Nordic countries struggle with a severe drug overdose problem

The drugs causing deaths differ among the five countries

Despite the fact that the Nordic countries are often seen as ideal in practically every global ranking of quality of life and social equality, the number of drug-related deaths in these countries are among the highest in Europe.

The Nordic countries are, however, far behind the United States in the number of fatal drug overdoses. Various measures to reduce drug-related harms have been introduced. Still hundreds of people die every year of fatal drug overdose.

"Despite the geographic vicinity and similarity of the social security and health care systems, there are differences in the drugs that cause overdose deaths in the Nordic countries", says Kirsten Wiese Simonsen who leads the group of Nordic researchers.

In Norway and Denmark, the number of deaths caused by a drug overdose decreased, whereas in Finland, Sweden and Iceland it increased, compared to a previous study from 2012.

This is shown in a recent scientific paper in which all overdose deaths among users of illegal drugs in the Nordic countries in 2017 were investigated by a group of forensic toxicologists and pathologists from all five countries.

The same study has been conducted seven times over a period of nearly 30 years, which gives excellent insight into changes in time as well as into differences and similarities between the countries.

Opioids were responsible for most of the overdose deaths

Heroin still causes a big portion of deaths in all Nordic countries except in Finland where buprenorphine continues to be the main drug causing overdose deaths. Heroin was the most common intoxicant in Sweden and Norway. In Denmark, heroin was the second most common drug, after methadone.

"All in all, opioids such as heroin, methadone and buprenorphine were responsible for the majority of all overdose deaths in the Nordic countries", Wiese Simonsen says.

Overall, deaths caused by an overdose by cocaine and MDMA increased, when compared to the previous study from 2012.

Sweden faced an epidemic of fentanyl derivatives in 2017, which caused an overall increase in the country's overdose mortality rate. The epidemic inflicted some legislative changes in the country, which have later reduced the number of deaths related to fentanyl derivatives to a markedly lower level.

In addition to the extremely dangerous fentanyl derivatives, many other new psychoactive substances (NPS) were seen in the Nordic countries, especially stimulant drugs. Most of the deaths were poly-drug poisonings with 4-6 different substances contributing to the overdose.

Twice the European average

The overdose mortality rate in the Nordic countries has levelled off over the years, with Sweden and Iceland being the top countries, and Denmark having the lowest rate. In all countries, however, the rate is more than twice the European average (2.26) published by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

The Nordic countries are still well behind the United States, where, according to the Center for Disease Control and Prevention (CDC), there occurred 20.7 drug overdose deaths per 100 000 inhabitants in 2018.

The age of the individuals in this study ranged between 14 and 70. The mean age at death in drug overdoses varied between the countries. In Denmark and Norway, a typical victim of an overdose death was 41 years, whereas the mean age was between 33 and 35 in the other countries.