Denmark

Basic Data

"The number of drug users in Denmark is estimated at 33,000, out of which 11,000 are estimated to be cannabis abusers only. This estimate was made by the Danish Health and Medicines Authority in 2010 (former National Board of Health). Compared to previous years, this is an increase in the number of drug users in Denmark. In 2006, the number of drug abusers were estimated to be 27,000, of which more than 7000 were drug users. This increase in the estimated number of drug users is thus dominated by an increase in the estimated number of cannabis users from a little over 7000 in 2006 to 11,000 in 2010. Statistics do not include experimental drug consumption, but estimates the number of individuals with a more constant use of drugs leading to physical, mental and/or social injuries. Actual drug addicts are therefore included in the estimate, as well as stabilised drug addicts (e.g. those being treated with methadone). At present, it is estimated that 13,000 drug users inject the drugs. Injecting drug users are particularly at risk of developing serious injuries and diseases and of dying.
"The most recent population survey from 2010 shows a decreasing tendency towards experimental use of illicit drugs - particularly among those under the age of 25 years. In 2008, 8% of those aged under 25 years reported having used one or several illicit drugs other than cannabis within the past year. This figure had gone down to 4 % in 2010. When viewing the drugs individually, the use of cocaine appears to be falling, which is particularly positive since the use of cocaine - as the only drug - was increasing up through the first years of 2000. Cannabis continues to be the most prevalent drug. Much fewer report taking amphetamine and cocaine and even fewer report using psilocybine mushrooms and ecstasy (SUSY 2010)."

"As table 2.2.4 shows, half (45%) of the young adults under the age of 35 in 2010 has tried cannabis ever, and 14% are current users - ie they state having used cannabis within the past years. As far as prevalence of illicit drugs other than cannabis is concerned, 14 % of the young adults under the age of 35 years in 2010 have tried such drugs, and 3 % are current users thereof (table 2.2.5). There is a small, however significant decrease in the current use of drugs other than cannabis among the 16-34-year-olds from 2008 to 2010.
"The current use of drugs among the 16-24-year-olds (cf. table 2.2.6 and 2.2.7 below) is higher than among the 25-34-year-olds. However, it is also among this age group that the use of illicit drugs from 2008 to 2010 is the highest. In 2010, 19% of the young people under the age of 25 years report having a current use of cannabis (report having used cannabis within the past year), which is more or less the same level as in 2008. However, 4% of the young people under the age of 25 years report in 2010 having a current use of illicit drugs other than cannabis, which is almost a 50% decrease and significantly fewer than in 2008, when 8% reported a current use.
"When considering the drugs individually, amphetamine, cocaine and ecstasy are the most prevalent drugs after cannabis. Table 2.2.8 and 2.2.9 below indicate that the proportion of the current use (drugs used within the past year) of amphetamine and ecstasy among the "young adults" is relatively stable from 2000 to 2008, whereas the current use of cocaine somewhat rises during the period. From 2008 to 2010, however, there is a drop in the current use of all three drugs, amphetamine, cocaine, and ecstasy. The decrease in the use of amphetamine is significant for the 16-34-year-olds, whereas the decrease in the use of cocaine and ecstasy is only significant among the 16-24-year-olds. The falling trend in the current use of amphetamine, cocaine and ecstasy during these years is thus particularly seen among the young people under the age of 25 years (re table 2.2.10 of the annex). It also appears from the tables that a significantly higher number of young men than women have a current use of amphetamine, cocaine and ecstasy."

"Ongoing surveys have been made on the experimental use of illicit drugs among the very young. The ESPAD surveys conducted in 1995, 1999, 2003, 2007 and in 2011 show an increase in the experimental use of cannabis and other illicit drugs among the 15-16-year-olds from 1995 to 1999. From this period, the experimental use stabilizes from 2007, however with minor, but significant increases in the experimental use of cannabis, ecstasy and cocaine from 2003 and onwards. From 2007 to 2011 there is a significant drop in the experimental use of the illicit drugs among the young people aged 15-16 years. For most of these drugs, this decrease is significant.
"As shown in table 2.3.1 below, a little less than 1/5 of the 15-16-year-olds has tried cannabis ever, and approximately 6% has tried cannabis within the past month. This reflects a decrease in the experimental use of cannabis among the very young Danish school children from 2007 until today, however the level is still high. As regards amphetamine, the drug has been tried by slightly less than 3%, whereas cocaine and ecstasy have been tried by approximately 2% of the young school children in 2011. This is a 50% decrease in the experimental use of these drugs from 2007 to 2011, and this drop is significant.
"The gender differences still apply in the experimental use of illicit drugs among the 15-16-year-olds and in general, more boys than girls have tried the different drugs. Only LSD, ecstasy, and sniffing have been tried by almost as many girls as boys."

