Norway

Mortality Among Patients In Opioid Substitution Treatment (OST) in Norway

"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 in Norway, 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 in Norway

"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).

Incidence of Hepatitis C in Norway Among People Who Inject Drugs

"The monitoring of hepatitis C in Norway was intensified from 1 January 2008. The notification criteria were changed so that all laboratory-confirmed cases of hepatitis C must now be reported to MSIS. Previously, only acute illness had to be reported, and this resulted in a very inadequate overview of the real incidence of the disease in the country. In 2013, 1,318 cases of hepatitis C (both acute and chronic cases) were reported.

Incidence of Hepatitis B in Norway Among People Who Inject Drugs

"In the period 1995–2008, a considerable increase in hepatitis B among drug users nationwide was reported to MSIS. In 2013, four of a total of 30 reported cases of acute hepatitis B involved injecting drug users. During the period 1995–2013, the total number of reported cases of acute hepatitis B infection among injecting drug users was 1,980. Hepatitis B vaccination has been offered free of charge to injecting drug users since the mid-1980s."

Incidence of HIV Among Injection Drug Users in Norway

"The incidence of HIV among injecting drug users has remained at a stable, low level for many years, with about 10 to 15 cases reported per year. The reason for this is not entirely clear, but a high level of testing, great openness regarding HIV status within the drug user community, combined with a strong fear of being infected and strong internal justice in the milieu, are assumed to be important factors.

Incidence of HIV Among People in Norway Who Inject Drugs

"In 2013, 233 cases of HIV infection were reported to the Norwegian Surveillance System for Communicable Diseases (MSIS). Eight of the cases were among injecting drug users: six men and two women. The median age was 31 years (30 to 37 years). Five of the eight injecting drug users who were diagnosed as HIV positive in 2013 were persons of foreign origin (mostly Eastern European) who had been infected before arriving in Norway.

Prevalence of Past-Month Drug Use in Norway

"The findings on drug use are based partly on positive findings from urine tests and partly on reported use during the last 30 days. The levels are overall quite similar to 2012. A proportion of 10 per cent reported having used an illegal morphine substance during the past month, 33 per cent cannabis, 16 per cent stimulants and as many as 42 per cent benzodiazepines. This figure includes both prescribed and non-prescribed benzodiazepines. Twenty-five per cent of all patients report having been prescribed the drug by a doctor. In other words, the others must have used illegal sources.

Opioid Substitution Programs in Norway

"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."

Treatment Utilization in Norway

"In 2011, reports were submitted to the NPR [Norwegian Patient Registry] from 159 units in the specialist health service concerning a total of 8,817 patients who started treatment for primarily drug-related problems (2010: 8,750 patients from 158 units). The number of patients broke down as 3,921 in in-patient treatment and 4,896 in outpatient treatment, including OST [Opioid Substitution Treatment]. Around 68 per cent of the total number of patients in treatment were men.

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