A shifting picture: Overdose deaths in the Nordic region

– Many who are prescribed opioids for chronic illness don’t see themselves at risk – and therefore don’t consider naloxone, even though the numbers tell a different story.

In Norway, overdoses have shifted from one demographic group to another. Young people using heroin were once overrepresented in the numbers; now the scales have shifted toward older people dying from prescription medications. The average age of those who have died from an overdose in Norway has risen from 36 years in 2006 to 45 years in 2020. This served as a wake-up call for the Directorate of Health, leading to a more flexible plan focused on concrete actions and quick responses to emerging needs.

– Earlier, we focused only on heroin use, but we have now moved to an action plan that broadens the scope to include several opioids found in prescription medications. We also discovered that alcohol plays an even larger role in overdose-related deaths than we had previously understood, says Espen Freng.

In addition to the new demographic groups, the Norwegian action plan also targets what Freng calls “vulnerable transitions” – moments when the risk of overdose is greatest, such as release from hospital or prison. At these points, the body’s tolerance is gone, making people especially vulnerable.

– Among those who die within three weeks of being released from prison, an astonishing 83% die from an overdose. If a person has received treatment for their dependence in prison or in a treatment centre, their tolerance is very low. These are what we call ‘vulnerable transitions’ – periods when people need extra support, says Freng.

Finland shares Norway’s high mortality rates, but the victims are younger

Finland is seeing a very different trend in overdose-related deaths. The victims are getting younger: in 2023, nearly a third of those who died from an overdose were under 25. Finland now has some of the highest youth mortality rates in Europe — and Finland’s leaders have been forced to act.

– The government is allocating 10 million euros to help the Finnish Welfare services counties to tackle fatal overdoses among young people. The Welfare services counties are currently mapping their services to identify any gaps in the care chain. This could involve, for example, where a person is referred after being admitted to the emergency room with an overdose, says Sanna Kailanto, a senior specialist at the Finnish Institute for Health and Welfare (THL). The high rate of fatal overdoses among young people has created a political momentum in Finland. Despite tight budgets, the government has allocated resources to reverse this trend.

At the same time, a new substance, alpha-PVP, has sparked lively debate in the media – a discussion that has had consequences on another level.

– The public discussion has focused heavily on the effects of alpha-PVP. The substance can cause aggressive behaviour, psychosis and even hallucinations. As a result, people who use alpha-PVP have been demonised in the media, which in turn has set back work that’s been done to combat stigmatisation of people with substance use disorders, says Kailanto.

Norway’s new law seen as a political signal

This spring, the Norwegian parliament, Stortinget, passed new legislation marking a shift in Nordic drug policy: the focus is now on help rather than punishment. Anyone caught with a small amount of narcotics will no longer end up with a criminal record, and young people will be referred to treatment instead. The law is described as a hybrid model between decriminalisation and zero tolerance, and it was the subject of ten years of debate before finally being passed. The law will take effect in 2026, so for now it remains unclear what practical impact it will have. Still, Sanna Kailanto views the change as a step in the right direction.

– It’s a symbolic shift that could potentially have significant long-term consequences. It serves as a political signal that the focus is on assistance rather than punishment, says Kailanto. There are no signs of a similar reform in either Sweden or Finland, both of which recently rejected initiatives to establish drug consumption rooms.

Norway is therefore breaking new ground – but whether the reform will have the desired effect remains to be seen.

– If the results are promising after a few years, I hope other countries will follow. But for now, it’s too early to draw any conclusions, says Espen Freng.

This article is produced in collaboration between Alkohol & Narkotika and PopNAD. Read the article, in Swedish, here.