Drug Abuse in the Global Village
Sweden

EXTENT PATTERNS AND TRENDS IN ILLICIT DRUG SUPPLY

Setting

            Sweden, with a land area of 412,000 square kilometres and a population of 8.7 million, borders on Norway and Finland and has long coastlines on both the Baltic Sea and the North Sea.  Industry accounts for 32% and services account for 66% of the GDP.  With a real GDP per capita of 18,320 (at 1992 Purchasing Power Parity), gross enrolment ratio of  78%, life expectancy at birth of 78 years, has one of the highest world ranking in terms of quality of life (HDR 1995).
           
            Illicit drug cultivation, manufacture, precursor and essential chemicals production, trafficking and money-laundering are not considered to be a major problem in Sweden.  The Government of Sweden takes a firm anti-narcotics stand.  Swedish drug law enforcement agencies have an excellent track record of cooperation with their counterparts in other countries as well as with international organizations. 

            Sweden strictly adheres to the three United Nations drug conventions and has rigorously implemented appropriate anti-narcotics legislation.  Of particular interest is the fact that Sweden, with a large budget deficit, is a major donor in both absolute and relative (as a percentage of its GNP) terms the United Nations International Drug Control Programme.

            Sweden is also a member of the Pompidou Group ( European Cooperation in the Struggle against Drug Abuse and Illicit Traffic), and the Dublin Group. 

Extent of Illicit Drug Supply

Cultivation

            None reported.

                                                                          Manufacture

            No manufacture of narcotic drugs or psychotropic substances was reported by the Swedish authorities (U.N. Part III 1994).   However, a government report expressed concern at the growing consumption of psychotropic substances, particularly central stimulants and indicated their suspicion that illicit production of phenmetrazine may be occuring in the Swedish pharmaceutical industry (Honeuro 1995).  

                                                   Patterns and Trends in Illicit Drug Supply

                                                                            Trafficking

            Sweden is primarily a destination country for illicit drugs although some may transit on to other countries.  Cannabis and amphetamines are the leading drugs consumed, but smaller quantities of cocaine, heroin, LSD and khat also are used.  There have been increased reports in recent years of illicit drug smuggling from Poland and through the Baltic States and the Russian Federation.  Traffic by sea is the principal threat, although narcotic drugs and psychotropic substances are also smuggled into the country overland, by mail, and by air (U.N. Part III 1994; INCSR 1995).  Please see Figure 1 for an indication of the main trafficking routes (attached). 

            The three largest metropolitan area of Stockholm, Gothenburg and Malmo serve as distribution points for drugs marketed to dealers in smaller cities throughout the country (U.N. 1994).

            Swedish authorities are particularly concerned about the increase in trafficking in central stimulants, such as amphetamines and phenmetrazine, as well as their admixures, phenylamine and phenyl.  Phenylamine is often mixed with amphetamines to prolong the effect up to 30 hours.  Phenyl is regarded as a synthetic substitute for heroin.  The active substance is 1000 times more potent than morphine and therefore carries great risk of overdosing (Honeuro 1995).  No annual seizure figures for central stimulants other than amphetamine is available for analysis (U.N. Part III various years).                                                                                                                                                         
            The Netherlands remain the main source for amphetamines, but an increasing amount of the substance is being supplied by Poland.  The Polish share of the market may have increased to 50 per cent in 1994.  The high purity level of  Polish amphetamines (80-100 per cent) accounts for their hold on Swedish markets (U.N. 1994; DEA 1995). 

            Polish nationals or former Polish nationals were responsible for most of  the amphetamines trafficked in Sweden in 1994.  Most of the illicit amphetamines enters the country through the southern ports.  The substances are most commonly concealed in the couriers clothes, false compartments of vehicles or in the petrol tanks.  Involvement of amphetamine traffickers in other East European countries, particularly with connections in Sweden, is also suspected (Honeuro 1995; U.N. 1994; DEA 1995).  
           
            Recent years have seen an increase in the availability of Southeast Asian heroin in Sweden.  Heroin is frequently smuggled into Sweden by air courier from Thailand.  The increase in supply of heroin from the Golden Triangle may be attributed to several factors.  First, the establishment of contacts with couriers in Swedish prisons.  Swedish government sources report that Swedish prison inmates tend to regard drug couriers as a source of future investment.  Frequently, after being released from prison, Southeast Asian heroin couriers procure the drug from the source countries for distribution to his former fellow prisoners (Honeuro 1995).

            Secondly, the combination of an increasing number of Swedish tourists to the Golden Triangle with a rapidly expanding Swedish/Nordic population living in Thailand and the Phillipines tends to facilitate both the acquisition of heroin and recruitment of couriers.  In addition, Swedish nationals are increasingly being recruited as couriers for other non-Scandinavian trafficking organizations, particularly Chinese drug trafficking groups based in Hong Kong (Honeuro 1995; DEA 1995; Sweden 1992).

            An increase of heroin trafficking from Southeast Asian countries by mail, primarily by Iranian nationals, was noted in 1994 (Honeuro 1995).    

            Southwest Asian heroin is also smuggled into Sweden by air courier.  In 1994, a special Nordic customs and police operation linked this to East African heroin couriers.  Primarily Tanzanian and Kenyan nationals travelled from the source countries  to Dar es Salaam or Nairobi in order to reach Scandinavia by first transiting through some other European country.  Their modus operandi was to conceal the drug in body cavities and also in false-bottomed suitcases and statuettes (Honeuro 1995; DEA 1995).

