The influence of lived experience in Norway 

13. september 2023

31. august 2023: The Scottish Drugs Forum held a conference with the title: Supporting Change: Amplifying Voices.

The leader of The Association for Humane Drug Policy, Norway held a talk called: The influence of lived experience in Norway:

You can now watch his presentation on YouTube!

Today markes The International Overdose Awareness Day. It is a day to remember those we have lost and to focus on overdose prevention. Because every single one who died, they had the potential for a great and lasting life until the very last heartbeat. 

And it is often portrayed as if overdose deaths means less than when others lose their lives too early, but we are not just as valuable as everyone else. Relatives are also very often left with an unusually deep and complicated grief. After the countless dilemmas they faced in the years before. Often heavily influenced by others' input, based on stigma and prejudice. So preventing overdoses is among our society's biggest tasks. And every overdose death can be prevented. 

So I want to thank the Scottish Drugs Forum for inviting me. It makes me feel proud, because once I lived on the streets of Oslo as an injecting drug user. I have survived several overdoses. And today I am invited to stand before you at this important conference here in Scotland. 

And I am proud to say that I am a drug user, because the biggest heroes in all great parts of our history are those that did not obey unjust laws.

The drug laws are both very unjust and they are based on a racist and colonization ideology. And they disproportionately target people of color, people with low social status and Indigenous people, all around the world. 

I am also very proud of the drug policy development that is going on in Norway and the reason behind it. We are in the midst of a drug policy reform and I will return to what that is all about, but the most important thing is that it is grounded on the basics of Harm Reduction.

Norway is a country with the same population size as you and we have more than 50 sites with needle and syringe services. And we have had drug consumption rooms since 2005. We have a big national substitution treatment program with more than 8200 people receiving, mainly, methadone or buprenorphine. And since 2004 those who need some kind of drug treatment have had patient rights. 

The beginning of Harm Reduction, in the late 1980s, was the first real turning point in drug policy. Even though we were in the harshest, most aggressive, period of the war on drugs; the HIV epidemic brought a desire for evidence on what works and what doesn’t.

This was the first time that we broke through the intolerant abstinence-only-approach. And since then the Harm Reduction programmes have increased and developed, and are now a key element in the ongoing development in drug policy.

So now I want you to try to imagine the ideology, the attitudes, the opinions, and the perspectives that the politicians, researchers and professionals had at that time.

And then I want you to try to imagine who came up with these new ideas, the suggestions for what could be done to prevent HIV. 

I mean: Handing out needles and syringes, so that people could inject their drugs with them! 

It was unthinkable for the professionals, it was unthinkable for the researchers and it was unthinkable for the politicians. 

Even that drug users could care about their own and others health or in any way be valuable resources, it was simply unthinkable. 

And it was unthinkable that it was necessary to have a room for consuming drugs in a safe environment, with good hygiene, with closeness to health workers and without fear for being criminalized.

And I mean, prescribing methadone and buprenorphine, formerly known as illicit drugs, drugs that the authorities fought against, it was unthinkable.

It was the drug users, those with lived and living experience, it was us, who suggested this. And eventually the politicians took us seriously and listened to us. 

We broke through. 

Drug use was still criminalized, but since then the health centered approach, and the tolerance and pragmatism, has grown and several drug user organizations have been established. 

The first drug user organizations in Norway were run by the temperance movement and to participate one had to be a former drug user with a turning point history, related to when they succeeded in drug treatment. When they stopped using drugs. 

But eventually we others could also establish drug user organizations. And we saw early on that the politics was now contradictory. On one hand we help and include, on the other we punish and exclude. On one side forces in the country fought for more help and inclusion. And on the other side forces fought for more punishment and exclusion. 

The health centered approach brings evidence to what works and what doesn’t. 

The organization I represent, The Association for Humane Drug Policy is a drug user organization with active drug users, former drug users, some in substitution treatment and some without. We were established in 2006 as a result of the ongoing debates about harm reduction and the need for drug users perspective. 

We had to organize because we stood up against big organizations and at that time most of the politicians. We are promoting Harm Reduction, substitution treatment and we are opposing criminalization and brutal police actions against the drug scenes. We also fight for legal regulation of drugs, we want the state to take control. We have a high media profile and we meet our opponents with the utmost respect. 

And since 2008 we have paved the way to be invited in to the Parliament together with active drug users, and that is now an annual tradition that we call The Drug Users Day.

Some of the authorities wanted us to be just a patient organization and only participate in the health care system. While organizations from the temperance movement could work on the political level and represent Norway internationally.

But, Nothing about us without us!

We also are a political force. We are not criminals because we use drugs. And we are not patients because we use drugs. First of all, we are citizens. We deserve not only patient rights, but also Human Rights. To be treated as equal. 

For more than ten years ago, we suggested new overdose prevention measures, which was to hand out the heroin antidote; Naloxone, to have a Switch-campaign where we inspire heroin users to switch from injecting to smoking and to raise the awareness by marking World overdose Awareness Day every August 31. And we prevailed, again. This is became the key elements in The Norwegian Parliaments National Overdose Strategy in 2014.

And again: These measures, it was unthinkable for the others. The use of Naloxone, and maybe especially the Switch-campaign, it brought a change in attitudes. More tolerance and pragmatism. And a bunch of new municipalities starting up harm reduction services.

So, in 2016 we, The Association for Humane Drug Policy, wrote a petition together with some other drug user organizations, in Norway's biggest newspaper. It was signed by 90 public figures. Academics, politicians and lawyers.

There we demanded

To be listened to.

