What lessons from Norway’s experience could be applied in the United States in response to the addiction and overdose crisis?

Abstract

on opioid consumption as evidence of the health system's failure to deliver relief from suffering and pain management was set as a priority of new health policy. Just as in the United States, opioids were destigmatized and became the symbol of pain management. Contracts were signed between the French government and global pharmaceutical companies in order to increase the health-care system's capacity to provide opioids; yet no disaster followed [7]. Where American pain specialists were convinced by insurance companies and hospital administrators to champion opioids as a means of cutting costs, French doctors were able to resist the pressure thanks to more favourable institutional conditions which allowed them to mute the effects of neoliberal health-care reform and to maintain a multi-modal approach to pain treatment [8].

Synthesizing advice to the United States from other nations that have experienced drug epidemics

“…Finally, we very much agree with Clausen's call for non-opioid and alternative therapies for acute and chronic pain management to prevent iatrogenic opioid dependence [4]. However, we must go further and work out changes to make for the longer term such that the current generation of young people do not end up like the current one.…”

“…In their summaries of the recent experience of Estonia and Sweden, Abel-Ollo [1] and Fugelstad [2], respectively, suggest an escalation in fatal poisonings from synthetic fentanyl can be curtailed if there is a concerted effort to help victims while law enforcement knocks out major distributors. For Bergeron and Colson [3] and Clausen [4], the policies in France and Norway share features and the combined effects of needle and syringe exchange services, low threshold opioid prescribing services and take-home naloxone schemes seem to have delivered success.…”

Opioid prescriptions among Sami and non-Sami with chronic pain: The SAMINOR 2 Questionnaire Survey and the Norwegian Prescription Database

“…These guidelines are more in line with the Norwegian guidelines, urging alternative non-opioid medications as first-line options for chronic pain [ 42 ]. It has been argued that there are several factors contributing to the relatively low and stable use of opioids in Norway and other Nordic countries compared to Canada and the U.S, including access to health care services almost free of charge, strong health institutions, universally available systems for social welfare and low socio-economic disparities [ 43–45 ]. A study found that state policies was associated with reduced misuse of opioid prescriptions [ 22 ].…”

Cohort Description: Preventing an Opioid Epidemic in Norway – Focusing on Treatment of Chronic Pain (POINT) – A National Registry-Based Study

“…5,6 In North America, this increase was in part culpable for the ongoing epidemic of opioid use and overdose deaths. 7,8 Short-term use of opioids for severe acute pain, palliative care and cancer pain is essential and widely utilised. However, chronic non-cancer pain may be underpinned by different mechanisms, as the pain is not always directly related to tissue damage, changing the nature of the pain.…”

“… 5 , 6 In North America, this increase was in part culpable for the ongoing epidemic of opioid use and overdose deaths. 7 , 8 …”