            The second largest route used for the trafficking of Southwest Asian heroin to Sweden consists of nationals of Poland, the Czech Republic and Slovakia.  The organization appears to be controlled from Kosovo and Macedonia in the former Yugoslavia.  The heroin is transported from the Czech Republic and Slovakia through Poland for markets in Sweden and Norway (Honeuro 1995; DEA 1995).

            There are indications of a third route for opiates of Southwest Asian origin trafficked in Sweden.  This route originates in Iran and Turkey and travels through the Russian Federation to reach Sweden.  However, to date, only  small quantities of opium have been trafficked to Sweden using this route (Honeuro 1995).

            The street level distribution of heroin in Stockholm is currently dominated by Africans and Iranians.  ( Honeuro 1995; DEA 1995).

            The main centres of cocaine distribution in Sweden seems to be Stockholm and Gothenburg.  Most of the cocaine arrives in Sweden by air from Caracas, Venezuela and Rio de Janeiro, Brazil, travelling through other European countries, often involving persons of Swedish origin or Labanese descent.  Cocaine intended for Sweden has also been seized in other West European countries, including Spain, France and Denmark.  The modus operandi used false-bottomed suitcases, shoes and bottles to conceal the drug (U.N. 1994; Honeuro 1995; DEA 1995).         

            Most of the cannabis trafficked to Sweden is in the form of resin (hashish) and originates in Morocco.  The drug is most frequently smuggled into Sweden in small quantities, often by private vehicles for personal use.  Transportation of the drug in trucks coming from the Netherlands has also been noted.  Swedish authorities have expressed concern at the increased use of small vessels to smuggle cannabis into Sweden (U.N. 1994; Honeuro 1995). 

            The trafficking of cannabis to Sweden is primarily organized by Swedes living in Denmark with contacts in the Netherlands.  The collaboration between Danish, Swedish and Dutch cannabis traffickers is well-documented.  This collaboration is strenghened by the fact that lower prices and greater availability draw many Swedish cannabis users to Denmark for their supply (U.N. 1994; Honeuro 1995).

            UNDCP did not receive any estimates of current prices of drugs from the Swedish Government.  The table below provides DEA estimated prices of amphetaime, heroin, cocaine and cannabis resin in 1993.

Table 1: Drug Prices (U.S. dollars), 1993

 Source: DEA Copenhagen Country Office, 1993.

                                                                              Seizures

            Table 2 below shows the total number and amount of major drugs seized by the Police and Customs.  The figures indicate a general increase which can partly be attributed to more efficient law enforcement efforts (Honeuro 1995).

            The dominance of central stimulants in hard drug abuse in Sweden is reflected in the seizure statistics.  Both the number and amount of central stimulants seized, i.e., amphetamines, have been rising since the late 1970s.  In 1994, ten times more amphetamines were seized than heroin in eight times as many cases, and nine times more amphetamines were seized than cocaine in thirty-five times as many cases. In 1993 and 1994, the number of seizures of amphetamines surpassed seizures of cannabis.  The quantity of amphetamines seized rose from 142 kg in 1993 to more than 210kg in 1994.  Polish nationals or former Polish nationals accounted for one-third of the total amphetamines seized in 1994.  Amphetamines of Polish origin accounts for 50 per cent of the quantity of the substance seized  during 1994 (U.N. Part III various years; Sweden 1992; Honeuro 1995).    
           
            The amount and number of heroin seizures have risen during the 1990s.  Annual heroin seizures from 1980-89 averaged around 6 kg; from 1990-94, they averaged 18 kg.  The number of heroin seizures increased from an annual average of 258 cases in the 1980s to 647 cases in the 1990s.  The trend is shifting towards an increase in seizures of heroin of Southeast Asian origin. Swedish authorities reported an increase in recent years in heroin from the Golden Triangle seized from both drug dependent abusers and couriers (U.N. Part III various years; Sweden 1992; Honeuro 1995).        

            Annual average cocaine seizures increased sharply in the 1980s, to approximately 341 kg per year, but this was heavily influenced by a record haul of 3,012 kg seized in 1986.  From 1990 to 1994, the annual average amount of cocaine seized was about 63 kg, mainly due to another peak in 1991 of 208.6 kg seized.  Swedish government sources indicate that cocaine abuse in Sweden still remains relatively marginal and the figures primarily reflect transit trafficking of the drug through Sweden to other European countries.  Approximately 75 per cent of  all cocaine seizures were made in the cities of Stockholm and Gothenburg, primarily at air and sea ports (Honeuro 1995; U.N. Part III various years; Sweden 1992).                

Table 2: Main Drugs Seized, 1991-1994 (kilograms)

*Number of seizures made
Source: U.N. Part III, various years; Country Report by Sweden, Honeuro 1995.

            The amount of cannabis seized fell from an annual average of 590 kg in the 1980s to an annual average of 560 kg from 1990 to 1994.  The number of seizures has fallen since 1991.  The decrease is most likely due to the drug enforcement priority placed by the Swedish authorities on stimulants, heroin and cocaine. In 1994, numerous 50 to 90 kg quantities of cannabis resin were smuggled in trucks from the Netherlands into Sweden (U.N. Part III various years; Sweden 1992; Honeuro 1995).        