"The data available have limitations in respect to quality and coverage, however, the information available suggests that heroin was only present in the majority of overdose deaths in a relatively small number of EU countries. A significant share of overdose deaths was reported by Austria (67%), Italy (56%), Ireland (46% in 2017), Poland (44% in 2016) and Romania (43%). In 7 other European countries, heroin was found in approximately a quarter to a third of reported overdose deaths: Portugal (37%), Slovenia (33%), Denmark (36%), France (33% in 2020), Türkiye (32%), Spain (28% in 2020) and Norway (23%). In 2021, in the north of Europe, less than 1 in 6 overdose deaths in Finland, Sweden and in the Baltic countries was reported to involve heroin."

"In 2021, the proportion of overdose deaths involving benzodiazepines increased in several countries and was present in more than half of the cases in Denmark, Austria, Portugal and Finland (see figure Proportion of drug-induced deaths with benzodiazepines involved in selected countries, 2019–2021 in Drug-induced deaths in Europe)."

"Results from the population surveys among the 16-44-year-olds made in 1994, 2000, 2005, 2008, and 2010 show increases in the experimental use of cannabis up until 2000, and from then on remain on a fairly stable level up until 2010, cf. table 2.2.1. Among both men and women, the current use of cannabis is highest among the young population (16 – 24 years) and then tapers off by increasing age (cf. table 2.2.2 of the annex).
"As the above table indicates, the current use of cannabis stagnated from 2000 to 2010 (cannabis used within the last year). Although there seems to be a drop from 2005-2010 in the proportion of those who have tried cannabis ever, the figures indicate that the trend has stabilized, as the "current use" is considered the most reliable target for the prevalence."

"The estimate on the number of drug abusers is associated with some uncertainty. The estimate is dependent, in one respect, on the definition of a drug abuser, and in another, on which methods and data material the estimate is based.
"As in previous years, the estimate made in 2010 was made using the capture-recapture model⁴. The estimate is carried out based on the National Patient Register (LPR) and the national register of drug abusers who are receiving or have received treatment (SIB). The approach has been to investigate how many persons are registered in the LPR with a drug-related diagnosis5. An analysis is then carried out of how many of these people are also listed in the SIB.
"The estimate on the number of drug abusers from 1996 to 2009 appears in table 4.2.1. Since the calculations of the estimates throughout the years are based on the 'live' registers, an adjustment in the estimates from previous years has also been made in
connection with the preparation of the 2010 estimate.
"The estimate does not include experimental drug use, but estimates the number of people who have a more constant us of drugs, as a result of which they suffer harmful physical, mental and/or social effects. Drug abusers in substitution treatment have been included in the estimate.
"The estimate is statistically uncertain (confidence interval). However, even when including this uncertainty, there is a clear increase in the number of drug abusers from 2001 to 2009. The number of drug abusers in 2009 is estimated to be 33,000, of which 10,900 are estimated to be cannabis abusers. In 2005 the number of cannabis abusers was 7,900.
"In recent years, the 'population' of drug users receiving treatment, which is one of figures used for calculating the estimate, has changed (the treatment population is described in the next section). There seems to be an actual, relative decrease in the number of drug users seeking treatment for opioids/heroin addiction, while there are an increasing number of users seeking treatment for addiction to cannabis and stimulants. The change is particularly seen among the 'new' individuals in drug treatment and is assumed to reflect the similar changes in the population of drug abusers."

