Drug Addiction, Crime or Disease?

Interim and Final Reports of the Joint Committee of the American Bar Association and the American Medical Association on Narcotic Drugs.

APPENDIX B

An Appraisal of International, British and Selected European Narcotic Drug Laws, Regulations and Policies

NORWAY

The Norwegians are concerned about their drug addiction problem, with an estimated 700 addicts31 (mostly concentrated in the Oslo area), in a population of 4 million.

Controls have been very lax. Doctors may treat addicts, including the administration of stabilizing doses, but if they do so too freely the Ministry of Health may issue a warning or suspend the doctor's right to prescribe drugs.

No doctors have ever been prosecuted for violating drug laws and regulations.

Though registration and licensing requirements are provided, they have not yet been vigorously enforced. For example, unlimited "repeat" prescriptions were freely permitted until the adoption of a new regulation last year.

Most addicts have met their needs by addressing themselves to one of twenty or thirty doctors (half of them in Oslo) who have acquired a reputation for prescribing drugs freely, and this situation has caused the Department of Health to press for new regulations which would create a control board similar to that established in Denmark.32 If a doctor wishes to reduce the dosages of a patient under his care (which happens in thirty or forty cases per year), he may notify the Health Department, which then puts out a bulletin on the case to pharmacists and other doctors, advising against the prescription of drugs to the individual patient involved. Local health authorities may initiate the same arrangement in the case of addicts who come to their notice, referring the case to a doctor to be handled in this fashion. Mental hospitals will accept patients for treatment on a voluntary basis, for periods up to nine months, but there is no provision for involuntary commitment for addiction alone.

The prescription records kept by pharmacists are supervised by two inspectors (who also have many other duties) and if a doctor's prescription practices appear to be far out of line, the Health Department may write to him or refer the matter to the medical officer of his district, though the Department had no power to impose penalties or enforce its views prior to the new regulations referred to above. It is emphasized that the police never take the initiative in connection with any narcotic drug matter, and that there are no officers specially assigned to this field. The law enforcement arm acts only upon the complaint of the Health Department.

There are a few cases of theft of drugs annually and many (several hundred) cases of forgery and fraud in connection with prescriptions. These offenses are not seriously regarded by the courts and the sentences given are light.

Ten to fifteen doctors a year get into trouble with their medical boards for personal addiction (two such cases ended in suicide last year).

Health Department officials recount that publicity about the new regulations has provoked a number of visits and communications from addicted persons, who are leading normal lives and who are very much concerned that repressive policies would drive them into supporting an illicit market.

There is little relation between addiction and criminality; addicted persons are virtually unknown in Norway's penal institutions; and those who end in prison usually are there for repeated petty offenses, such as the forging of prescriptions.