                                                        Arrests/Convictions/Imprisonments     

            Persons convicted for possession of drugs for abuse in Sweden tend to predominantly male aged 30 and above; most frequently they are charged with possession of cannabis and central nervous stimulants.  In 1994, a total of 22,210 persons were arrested for possession/abuse of drugs, out of which 5,523 persons were convicted; 816 persons were arrested for trafficking.  No figures are available for the previous years of total persons arrested and persons arrested or convicted for trafficking (U.N. Part III various years).

            In 1994, out of the 5,523 persons convicted for possesion of drugs for abuse, 86 per cent (4778 persons) were male and 50 per cent were aged 30 and above.  No breakdown of convictions or arrests according to drug types was provided in 1994 (U.N. Part III, 1994).  Analysis of available data in the 1990s indicate that  around 86-87% of persons convicted of possession tend to be males; 50-55% of those convicted for possession tend to be aged 30 and above; 45-54% tend to be convicted for possession of cannabis (U.N. Part III various years).       
             
            Available statistics indicate that next to cannabis, the second largest number of persons (30-35%) tend to be convicted for possession of amphetamines (U.N. Part III various years).

                                                                               Trends
           
*          In 1993 and 1994 the  number of cases of amphetamine seizures in Sweden for the first time surpassed those of cannabis.  Although this increase  may be mainly due to the present law enforcement emphasis on amphetamines, the figures also indicate a trend towards greater availability of  and demand for the substance.  In the second half of 1994 there was a 100 per cent increase in the interception of Polish amphetamine, which remains in great demand because of  its high purity levels (80-100 per cent) (Honeuro 1995).   In 1993 and 1994, Sweden ranked second out of all European countries in terms of total quantity of amphetamines seized ( ICPO 1995b).

*          It is likely that traffickers will make greater use of sea routes to transport amphetamine to Sweden.  The ports in Sweden that have direct connections to Poland will be the most vulnerable to amphetamine-trafficking.  In 1993 and 1994, Interpol reported that all places in Sweden where amphetamines were seized have ferry links to Poland (ICPO 1995a).

*          It seems probable that heroin will continue to be trafficked to Sweden, increasingly from Southeast Asia.  The buoyant tourism industry, availability of direct flights to countries in Southeast Asia, and the presence of  a sizable Scandinavian community all continue to facilitate the transportation of heroin to Sweden (Honeuro 1995).

*          It is likely that cannabis, primarily from Morocco, will continue to be trafficked to Sweden in small consignments, but adding up to large annual quantities.  In particular, the close links between Scandinavian and Dutch cannabis traffickers will continue to be utilized (Honeuro 1995).    

EXTENT, PATTERNS AND TRENDS IN DRUG ABUSE

                                                                   Extent of Drug Abuse

            According to a 1993 national survey (S=1000), conducted among those aged between 15 and 75 years old, 10.5 per cent of the population ever used a drug and 1.3 per cent used a drug in the year prior to the survey. Ever use of cannabis is the most prevalent (8 per cent), followed by amphetamines (1.3 per cent), hallucinogens (0.5 per cent), cocaine (0.4 per cent) and opiates (0.2). Any use the year prior to the survey was highest for cannabis (0.7 per cent) and amphetamines (0.2 per cent) (U.N. 1993).

            Statistics on occasional experimentation with drugs are obtained every year through surveys of school children and military conscripts.  In the early 1970's , about 15 per cent of the pupils (15‑16 years old) reported having tried drugs at least once.  The proportion has gradually declined, and for the past few years, 3 to 4 per cent report having tried drugs at least once.  Lifetime prevalence among conscripts, aged 17 to  18 years, reached its peak in 1980 (19 per cent) and has declined to under 6 per cent in 1992.  In 1993, 5 per cent  of the school children and 7 per cent of the conscript reported having tried drugs (U.N. 1993). A detailed analysis follows in the trend section below.

            The estimated number of annual abusers, based on a National Case Finding Study, ranges from 14,000 to 20,000 drug dependent abusers (“severe drug abusers” in source). The dependent drug abusers are defined as intravenous or daily drug abusers. Most are multiple drug abusers (77 per cent). Dependent drug abusers consume amphetamines (13,800), sedatives (13,450), cannabis (11,200), opiates (5,700), cocaine (850), hallucinogens (350) and volatile substances (170) (p.9-correction) (U.N. 1994,II). The 1994 estimates represents an increase compared to 1979 (10,000 to 14,000) (Ministry of Health and Social Affairs 1992).

            According to survey studies among youth, about 1 per cent of the males tried anabolic steroids at least once. Volatile substance abuse has been drawing attention in recent years but it is considered a temporary phenomena (U.N. 1994).
           
            Psychotropic substances, particularly sleeping pills and tranquilizers, are also reported important drugs of abuse. Women make up the greatest proportion of these abusers (U.N. 1990).

            Sweden reported in 1994 that it did not maintain a registry and that it did not conduct qualitative studies. It conducted sample surveys and a study on attitudes will be completed in 1996. The same report indicates that the improvement of the data collection system is constrained by resources allocation and not to methodological or epidemiological state of knowledge in the country (U.N. 1994).