"During the period 2004-2008, the then National Board of Health supported the DEADHEP project, under which, as part of the study on HIV and hepatitis prevalence among drug-related deaths in Denmark, also by means of autopsies, it was examined whether or not the deceased suffered from hepatitis as a sign of intravenous drug abuse (Christensen et al 2006) (read more in chapter 6). Based on the this, the Danish Health and Medicines Authority started to estimate the number of intravenous drug abusers by comparing DEADHEP with the Danish Health and Medicines Authority’s register on drug users enrolled in treatment (SIB = Stofmisbrugere Indskrevet i Behandling) (Christensen et al 2009). "The estimate is based on a capture-recapture estimate made on newly admitted patients in the treatment registry in each of the years 2003 and 2005 and those registered in DEADHEP in 2006 (a total of 5,126 subjects). The estimate was stratified by age, gender and geographic region and calculated by means of a log-linear model.
"Based on these calculations, the estimate is that at present there are 13,000 active intravenous drug users in Denmark (safety interval of 10,066-16,821). Half of them live east of the Great Belt. Between half and 2/3 are unknown to the treatment system.
"As shown previously in this chapter, the Danish Health and Medicines Authority's overall estimate of the number of drug abusers is 33,000, of which 11,000 are cannabis abusers. As it is estimated that there are 13,000 intravenous drug abusers in Denmark, it is assumed that around 60% of the drug abusers (not including cannabis abusers) are intravenous drug users (primarily users of opioids).
"The 13,000 intravenous drug users equal 3.6/1000 inhabitants between 15 and 64 years in Denmark (95%, safety interval of 2.8-4.6). The proportion of intravenous drug users in the Danish population equals the share of drug abusers in the other European countries of 1-5/1000 of the 15-64-year-olds (EMCDDA 2010).
"Number of intravenous drug users calculated by mortality
"As a supplement to the above calculations, an estimate was made on the number of intravenous drug users in Denmark from a multiplicative model based on the mortality observed among intravenous drug users in treatment during the period 2004-2006. The mortality observed among intravenous drug users in treatment was 2.0/100 person years and the calculated number of deaths were an average of 225/year. This equals a one-year prevalence of 11,186 (95%, safety interval of 9,670-15,634). The estimate is slightly lower than the 13,000 observed when using the capture-recapture method."

"Despite minor fluctuations, there seems to have been a decline in the number of registered acute hepatitis cases in the Danish population as a whole over recent years (Table 6.2.2 of the Annex). During the period, the share of acute hepatitis cases, where the infected person has been an intravenous drug abuser, has been under our around 1% for hepatitis A, varied between 0 and 32% for acute hepatitis B and between 0 to 85% for acute hepatitis C. However, the proportion of persons reported with chronic hepatitis C resulting from intravenous drug abuse is relatively stable at 67-75%. The number of reported cases of acute hepatitis B and C is low in Denmark. Therefore, the major fluctuations in the proportion attributable to intravenous drug abuse should be read with caution. Since hepatitis C is often asymptomatic in the acute phase, the reported cases are most likely underestimated."

"Action taken in Denmark against HIV is based on the principle of voluntarism, anonymity and openness, providing direct and honest information and security for individuals in their contact with the health authorities. HIV testing is voluntary and people who are HIV-infected are reported anonymously. The HIV reporting system includes age, gender, information about any earlier HIV test and risk behaviour, as well as the presumed method of infection. Cases of AIDS are reported by name and personal data. Table 6.2.1 of the annex shows the number of reported newly diagnosed HIV positive and out of them, the number of intravenous drug users the past 10 years¹². The number of persons newly diagnosed as HIV positive has varied from year to year, as has the number of infected persons where the source of infection is assumed to be intravenous drug use. In 2011, 4% (10 persons) of those newly diagnosed as HIV positive were registered as intravenous drug users. This percentage has remained more or less the same between 4% and 11% the past 10 years.
"The proportion of newly diagnosed AIDS cases where the source of infection is considered to be intravenous drug use is relatively stable around 10%. In 2011, 9 % of those diagnosed with AIDS were intravenous drug users, which were 5 out of a total of 58 persons."

