug-Involved Deaths By Drug Type

(Drug-Involved Deaths By Drug Type) "Many of the drug-related deaths are believed to be due to extensive multiple-drug use. The heroin-specific metabolite monoacetylmorphine was detected in 38 per cent of the deaths, but other substances were found to be present as well in 40 per cent of heroin/morphine-related deaths. Methadone was detected in 16 per cent of the deaths, but it was the only detected substance in only 18 cases. Amphetamine and/or methamphetamine and/or cocaine were detected in 16 per cent of the deaths."

Drug-Related Mortality

(Drug-Related Mortality) "Concerning the 248 drug-related deaths in 2010 that were recorded by Statistics Norway, 173 (70 %) deaths involved opioids with or without additional drugs (Figure 5), 93 were deaths due to heroin (X42, X44, X62, X64 + T401), 36 deaths were recorded with methadone poisoning as the underlying cause (X42, X44, X62, X64 + T403), and 44 with other opioids, either as poisoning or dependency (X42, X44, X62, X64 + T402, F112).

Opioid Substitution Program

(Opioid Substitution Program) "The proportion treated with methadone was 47 per cent, while 53 per cent were treated with buprenorphine-based medication. Nationwide, 67 per cent now get their medication prescribed by their GP. GPs thus play a key role in OST, a role that seems to be increasing. Almost half (47%) are issued their medication at a pharmacy, and an additional 32 per cent receive it from municipal services. Only three per cent received their medication from an OST centre."