                                                                  Abuser Characteristics

            Of the heavy drug abusers reported in 1992, 77 per cent are males and 22 per cent females. The average age is 34.1 for males and 32.6 for females. Heavy drug abuse is most frequent among the 30 to 34 age group (25 per cent), followed by those 35 to 39 (22 per cent), 25 to 29 (21 per cent), 40 to 44 (12 per cent) and 20 to 24 (9 per cent) (Ministry of Health and Social Affairs 1992).

            About 16 per cent of the population in Sweden are immigrants or of immigrant background; however, they  constitute 18 per cent of the heavy drug abusers. Among these heavy drug abusers, 48 per cent are Scandinavians and 50 per cent of non Scandinavian countries (Ministry of Health and Social Affairs 1992).

             Psychopharmaceutical drugs and especially sleeping pills and tranquillizers abuse is more prevalent among women than men and their abuse increases with age (Swedish Council 1991).

            About 40% of the total prison population are drug abusers (U.N. 1993).

                                                                     Regional Variations

            Of the 10,000 to 14,000 heavy drug abusers in Sweden in 1978/79, 3,000 to 4,500 are in Stockholm metropolitan area, 1,400 to 2,000 in each of the metropolitan areas of  Malmo-Lund and Gothenburg (Swedish Council 1991).

            Cannabis and amphetamines are spread all over the country.  Heroin is mainly concentrated in the regions of Stockholm and Malmo.  MDMA, cocaine and LSD is mainly available in the three big cities (U.N. 1993).

                                                                               Trends

            Ever abuse of any drug appear to have increased to 10.5 per cent in 1993 compared to 8 per cent in 1989. Annual prevalence also increased to 1.3 per cent in 1993 compared to 1 per cent in 1989. A significant increase compared to 1979 has also been reported, based on a survey of the National Institute for Public Opinion Research (U.N. 1993; CMO 1991).

            Some increase in heroin smoking is reported. The increase is attributed to unemployment and social marginalization. Social attitudes towards drug abuse are negative. Drug abuse is concentrated in large cities although drugs are found in almost all parts of Sweden  (U.N. 1994).

            Some increases in the abuse of heroin, cannabis and hallucinogens (very low prevalence) are reported.  Cocaine (very low prevalence), amphetamines, benzodiazepines and volatile substances are reported stable. These estimates are based on data of limited validity. Slightly more positive attitudes towards cannabis among certain groups have been reported by the police, social workers and others.  More heroin is available from Eastern Europe.  Availabiltiy of amphetamines, produced and smuggled from Poland, has increased (U.N. 1993).

            The proportion of young persons who are heavy drug abusers has declined since 1979, when 6 per cent were under 20 years old and 37 per cent under 25 years old, compared to 1 and 10 per cent respectively (Ministry of Health and Socail Affairs 1992).

            Opiates abuse was rare in Sweden prior to 1965. It was reported among medical staff and among patients, by prescription. Amphetamines were introduced in 1935 and were available over the counter. In 1938, 140,000 were sold during the first six months and 260,000 in the rest of the year.  In 1942, 6 million pills were sold. An estimated  3 per cent of the population used them in 1942/43. In the 1950's, abuse by injection began to spread. As of 1943, an effort to restict abuse began and prescriptions were required. In 1955, certain types of amphetamines were reintroduced for weight reduction, thus increasing abuse to 33 million pills by 1959. In 1965, legal sales decreased to 5 million pills but illegal abuse increased. Cannabis based preparations have been used for tranquillizing medical purposes until 1950. Cannabis smoking was limited to entertainers until 1965, when abuse began to spread among youth. Other drugs abuse (i.e., LSD and cocaine) was rare (Swedish Council 1991).

            The year 1965 is considered as a turning point in terms of drug abuse in Sweden. Cannabis abuse spread among youth. Amphetamines became the predominant drug of abuse (mostly by injection) among an estimated 6,000 abusers in 1967. Opiates and LSD began also to gain ground around this time  (Swedish Council 1991).

            As of 1970, surveys among youth became the primary source of information on drug abuse. The surveys focus on high schools (15-16 years old) and military conscripts (17-18 years old).  In the early 70's, 15 per cent of high school students reported ever drug use at least once, declining to 7-8 per cent in 1975, to 5 per cent in 1983 and to 3 per cent among females and 4 per cent among males in 1990. The proportion of military conscripts who report ever trying drugs varied from 15 to 19 per cent between 1971 and 1982, peaking in 1973 and 1980 and declining from 16 per cent in 1982 to 6 per cent in 1988  (Swedish Council 1991). 

            As of 1979, national case finding studies were initiated to monitor drug abuse among “heavy drug users”. According to the 1992 case finding study, the number of "heavy drug abusers" amounts to 14,000‑20,000, compared to 10 000‑14 000 in 1979. In 1979, about 7,500-10,000 of the drug abusers injected drugs and 1,500 to 2,000 injected them daily or near daily. Most of the increase is believed to have taken place during the first years of the 1980's. Stimulants, especially amphetamines, were the main drug of abuse among injecting drug abusers during the whole period. During the 60's crude opium was dominant among opiates abusers, gradually replaced by morphine and then heroin in the mid 70's. Increases in heroin abuse are among older abusers but not the young (U.N. 1993; Swedish Council 1991).

