Overdoses remain one of the most significant challenges in Norwegian drug policy and public health. New and unexpected substances, potent opioid mixtures, and local incidents can lead to severe poisoning and fatalities within a short period of time. To identify such threats earlier and share critical information more rapidly, Norway has launched overdosefare.no, a national reporting and alert system for overdose-related risks. In this article, Espen Freng takes us through the portal’s first months of operation, and the lessons learned so far.
The aim of the system is simple: to identify potentially dangerous situations early enough for people to protect themselves and others. Through collaboration between people who use drugs, healthcare services, municipalities, police, voluntary organizations, and public authorities, overdosefare.no aims to prevent injuries, overdoses and deaths.
The system was developed through close cooperation between user organizations, professionals in the field, and government authorities.
Why was there a need for overdosefare.no?
Before overdosefare.no was established, Norway lacked a national system for systematically collecting, assessing and sharing information about highly harmful substances, unexpected adverse reactions, and local overdose incidents. Important information often remained confined to local areas and did not necessarily reach other parts of the country, or those who could benefit from it.
At the same time, experience since the launch of the system has also shown that the threshold for issuing a national alert is relatively high, as it should be. In some cases, concerning signals were identified, but the situation was not severe enough to warrant a nationwide alert. This created a need for a more flexible model that could communicate increased risk without triggering a formal national warning.
Overdosefare.no was developed to address this gap. The system makes it possible to collect information from across the country, assess the level of risk, and communicate findings quickly and effectively.
How has the system worked?
Since its launch on 14 January and up to 15 September, overdosefare.no has received 130 reports. These have included suspected dangerous substances, overdoses, unexpected reactions, and other incidents that may signal an increased risk of serious harm or death.
The first months of operation show that the system is functioning as intended. Reports are received, assessed, and reviewed by experts and professional networks. At the same time, the first months of operation have provided valuable insights into how risk should be communicated.
One of the most important developments has been the introduction of a new alert level, “Be Cautious”. Experience showed that the criteria for issuing a national warning were too strict in relation to the information available. In certain situations, there was a need to make services and target groups aware of a potential risk, even though there was insufficient evidence to justify a national alert.
As a result, the system has evolved from a two-level structure to a three-level structure, creating greater flexibility in how emerging risks are communicated.
Level 1: Report Submission
At Level 1, information is received through the reporting form on overdosefare.no.
Reports may come from people who use drugs, family members, healthcare professionals, municipal services, police, ambulance services, voluntary organizations, and others who observe circumstances that may indicate an increased risk of harm.
All reports are assessed by relevant professionals using expert judgement. At this stage, there is insufficient evidence to issue either a “Be Cautious” message or a national alert. However, the information is registered and monitored for further developments when necessary.
Level 2: Be Cautious
If the assessment of incoming reports indicates a need for increased vigilance or preparedness, a “Be Cautious” message may be issued.
These messages are published on overdosefare.no following assessment at Level 1, in cooperation with the national overdose coordinators and the Norwegian Directorate of Health. Everyone registered in the system will receive the message by SMS or email.
The purpose is to inform relevant target groups about a potential risk and encourage increased awareness while acknowledging that the evidence base may still be limited, or that the situation primarily calls for heightened vigilance.
To date, two “Be Cautious” messages have been issued.
Level 3: National Alert
The highest level in the system is a National Alert.
A national alert may be issued following assessment at Level 2 if the situation is considered serious enough to require broad national attention. Before such an alert can be published, the National research centre on protection against chemical, biological, radiological, nuclear, and explosives threats (CBRNE) and the Norwegian Directorate of Health must be consulted.
National alerts are reserved for situations where the evidence points to a significant and immediate threat to life and health.
To date, no national alert has been issued.
How has it been received?
The response to overdosefare.no has been overwhelmingly positive.
People who use drugs, service providers, professional communities, and public authorities have all recognized the value of a system that collects and shares information about potential overdose risks. Naturally, there are areas for improvement, including technology, usability, and communication, but the experience so far suggests that the system meets an important need and is being actively used.
More than 3,000 people have registered to receive notifications from overdosefare.no. In addition, the approximately 130 reports submitted demonstrate that stakeholders are actively using the system when they identify situations that may involve risk.
This participation is crucial for the system to function effectively as an early warning system. The value of the system depends on people sharing information whenever they observe something unusual or concerning.
What happens next?
The development of overdosefare.no is ongoing.
Work is currently underway to establish an English-language version of the website, making information and reporting tools accessible to a wider audience, including people who do not speak Norwegian.
At the same time, the initiative is being continuously evaluated by SERAF (Norwegian Centre for Addiction Research). The aim is to identify opportunities for improvement and ensure that the system continues to evolve in response to the needs of the field.
In an ideal world, overdosefare.no would receive very few reports and issue very few alerts. That would mean fewer people experiencing overdoses and other serious incidents. Unfortunately, experiences from other countries suggest that the need for systems like this is likely to continue in the future.
For that reason, continued engagement with the system remains essential. Whether you are a person who uses drugs, a family member, a healthcare worker, a police officer, an ambulance professional, a municipal employee, or a representative of a voluntary organization, the information you possess may help prevent serious incidents.
Together we can save lives
Overdosefare.no is more than a website. It is a collaborative early warning system built on a simple principle: people share knowledge and experiences when they encounter situations that may pose a risk to others.
The system’s greatest strength is its ability to identify risks early, share information quickly, and enable action before isolated incidents develop into larger public health concerns. The experience from the first months of operation shows that the need is real, that the system is being used, and that it is regarded as valuable by users, services, and public authorities alike.
The more people who participate and contribute information, the greater our ability to prevent overdoses and save lives. Together, we can make Norway safer for people at risk of experiencing drug-related harm and overdose.
The article is written by
Espen Freng
Senior adviser at the Norwegian Directorate of Health
at the request of popNAD
Photo: Mostphotos, Thomas Andrew Haugen Koonce, overdosefare.no