"In 2010, the number of recorded drug-related deaths was 204. When considering the whole period, 1995-2010, the number of deaths fluctuate between 200-250. The number of deaths reached a rock bottom low in 2010 with 204 recorded deaths. In 2010, men accounted for 77 % (158) of all drug-related deaths. During the other years, their share of drug-related deaths is between 69% and 74%.
"Statistics based on the National Commissioner of Police's register
"From the mid-1990s (figure 6.4.2), the number of deaths recorded in the register of the National Commissioner's has been more or less constant, however with annual fluctuations (see table 6.4.1 of the annex). In 2011, 285 drug-related deaths were recorded, and this is the highest number ever. Out of the 285 deaths, 81% were men (232) and 19% were women (53).
"The average age at death has gone up for many years. In 1993, the average age was 33 years, whereas in 2011, it was 40.4 years, ie 39.6 years for men and 43.9 years for women, respectively. The proportion of young people under the age of 30 years accounted for 19 per cent of all drug-related deaths in 2011 (the rate was 22% in 2010).
"Out of the 285 deaths in 2011, 76% (218) was caused by poisonings after the intake of one or several drugs, whereas 24% (67) was due to another type of drug-related death - for instance violence, accident other than poisoning, illness or an unknown cause of
death.
"As it appears in Table 6.4.3 below, 24 % of all poisonings (53 out of 218) were caused by heroin/morphine or heroin/morphine in combination with another drug, whereas 52% of the poisonings (114 out of 218) were caused by methadone or methadone in combination with another drug. 23% of the poisonings (51 out of 218) are caused by other drugs."

"The total number of drug users admitted to treatment during 2011, is slightly under 16,200, which is the second highest number registered drug abusers since the opening of the register. The development in the number of drug abusers receiving treatment has been increasing over recent years, cf figure 5.3.1.
"In 2011, 5,686 persons were admitted to treatment in Denmark. This figure includes people admitted for the first time and those who are readmitted for treatment. The rate of persons who have not previously been admitted to treatment is 32% in 2011, which is the same level as in previous years."

"In 2011, 63% of the drug users reported cannabis as their primary drug when admitted to treatment for drug abuse. The opioids as a primary drug were reported by 17%, stimulants and cocaine by 15% and 6% reported 'other drugs' as the primary drug on admission. Quite a few drug abusers seeking treatment use several drugs, where 45% of the drug users reported having used more than one drug prior to admission in 2011.
"The stimulants which are particularly in focus of the young people's experimental use of drugs appears to a lesser degree as the primary drug for abusers admitted to treatment in 2011. 9% report amphetamine, 5% report cocaine, and 0.3% report ecstasy⁸ as their primary drug⁹. These drugs are thus mainly used as a supplement. Cannabis was the primary drug for 63% of those admitted to treatment and is also used as a secondary drug among 14% of those admitted to treatment in 2011."

"Previously, the Danish Health and Medicines Authority recorded the number of persons in long-term methadone treatment based on data from the prescription register. The most recent records show that 5,700 persons in 2004 were admitted to substitution treatment with methadone. The records provided information about the number of persons admitted to methadone treatment under the Danish Prison and Probation Service and number of persons without a civil registration number (Sundhedsstyrelsen 2008a).
"From 2008, the figures are based on the number of drug abusers in substitution treatment with either methadone or buprenorphine on data reported to the register on drug abusers in treatment (SIB). Since the compilation method10 and the data basis¹¹ vary from 2008 and onwards compared to the years before 2004, the results from the various periods are not directly comparable.
"The most recent figures from the register on drug abusers in treatment shows that among all those receiving drug abuse treatment, around 7,050 persons were in substitution treatment in 2011. When including data from the Danish Prison and Probation Service, the total number of persons in substitution treatment arrives at barely 7,600 in 2011. This is lower than the updated figures for 2010 based on the SIB data retrieved from the new joint reporting portal (SIB), which showed that less than 7,850 persons received substitution treatment.
"Buprenorphine and methadone are used in substitution treatment. The Danish Health and Medicines Authority's revised guidelines on the prescription of addictive medicines from 2008 emphasizes that buprenorphine should be used as a first-line preparation for opioid dependent drug users which had not previously been treated and that this drug in any event should be used to the greatest extent possible in substitution treatment.
"The number of persons in substitution treatment with buprenorphine were approximately 1,400 persons in 2011, which is slightly lower than in 2010, which could be due to the transition to the new drug abuser reporting portal, SIB."