            The largest increases in drug consumption occured in psychopharmaceutical drugs and especially sleeping pills and tranquillizers between the 1960's and 1971, a peak year. Sales increased by 5 per cent between 1981 and 1988 and fell by 13 per cent between 1986 and 1990 (Swedish Council 1991).

            The number of drug abusers in correctional institutions increased from 450 (or 9 per cent of inmates) in 1966 to 1,597 (or 40 per cent of inmates) in 1990. The number of drug abusers in non-institutional care within the penal system also increased from 572 (or 3 per cent of inmates) in 1966 to 3,412 (or 28 per cent of inmates) in 1990 (Swedish Council 1991). 

            Psychiatric care discharges with diagnosis of drug dependence increased from 2,359 in 1969 to 3,067 in 1983, stable at 3 per cent of all discharges during the whole period of study. The percentage of women in discharges with drug dependence diagnosis remained also stable at about 35 per cent during the same period  (Swedish Council 1991).
           
            Drug abuse has been decreasing among high school students (15-16 years old) and militay conscripts (17-18 years old) (Swedish Council 1991).  Ever use of any drug among students, in 1993,  is  5 per cent, equally distributed among males and females, and use in the month before the survey is 1 per cent (U.N. 1993). As recruitment of the young into drug abuse is declining, the average age of drug abusers is rising (Swedish Council 1991).  

                                                                        Mode of Intake

            Opiates and amphetamines are injected. Hallucinogens and sedatives are ingested.  Cannabis is smoked. Cocaine is sniffed.  Volatile solvents are inhaled (U.N. 1994). IDU among young people is very limited and there is a growing resistance among drug abusers to turn to intravenous practices (U.N. 1993). Opiates and amphetamines are taken in combination with cannabis, sedatives and alcohol. Cannabis is taken in combination with amphetamines, sedatives and alcohol. Sedatives are taken in combination with alcohol (U.N. 1994).

            Among the estimated  10,000 to 14,000 heavy drug abusers in 1978/79 in Sweden: 7,500 to 10,000 injected drugs and 1,500 to 2,000 injected daily (Swedish Council 1991). In 1992, 93 per cent of the heavy drug abusers reported injecting drugs: 81 per cent abuse amphetamines, most by injection (97 per cent); 34 per cent abuse opiates, about a third (28 per cent) by injection (Ministry of Health and Social Affairs 1992).

                                               COSTS AND CONSEQUENCES OF ABUSE

The cost of treatment of drug abuse was estimated at about 150 million US$ in 1991 (CMO 1991).

            A total of 148 drug related deaths were reported in 1991, of which 81 per cent were men, 68 per cent were attributed to opiates abuse, 73 per cent between 25 and 34 years of age (U.N. 1991). In 1993, a total of 150 drug related deaths were reported (U.N. 1993). Official statistics on alcohol and other drug related causes of  death are probably under reported. However, drug related deaths ranged between 16 and 26 deaths per year compared to 400 to 500 alcohol related deaths per year from 1980 through 1985, suggesting an increase in drug related deaths  in 1991 and 1993 (Solarz 19??).
 
            The spread of HIV among drug abusers has led to efforts to develop care and rehabilitation services for drug abusers. Expenditures to this end amounts to 350 million Swedish Crowns over a five year period (Sweden 1991). Sweden requires testing for HIV and anonymous coded reporting of positive cases to the authorities. Testing for HIV is a standard component of care for drug abusers. The other component is treatment and rehabilitation. In general, drug abuse by injection appear to have been contained and there are also signs that it is decreasing among new recruits to drug abuse (Sweden 1990)

Table 3

HIV, AIDS and Injection in Sweden, 1988 through 1990

YEAR             AIDS                                                   HIV positive
                        N         died      injecting                        N                     injecting
1988                256      121      5                                  2,007               481
1989                378      183      10                                2,315               526
1990                509      279      17                                2,655               575

Source: Sweden 1991

            The cumulative number of AIDS cases from 1985 through June 30, 1992, is 714, of which 7 per cent are injecting drug abusers. The number of AIDS and IDU cases in Sweden is among the lowest in Europe. The cumulative total of HIV infection from 1985 through June 30, 1992 is 3,134, of which 20 per cent are IDU’s. The proportion of IDU’s declined from 44 per cent in 1985 to 9 per cent in 1991 (Ministry of Health and Social Affairs 9/1992).

            The number of cases of hepatitis declined from 1,233 in 1969 to 827 in 1990. Of the 827 reported in 1990, 447 had hepatitis C (62 per cent of which injecting drug abusers), 258 hepatitis B (35 per cent of which injecting drug abusers) and 122 nonAnonB (51 per cent of which injecting drug abusers) (Swedish Council 1991). 

            A longitudinal study of 50,457 military conscripts in 1970 and their cohort follow up led to the finding that drug abuse intensity is positively associated with criminality (table 4). It should be noted, however, that 27 per cent of the heavy drug abusers have not been registered as offenders during the 15 years follow up study. Heavy drug abusers are responsible for 10 per cent of the entire criminality. Higher figures are found among alcohol users and abusers (Solarz 19??).