That human rights must form the basis of all drug policies.

And that the use and possession of drugs for one’s own use must be decriminalized, without being replaced by new and intrusive sanctions. 

The then minister of health,in a conservative government, Bent Høie has since stated that this was a turning point for him.

In 2017 it became clear that a majority of the representatives in Parliament supported a move from justice to health. And in 2018 the Government formed a Drug Reform Committee to look at the findings from many countries.

The Drug Reform Committee did extensive research for a year and in 2019 the Committee suggested a model for decriminalization of drug use.

Their findings confirmed our view: Criminalization of drug use does not prevent drug use. It only creates stigma, marginalization, and it creates crimes and it creates most of the elements in what we call drug problems. 

Criminalization is actively counterproductive. Very few of those with drug related problems seek help because of the stigma. An individual with drug related problems doesn’t find the health related approach very interesting as long as he or she is treated as a criminal being. 

As long as we are criminalized, the health centered approach is also very small, narrowed and moralistic. Because it creates an attitude that one must not go too far in helping those who the overall politics is to punish.

In March 2020, the minister of health Bent Høie held a side event at The Commission On Narcotic Drugs, in The UN Building in Vienna, about the findings and the suggestion for a drug policy reform with decriminalization.

At this meeting, with representatives from all over the world, I thanked the minister for including the drug user representatives in the work for a more evidence based and Human Rights based politics. 

Then, at this moment, with all these people around in the lion's den, that Bent Høie replied: “Thank you Arild, we have been discussing this for more than twenty years and had our disagreeings. You were right. I was wrong”. 

The proposal from Norway was very well received by representatives for The World Health Organization, the Office of the High Commissioner for Human Rights, UNODC and several other high level organizations. In short they received it as best practice within, and fully consistent with the conventions, and they said “look to Norway”.

And when the government was ready with their proposal the year after, in 2021, the minister of health wrote to me in a hard copy of the government proposal: Dear Arild, this is Lex Knutsen. That means The Knutsens Law.

In that the minister of health Bent Høie again showed his remarkable acceptance for the drug user organizations.

The Parliament was still not ready for it, so they turned the minority government's suggestion down. The majority of the Parliament supported a move from justice to health and they thought that they should replace punishment with offering treatment for persons with severe drug dependence, but they opposed decriminalization as such.

Because they still thought that one should maintain the criminal responsibility for young experimenting drug users and adult recreational users. In my view that is a political abdication of responsibility,  but even though: The discussion is still going strong and there has happened so much in the aftermath of this, that it is really amazing.

When the big debate about decriminalization started, peoples eyes where opened. Different parts of society began to evaluate itself.

It gave birth to rethinking what had been considered as right and wrong for decades. So now we are experiencing structural and cultural changes in attitudes and practices that are even greater than a change in laws could bring. 

We now have two clinics with heroin assisted treatment for more than 70 people. And also we are in the midst of a groundbreaking development of the substitution treatment, where we have tryouts with substitution medications also for other serious addictions, with benzodiazepines and central stimulants. 

Last year The National Institute for Human Rights published a report about drug use and human rights. They point out stigma as a central issue and they point towards efforts that can be done to secure human rights for people who use drugs. And to end the wrongs that have been done because of stigmatizing attitudes. 

Since 2021 the police have been forced by the Attorney General to change the way they treat people who use drugs upon arrest, after for years using integrity infringing measures, that really wasn’t allowed. 

And the court system has started reducing penalties in drug cases since 2021. In some cases changing sentences from months in prison to a few weeks suspended sentence. Within the court system it has also been expressed that punishment for drug use is pointless.

In April last year the Supreme Court finally decided that those with substance use disorders shall no longer receive punishment for their own personal use. In one tried case, even a recreational user was let off with probation for 10 grams of amphetamine, due to “personal circumstances”

So I must say that the Norwegian society has really started taking considerations to the wellbeing of the people to whom this applies, rather than blindly punishing them for the sake of the society. 

The Attorney General has since instructed the police that if a person suspected to be in possession of drugs for their own use is addicted to drugs, this person should no longer be stopped, searched, or arrested. If they are in doubt as to whether the person is addicted to drugs, then the benefit of the doubt must be given to that person. 

There has been a historic drop in reported drug offenses after this, and the development shows that what we now deserve is an extensive research on whether the police should prioritize use of illegal drugs at all. Because, since the police have taken a step back, it has opened for social workers to take two steps forward. They have the right expertise, the right tools and then the police can prioritize serious crime, even such crime that traumatizes people and creates the kind of trouble a lot of people use drugs to be able to bear with. 

It is also time to acknowledge that drug users have a particular vulnerability to being exposed to crime and that they must be protected.

The police should change their practice from criminalization to behavior regulation. And they should join the efforts for more Harm Reduction.

They should ensure that drug users are just as protected from crime as everyone else. We want drug users to have the same protection of the law that everyone else can take for granted.

A few months ago a local police officer said to me “You know, I think there are other professions that can do drug prevention work much better than us in the Police”

And I think he is very right!

When we look into what the authorities have taken into account and what the discussions mainly is about, it is about the follow-up after arrest. 

What we are suggesting is a concrete discussion about police work and priorities. In all stories about oppression and human rights violations throughout history, police control instead of police protection is at the center of these stories.

So to conclude, the inclusion of the drug users' perspectives and the focusing on overdose prevention has resulted in such changes in attitudes and practises, that we are actually changing a whole society, a whole population, eventually the whole world to the better. We are among the most valuable resources, we deserve to live and thank you for your attention!

The presentation on Youtube can be seen here.

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