"In 2009, as a result of a request from the Ministry of Health, Local Government Denmark looked into the prevalence of syringe exchange schemes in the various municipalities in Denmark. In its report, Local Government Denmark concluded that the number of drug abusers who have access to clean syringes and needles is high. The reason is that all the large municipalities that have a relatively large number of drug abusers hand-out clean "tools". The survey has not been broken down on a local level, but Local Government Denmark has found that it provides a useful picture of local practice.
"The hand-out of syringes and needles typically takes place via treatment institutions, the local pharmacies, drop-in centres or shelters. In some places, vending machines have been installed.
"The municipalities are not legally bound to dispense syringes and needles to drug abusers. However, most of the municipalities have a practice for doing so. Expenses for handing out clean tools are financed by the municipalities. Via the social reserve fund agreement for 2004, the municipalities are compensated with EUR 107,000 per year for the hand-out of water ampoules together with the syringe kit which is already being dispensed."

"After Act no. 606 of 18 June 2012 was passed on the amendment of act on psychoactive substances, it has become possible for the municipalities to establish drug consumption rooms as part of their overall services to drug abusers. If the municipality wishes to establish a drug consumption room, the local Social Services Administration must apply to the Ministry of Health.
"The purpose of this is to render it possible for the municipalities to include the drug consumption rooms in their harm reduction interventions. The drug consumption rooms must thus contribute to reducing mortality rates and improve the health conditions for the drug abusers. Also, it is assumed that introducing drug consumption rooms might contribute to reducing the disturbance which is felt by the people living in the areas affected by drug abuse. The target group of the drug consumption rooms is people at the age of 18 and above and people who are severely addicted as a result of long-term and persistent abuse of psychoactive substances.
"The drug consumption rooms are to act as low threshold services and should match local needs. Therefore, the municipalities are responsible for considering access to drug consumption rooms, capacity, staff, control, types of drugs and - modes of administration as well as rules and regulations, etc. Their deliberations should be made in collaboration with the police, the local community and, where needed, the affected drug abusers. In connection with the drug consumption room, access should be given to relevant social and health care programs. The drug consumption rooms must be manned by qualified personnel, which will also be monitoring drug intake. Monitoring of drug consumption, hand-out of equipment for drug use and guidance is not, in a drug consumption room context, considered as treatment comprised by the Health Care Act or as a business comprised by the Authorisation Act (Indenrigs- og Sundhedsministeriet 2011). However, first aid following an OD or as part of health care programs associated with the drug consumption rooms will be comprised by the Health Care Act and the Authorisation Act.
"It is assumed that possession for own use close to a local drug consumption room will not be subject to punishment, confiscation or seizure. It is for the police to assess, whether or not the possession of drugs is meant for own use."

The Danish National Board of Health reported in 2000 that "The Buprenorphine project was initiated in the City of Copenhagen during the autumn of 1998 and was evaluated this year. In conclusion the report points out that this type of substitution therapy is suitable for clients who have not previously been subjected to methadone treatment and which are resourceful. Furthermore, the report concluded that buprenorphine treatment may contribute by a significant percentage to the drug addict becoming drug-free and being able to revert to normal life through work, activation and education rather than any other kind of therapy.²⁰"

Laws and Policies

"The national action plan against drug abuse from October 2010 indicates that Danish drug policy is based on four basic elements: prevention, treatment, harm reduction and control. Prohibition and control intervention will not solve the problem alone. There is also a need for targeted and persistent intervention in order to prevent, intervene, treat and reduce injury. And even more - to reduce supply of and demand for drugs.
"Viewed against a relentless fight against drugs and the hope for a drug free society, the existing harm reduction initiatives may appear in conflict. However, the fact is that these initiatives are pragmatic and sensible and launched in consideration of the weakest drug abusers and society. Harm reduction will therefore continue to be a fundamental pillar in drugs policy in Denmark."

"The distribution of responsibility on a central level requires coordination. This is handled by the Ministry of Health which acts as the central coordinator of projects carried out by various authorities. This Ministry regularly assesses the overall drugs policy, including the need for adjustment. This also includes the need for interdisciplinary initiatives as a response to current and future challenges. The Ministry is also responsible for the necessary follow-up on the implementation of the interdisciplinary initiatives which are reflected in the national action plan against drug abuse."