Table 4

Persons found guilty of various offenses, 1966-1988, by drug abuse

Drug abuse intensity                  N                     Drug abusers                Offenders        
                                                                                    %                                 %
Total                                                    50,457                                                 29.5

never abused                                        41,277             81.81                           26.5
abused once                                         1,946               3.86                             32.5
abused 2 to 4 times                               1,591               3.15                             47.25
abused 5 to 10 times                             898                  1.78                             50.8
abused 11 to 50 times                           912                  1.81                             55.2
50 or injection (heavy)              1,007               2.00                             73.2
no answer                                             2,736               5.42                             31.9
missing data                                          90                    0.18                             0.3

Source: Solarz 19??

                                                                                    
                                              NATIONAL RESPONSES TO DRUG ABUSE

National Strategy

            The Government of Sweden has a comprehensive drug control strategy.  Sweden rigorously follows  the UN Conventions and has implemented numerous anti-narcotics legislation.

            There is a nearly total political and popular agreement behind the restrictive national drug policy in Sweden (U.N. 1993). Sweden’s drug policy aims towards a drug free society is based on popular involvement, control policy, prevention, treatment and rehabilitation and international cooperation (Sweden 1991).
            Outcome evaluation of the overall Swedish drug strategy suggests that drug prohibition combined with comprehensive supply and demand reduction programmes are effective intervention methods. Trend data suggest a decline in drug abuse overall. The average age of IDU has risen significantly. Experimentation with cannabis is considered very low and recruitment of young abusers into heavy drug abuse has been very limited for many years (Swedish National Institute of Public Health 1993). This positive evaluation of the Swedish anti drug strategy has been subject to critical reviews by researchers who point out that the association between the strategy and existing statistics  is weak (Solarz 19??; Ahren 1991).

                                                  Structure of National Drug Control Organs

            The central government unit responsible for liaison and coordination of national drug control policy is the Ministry of Health and Social Affairs. The Medical Products Agency is the competent authority empowered to issue authorizations and certificates for the import and export of narcotic drugs and psychotropic substances and provides drug related statistics to UNDCP.(U.N. various years; INCSR 1995).
 
            Drug enforcement is the responsibilty of the Swedish National Police.  The Drug Offences Division of the National Police Board conducts criminal investigations and inquiries related to organized crime, or other drug-related offences on a national or international scale. The Drug Offences Division also has a drug intelligence unit which collects and analyzes domestic as well international drug-related information.  The Customs service controls points of entry into Sweden (U.N. Part I and III various years; DEA 1995).

            Drug demand reduction activities are coordinated by the National Institute of Public Health. Operational activities are coordinated at the regional and municipal level (U.N. 1994). Most municipalities have local coordination mechanisms with the participation of social services, the police, prison and probation services, medical services, schools and others concerned (Sweden 1991).

LEGAL, ADMINISTRATIVE AND OTHER ACTION
TAKEN TO IMPLEMENT THE INTERNATIONAL
DRUG CONTROL TREATIES**

                                                                      Treaty Adherence

            Sweden is party to the 1961 Single Convention on Narcotic Drugs as amended by the 1972 Protocol, the 1971 Convention on Psychotropic Substances and the 1988 Convention Against Illicit Trafficking in Narcotic Drugs (U.N. Part I, various years).

            Sweden has bi-lateral customs agreements with the United States, Germany, the United Kingdom, the Netherlands, France, Finland, Denmark, Norway, Iceland, Spain and Poland.  New customs agreements entered into force in early 1994 with Russia, Estonia, and Hungary (DEA 1995).

                                               Measures Taken with respect to Drug Control

Recently enacted laws and regulations

            In 1993, section 2 of the Narcotic Drugs Act was amended to the effect that consumption of drugs is now an offence punishable by imprisonment. Simultaneously, a special regulation which had provided that drug consumption should not be punished as a crime if the offender requested treatment was abolished.  On 1 January 1994, an Act on Measures against Money-Laundering was enacted. Legislation persuant to Sweden’s EU accession on January 1, 1995 was passed in late 1994, which included legislation related to cooperation on police and customs control(U.N. Part I, various years; INCSR 1995). 

Licensing system for manufacture, trade and distribution

            There is a government-controlled licensing system. The Government of Sweden monitors imports and exports of all precursor and essential chemicals.  The Swedish Medical Products Agency is responsible for precursor and essential chemical control (U.N., Part III, various years).

Control system

Prescription requirement:  There is a prescription requirement for supply or dispensation of preparations containing narcotic drugs and psychotropic substances (U.N. Part I, various years). .

Warnings on packages:  The law requires warnings on packages or accompanying leaflet information to safeguard the abusers of preparations containing narcotic drugs and psychotropic substances (U.N. Part I, various years).

Control of non-treaty substances, if any:  Zopiclone was placed under national control in 1993 (U.N. Part I, various years).

Other administrative measures:  None reported.

Social Measures

Penal Sanctions related to social measures

            In 1993, courts applied measures of treatment, education, after-care, rehabilitation or social reintegration for a drug-related offence both as an alternative and in addition to conviction or punishment (U.N. Part I, various years).

Other social measures

            The National Institute of  Public Health started a special "narcotics offense" in April 1994 with the purpose to fight drug abuse, especially of young people, and to develop methods for prevention work (U.N. Part I, various years).

