Vi är brukare, inte missbrukare — upprop för en narkotikapolitik som inte skadar

Sverige har en av de högsta dödligheterna bland missbrukare i Europa, med dödstal som ligger fyra gånger högre än EU-genomsnittet. Enligt rapporter från EU:s narkotikabyrå (EMCDDA) ligger Sverige på första eller andra plats i jämförelser, där bara Estland ibland har högre siffror.

Portugal has achieved significantly lower overdose and addiction rates compared to Sweden, primarily due to Portugal's 2001 decriminalization of drug use and its focus on public health rather than criminal punishment. While Sweden maintains a zero-tolerance policy, Portugal’s harm-reduction model has resulted in overdose death rates that are a tiny fraction of those in the U.S. and substantially lower than Sweden’s.

Key Comparisons:

Overdose Mortality: Portugal’s drug overdose rate is approximately 3 to 10 deaths per million people, whereas Sweden reports rates as high as 69.7 per million (in 2015 data) and 450 to 643 total deaths per year (2017–2021 data). People in Portugal are 45 times less likely to die from an overdose than those in the U.S., and far less likely than in Sweden.
Policy Approach: Sweden adheres to a strict zero-tolerance and abstinence-based model, which critics argue is outdated and ineffective, leading to higher mortality. In contrast, Portugal decriminalized personal drug possession and redirected resources toward free healthcare, addiction treatment, and harm reduction (e.g., supervised consumption sites), treating addiction as a disease rather than a crime.
Treatment Access: In Portugal, over 75% of people with opioid use disorders seek treatment, and the police refer users to counseling rather than arresting them. Sweden’s restrictive approach limits access to certain promising treatments (like ibogaine or supervised consumption) available in Portugal, contributing to Sweden’s status as a destination for some addicts seeking care abroad.
Recent Trends: While Portugal has seen a recent uptick in overdose rates (hitting a 12-year high in Lisbon since 2019) and increased cocaine use, its overall rates remain among the lowest in Europe. Sweden continues to struggle with rising drug deaths, including those involving cocaine and oxycodone, highlighting the limitations of its punitive strategy.

The Netherlands maintains significantly lower overall drug-related mortality than Sweden, despite having much higher rates of illicit drug use and serving as Europe’s primary entry point for cocaine and heroin. While Sweden has seen a steady rise in overdose deaths—particularly among young men and linked to synthetic opioids like metonitazene—the Netherlands benefits from a public health-oriented approach that keeps its overdose mortality rate well below the European average.

Key comparative factors include:

Mortality Rates: The Netherlands reported a drug-induced mortality rate of 16.5 deaths per million adults in 2015, which is lower than the European average of 20.3. In contrast, Sweden has experienced a continuous increase in drug-induced deaths since 2003, with a 2023 overdose mortality rate of 117 deaths per million for men aged 25–39.
Substance Trends: In the Netherlands, recent overdoses are primarily associated with opiates and cocaine, with total deaths rising to a record 338 in 2023. Sweden faces distinct challenges with synthetic opioids (such as metonitazene) and high rates of amphetamine abuse, which dominates its treatment demand.
Policy Impact: The Netherlands’s tolerance and regulated access (e.g., coffee shops) are linked to lower contact with hard drug dealers and lower HIV rates among users. Sweden’s strict prohibitionist model has resulted in lower general prevalence (e.g., 3.9% illicit drug use among adults vs. 13.2% in the Netherlands) but higher per-capita mortality and fewer users successfully integrated into harm reduction services.