"In the 2004-05 parliamentary year, members of the Opposition tabled a motion for legalisation of cannabis. A large majority voted against the bill at the 1st reading of it. The bill did not reach the 2nd reading, nor did it reach a final vote. Another bill tabled during the parliamentary year of 2004-2005 was the introduction of drug injection rooms. That bill was rejected by a parliamentary majority at the 2nd reading. The government rejects any legalisation of cannabis, establishment of drug injection rooms and medical prescription of heroin, considering such action to be far too lenient and, as far as legalisation of cannabis and the establishment of drug injection rooms are concerned, also in contravention of the international drug conventions as well as with the core of the Danish drugs policy."

"Drug-related crime is punishable under the law of psychoactive substances and Section 191 of the Danish Criminal Code. Violations of the Act on Psychoactive Substances will be punished by fine or prison for a period of no more than 2 years. In connection with sentencing, it is considered whether or not the drug is intended for own use, or if the drug has been sold or intended for selling. Also, the type and quantity of the drug is considered. Where the possession of the drug is caused by heavy addiction following long-term and persistent use of psychoactive substances, the alternative sentence may be a warning supported by social conditions.
"Section 191 of the Danish Criminal Code provides for stricter punishment on qualified violations of the Act on Psychoactive Substances. This means that if the transfer of psychoactive substances is made to a large number of people against considerable remuneration or under other particularly incriminating conditions, the punishment for violation of the Act on Psychoactive Substances may be extended to prison for a period of up to 10 years. When selling particularly dangerous or injurious substances, the offender may be further punished with a sentence of prison for a period of up to 16 years."

"Treatment with prescription heroin was launched in Denmark in 2010. The rules on the prescription of and treatment with heroin are laid down in the National Board of Health's guidelines from January 2010 together with associated legal framework and executive orders.
"The social reserve agreements for 2009 and 2010 provide that as of 2010, a total amount of 8.5 million EUR must be set aside for permanent financing of the prescription heroin scheme. Similar to any drug use treatment schemes in Denmark, including social and substitution treatment with methadone and buprenorphine, heroin treatment is provided free of charge.
"The National Board of Health has estimated that approximately 10% of all drug abusers in long-term substitution treatment fulfil the criteria for treatment with heroin. Furthermore, the National Board of Health has assessed that approximately 300 drug abusers will receive heroin treatment in Denmark within the next few years."

"In Denmark, there is a clear correlation between drug abuse and problematic social and economic life conditions. The social marginalization of drug abusers is high. When taking a look at the social, residential and educational conditions among the drug abusers in treatment, it is clear that they are a marginalized group compared to the rest of the population. They are more often homeless, they more often have a short educational background and they are more frequently provided for through cash benefits and pensions.
"As mentioned in chapter 5, the group of drug abusers admitted to treatment are characterized by having a relatively remote affiliation to the labour market. Thus, only 12% of them who were in treatment in 2010 were on payroll and as many as 66% were on transfer income. Furthermore, “only” 25% have completed an education beyond “folke-skole” (primary and secondary school) and 8% have left school before the 9th grade.
"Although these figures indicate that we are dealing with a relatively marginalised group, it is also important to point out that the number of drug abusers employed has gone up the last year as has the educational level, which to a high extent is attributable to the change in drug use patterns.
"As regards the housing situation of those who are admitted to treatment, only 59% of them report having a home of their own, whereas 4% report that they are homeless."

"For the purpose of preventing against drug-related diseases, physical withdrawal symptoms, and mental craving for drugs, the Danish Prison and Probation Service provides medical substitution treatment. This temporary treatment may extend over weeks or months. It is very to a wide extent followed by continuous substitution treatment that may last up to several years when deemed necessary by an interdisciplinary panel of people –which is more the rule than the exception. This service is normally received and communicated to the institution expected to take over treatment after the prisoner’s release.
"For the purpose of preventing against infectious diseases, including in particular abscesses, sepsis, hepatitis, HIV and AIDS, the Danish Prison and Probation Service dispenses condoms, chlorine rinse fluid for cleaning of needles and syringes, vaccination against hepatitis B and A and general health assistance, including information about the above diseases and general medical treatment on an equal footing with the rest of the population. Inmates, however, do not have access to free syringes and needles."