                                                      SUPPLY REDUCTION ACTIVITIES
                                                                                    

                                                                       Crop Eradication

Not applicable

                                                                Alternative Development

Not applicable.

                                                                           Enforcement

            The abuse, possession and sale of drugs are punisible by Swedish law.  Legislation is divided into three degrees of criminality, from minor offenses ( up to six months imprisonment) to “drug offences” (up to three years of imprisonment) to “ aggravated drug offences” (where penalties range from 2 to 10 years imprisonment).  In 1994, Swedish law enforcement officials were assigned to Tallin and Riga.  Swedish police and customs officials are also posted to The Hague, Bangkok, Athens, Copenhagen, Lisbon, London, Warsaw, Bonn and Budapest (DEA 1995).

                                                                     Money-Laundering

            Sweden is not considered  an important financial or drug-related money laundering centre.

            Money-laundering is a crime under the Swedish penal code, with laws permitting the seizure of any criminal assets acquired through drug trafficking.  In 1993, a specialized unit of “financial police” was established directly under the police commissioner to deal exclusively with money-laundering enforcement.  Furthermore, legislation that took effect in 1993 now requires banks and other financial institutions to apply stricter measures to identify new customers and in monitoring transactions which involve large sums of money (DEA 1995).

DEMAND REDUCTION ACTIVITIES

                                                                     Primary Prevention

            The media are active in promoting drug prevention. Television, cinema and magazines advertising targets teenages and parent. Newspapers carry articles which target youth and the general public. Videos are produced to target youth and special groups. Drama is also used to target youth, parents and employees. Music is used to reach youth. There are no legal restrictions concerning the portrayal of drugs. In a few cases, some records are not allowed to be played on Swedish radio. Informal mechanisms for the collaboration of the media with health professionals, law enforcement agencies and private companies are reported. Government ministries are also permited to broadcast messages on a special bulletin board of one of the television channels (U.N. 1994).

            Prevention through education is carried out in primary and secondary schools (90 per cent enrolled), and in further education institutions (35 per cent enrolled) and higher education (5 per cent enrolled). Drug education as part of the curricula is in primary and secondary schools, and institutions of further education (U.N. 1994, 1993). Special programmes are developed to reach youth who are cannot be reached through schools or other “normal” channels (U.N. 1994). A study among high school students in grade 9, suggests that schooling is the most important source of knowledge about alcohol and drugs (U.N. 1993). Prevention through education consists of “drug theme days” during which drug and drug related problems are addressed in classes, lectures, theatre, video and films. Educational institutions collaborate with the police, social workers and NGO’s representatives in the delivery of drug prevention education. Low school budgets make programme implementation difficult (U.N. 1994).

            Drug education is part of the education of doctors, nurses, social workers, teachers and law enforcement personnel.  Further training is also provided to teachers (U.N. 1993, 1994).

            Drug prevention activities target parents, youth groups, drop outs, refugees and the unemployed (U.N. 1993, 1994).

            The work force consist of 4,400,000 active employees, of which 48 per cent are women. Drug abuse related guidelines are provided to employees and workers organizations. Drug testing is carried out through local arrangements between employers and local trade unions. Drug legislation does not forbid the testing of employees for illicit drug abuse but there is no legislated requirement for drug testing of any profesional group. Lorry drivers have been identified as a high risk group and thus are targeted for a special study. No other studies in the workplace have been undertaken. Demand reduction activities in the work place consist of prevention, treatment and rehabilitation. Drug abuse assistance programmes are also reported (U.N. 1994).

            Leisure activities are part of drug prevention programmes. Youth 15 to 18 years of age are targeted  in a wide variety of activities organized by local authorities (NGO’s and municipalities), including drug free dances, poetry and writing competitions on drug related issues. Parents are also targeted to increase their involvement in youth activities (U.N. 1994).
   
            Prevention programmes are carried out by civic groups, professional organizations, trade unions, voluntary agencies, religious groups, political parties, parent-teacher associations, drug dependent abusers self-help groups, sport clubs, law enforcement agencies, temperance and anti drug organizations and voluntary organizations (U.N. 1993, 1994). Prevention of drug abuse among immigrants is led by a non profit association (Simon 1990).

                                                             Treatment and Rehabilitation

            The aim of the Swedish drug policy is for all drug abusers to receive treatment and rehabilitation on a voluntary basis. Drug abusers are encouraged to undertake treatment voluntarily. However, they may be forcibly committed for care on grounds of serious abuse. The maximum period for coercive care is six months. About 400 drug abusers were committed for compulsory care in 1990 (Sweden 1991). Compulsory treatment may be used for both alcohol and drug abusers. About 3,000 patients (or 3 per cent of all patients) are discharged each year with the diagnosis of drug abuse. About 1,100 to 2,000 persons are compulsarily admitted to treatment for drug abuse, and in 1985, 2558 children and young people who were subjected to measures under the Social Services Act or the Care of Young Persons Act were discharged (Solarz 19??).

            Treatment services consist of a continuum which involves social and medical care. Outpatient care teams provide outreach and other non residential therapeutic services. Treatment may also take place in residential and family setting, including prison and probation services. Evaluation studies indicate that drug abuse care reaches the majority of drug abusers, (i.e., 80 per cent of IDU’s in Stockholm). Sweden has about 60 residential treatment centres with admission  capacity of 1,300, specially adult drug abusers. An additional 50 residential treatment centres cater to children and youth. Outcome studies suggest that 51 per cent have been off drugs and 37 per cent of any drug, including alcohol and pharmaceuticals, after a six months follow up. Drug abusers with prolonged history of abuse are admitted to compulsory care in one of 10 institutions which have a combined capacity of 225 admissions. Outcome evaluation findings of compulsory care in three institutions suggests that 9 per cent discontinued abuse, 18 per cent reduce drug abuse and another 28 per cent have been motivated to pursue further intitutional care on a voluntary basis  (Swedish National Institute of Public Health 1993).   

            Another interesting approach to treatment is family care. This form of care began as a treatment service for children and youth, but was extended to adults by the end of the 60's. In 1993, it consisted  of 18 family care units with a total of 350 families. Each unit consists of 10 to 15 families in a network supported by trained professionals (Swedish National Institute of Public Health 1993).
 
            Treatment and rehabilitation services have been tripled from 1985 to 1990. The treatment capacity increased to 5,000 drug abusers in 1990. There is strong objection to supplying needles to drug abusers as it may weaken the official drug abue prohibition. In spite of the objection, pilot needle exchange programmes have been reported as part of the effort to prevent the spread of HIV in Lund and Malmo. The programmes offer testing for HIV, prevention information, condoms and needle and syringes exchange. About 75 per cent of the injecting equipment is returned. Clients are counselled to go for drug treatment and demand for it has been increasing. Supply of injection equipment by prescription based on medical considerations is possible but discouraged by authorities. No malpractice cases have been reported on this account  (Sweden 1990).

            In 1993, treatment facilities included 68 non-hospital residential units, 48 psychiatric hospitals, 20 self-help facilities, 90 primary care facilities, 12 specialized detoxification facilities, 21 facilities within prison and 20 family care.  The number of patients treated in a year are 8,120 males and 2,480 females.  The number of patients seeking treatment for the first time is 2,880 (U.N. 1993).     

            All prisons provide general medical care, drug counselling, counselling on drug related diseases, vocational training, social reintegration and after care. Some prisons provide detoxification, general education and aim for  drug-free prisons (U.N. 1993).

            Social reintegration services consist of special assistance in finding employment, accommodation, training opportunities, counselling services for ex-abusers and their families and halfway houses (U.N. 1993).

References and  Notes

Supply Reduction

U.N.1980-1994. Replies to the UNDCP "Annual Reports Questionnaire", Part III on Illicit Traffic, for the year 1992, 1993, and 1994.

HDR 1995.  Human Development Report 1995, published for the United Nations Development Programme (UNDP), New York, Oxford University Press.

Sweden 1992.  Summary of the Drug Situation in Sweden, National Swedish Police Board, National Crime Investigation and Intelligence Service, April 1992.

Honeuro 1995.  Curent Situation and Most Recent Trends in Illicit Drug Traffic in the African Region:    Country Report by Sweden, Third Meeting of Heads of National Law Enforcement Agencies (HONLEA),Europe.Vienna, 30 January to 3 February1995. UNDCP/HONEURO/1995/CRP.17.

DEA 1995.  Drug Trafficking in Europe. Drug Enforcement Administration, U. S. Department of Justice, June 1995.

ICPO 1995a.  Study on Polish Nationals involved in the trafficking of Heroin or Amphetamine, Interpol/ICPO General Secretariat, January 1995.

ICPO 1995b.  Annual Status Report on Psychotropic Substances in Europe 1994, Interpol/ICPO General Secretariat, 1995

INCSR 1995.  International Narcotics Control Strategy Report. Bureau of International Narcotics Matters, United States Department of State.  March 1995.

Demand Reduction

Ahren G. 1991 “Drug Policy Successfulness Analyzed” In JPRS January 1991

U.N. 1988-1994. Replies to the UNDCP "Annual Reports Questionnaires" for the years 1988, 1989, 1990, 1991, 1993, and 1994 and 1994 correction.

CMO 1991. Reply to the questionnaire concerning the first seven targets of the "Comprehensive Multidisciplinary Outline of future Activities in Drug Abuse Control" (CMO), 1991.

Ministry of Health and Social Affairs 1992 “Summary of Findings from the UNO Survey of the Extent of Drug Abuse in Sweden”

Ministry of Health and Social Affairs 9/1992 “HIV and AIDS in Sweden”

Simon 1990 “Immigrants in Sweden Against Narcotics”

Solarz A. 19?? “Drug Policy in Sweden”

Sweden 1990 “Overview Summary”

Sweden 1991. National Report of Sweden to the First Pan-European Ministerial Conference on Co-operation on illicit drug abuse problems. Oslo, 9-10 May 1991.

Swedish National Institute of Public Health 1993 “A Restrictive Drug Policy: The Swedish Experience”

Swedish Council 1991. Trends in alcohol and drug use in Sweden. The Swedish Council for Information on Alcohol and other Drugs. Nr. 17.

Notes:

* The general background information is taken from:
Human Development Report 1995, published for the United Nations Development Programme (UNDP), New York, Oxford University Press,

** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section was based on Annual Reports Questionnaire Part I, various  years, DEA 1995, INCSR 1995 (see references in the Supply Reduction Sources of Information).