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Public Health Report

Alcohol and other psychoactive substances in Norway

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On average, Norwegians consume almost 7 litres of pure alcohol per year, with men drinking twice as much as women. Cannabis is the most used illicit drug in Norway.

illustrasjon alkohol og andre rusmidler
Illustrasjon: FHI/fetetyper.no

On average, Norwegians consume almost 7 litres of pure alcohol per year, with men drinking twice as much as women. Cannabis is the most used illicit drug in Norway.

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Main points

  • On average, Norwegians consume almost seven litres of pure alcohol per year, calculated per inhabitant aged 15 years and older.
  • The registered consumption increased from 1990 until 2008 but has since declined.
  • Men drink more often and twice as much as women, on average.
  • Although older people drink alcohol more frequently than younger people, they drink less.
  • We drink less alcohol in Norway than in most European countries, calculated per inhabitant aged 15 years and older.
  • Cannabis is the most used illicit drug in the Norwegian population.
  • Psychoactive substance use is among the most important risk factors for death and years of healthy life lost in the population.
  • Alcohol is the cause of significantly more health and social problems in society than illicit drugs. There is no sharp divide between use and abuse.

What is a psychoactive substance? 

Psychoactive substances include alcohol, medicines with abuse potential and illicit drugs (narcotics) such as cannabis, amphetamine, heroin and cocaine.

Medicines with abuse potential are mainly sedatives and hypnotics of the benzodiazepine group. A large proportion of the tablets sold on the black market are not from approved pharmaceutical manufacturers. Illicit substances often contain a higher amount of active ingredients compared with registered products sold in pharmacies (National Criminal Investigation Service (Kripos), 2014).

The effects of psychoactive substances can be divided into three primary groups: depressant, stimulant and hallucinogenic, see Figure 1. Several drugs have a combination of these effects, for example alcohol and ecstasy.

FHR 2014 Alcohol Figure 1.jpg

Figure 1. Psychoactive substances can be depressant, stimulant or hallucinogenic. Several drugs have a combination of these effects. Figure: Norwegian Institute of Public Health.

Data source

Alcohol consumption mainly comprises alcohol bought in a shop (Vinmonopol and grocery stores) and in licensed premises. We refer to taxable domestic sales as registered consumption. Alcohol consumption from duty-free trade at airports, ferries and border trade in Sweden is referred to as unregistered consumption.
 
Statistics Norway publishes information about registered consumption. This is stated in litres of pure alcohol per inhabitant over the age of 15 for each drink type (spirits, wine, beer and alcoholic fruit drinks), in total and per year.
 
Duty-free sales of alcohol at Norwegian airports are included in the unregistered consumption and since 2010 have been reported to the Norwegian Institute of Public Health. The remaining unregistered consumption is calculated based on annual population surveys carried out by the Norwegian Institute of Public Health, in collaboration with Statistics Norway. Here, the duty-free sales of alcohol on ferries to Norway and border trade in Sweden are mapped.
 
These two sources (duty-free sales at Norwegian airports and Statistics Norway surveys) form the basis for annual estimates for unregistered consumption. Smuggling and home-brewing are excluded from this estimate. According to the surveys, these sources contribute little to the total alcohol consumption.

The Norwegian Patient Register has an overview of hospital admissions where alcohol-induced disease is registered as the main cause of admission (NIPH, 2016). However, in many cases alcohol is a contributing cause and there are no data for this in the Patient Register.

Statistics Norway surveys also provide a basis for describing alcohol consumption and experience with illicit drugs in different population groups between 16 and 79 years.

Other surveys and studies were used, see the references.

Alcohol use in Norway

Each inhabitant in the age group 15 years and over consumes an average of 6.79 litres of pure alcohol per year, (figure 2).

This is distributed as follows:

  • 3 litres bought at Vinmonopol (state-run off-licence)
  • 3 litres bought in grocery stores and bars.
  • Approximately ¾ litres are unregistered sales purchased in duty-free shops in Sweden and other countries.
Alcohol_figure2_FHR.jpg

Figure 2. Alcohol consumption in litres of pure alcohol per person aged 15 or over from different sources in 2016. On the right you see how the unregistered consumption is distributed. Nightlife includes restaurants/cafes, bars and hotels. Registered consumption (6.02 litres) plus unregistered consumption (0.76 litres) gives a total of 6.78 litres. 

In 2016, over 80 per cent of adults had consumed alcohol during the past year. The ten per cent that drink most are responsible for half of the total consumption.

Alcohol_figure1_FHR.jpg

Figure 3. Annual registered alcohol consumption per inhabitant aged 15 and older (litres of pure alcohol), 1980–2016. Unregistered consumption is not included. Source: Statistics Norway/Norwegian Institute of Public Health.

The increase in registered consumption up until 2008 is due to increased wine sales.
At the same time, there was a shift from bottled wine to bag-in-box wines.

  • Wine in two and three litre bag-in-boxes has been available in Norway since 1988 and counts for just over half of all wine sold by Vinmonopolet.
  • Alcoholic fruit drinks (cider and alcopops) comprise a relatively small proportion of the total alcohol consumption.

Alcohol consumption among different population groups

The main findings from population studies show that (NIPH, 2018b):

  • More women and more elderly people drink alcohol now than before.
  • Men drink more often than women and twice as much alcohol.
  • Older people drink more frequently but drink less than younger people.
  • Beer makes up more than half of male consumption, while wine accounts for more than 60 per cent of female alcohol consumption.
  • One in ten people reported being intoxicated during the past 12 months. Getting drunk is most common in the younger age groups and men report being drunk twice as often as women.
  • About two out of ten report that they drank 6 or more units on the same occasion during the past 12 months. This proportion is about twice as high among men as among women.

Alcohol consumption among adolescents

Data from the European School Survey Project on Alcohol and Other Drugs (ESPAD) show that between 1999 and 2015 there was a decline in alcohol consumption by 15-16-year-olds:

  • There was a decline in the proportion who had ever consumed alcohol, or consumed alcohol during the past 12 months or during the past 30 days, see figure 4 (NIPH, 2017).
  • There was also a decline until 2015 for heavy episodic drinking (five or more alcohol units on the same occasion) in the last 30 days, see table 1.
  • There was consistently little or no difference between girls and boys in alcohol consumption.

Most adolescents who drank alcohol in the last 30 days also had at least one high-risk situation in the same period, see table 1 and figure 4. The decrease in alcohol consumption is in line with findings from other studies in Norway among adolescents of the same age (HEMIL Centre, 2016; NOVA, 2016).

Alcohol_figure5_FHR.jpg

Figure 4.  Percentage of 15-16-year-olds who said they had one or more heavy drinking episodes ever, during the last 12 months and during the last 30 days 1995-2015.

 

Table 1. Percentage of 15-16-year-olds who said that during the last 30 days that they had drunk 5 or more units1, and 5 or more units three times or more, 1995 – 2015.

Year

1995

1999

2003

2007

2011

2015

Drank 5 or more units during the last 30 days

37

50

47

39

31

21

Drank 5 or more units three times or more during the last 30 days

17

24

24

20

14

8

 1 An alcohol unit is defined as a bottle of beer, a glass of wine, a small glass of spirits or a cocktail.

Socioeconomic differences

Alcohol consumption and its frequency increase in line with higher education and income but fewer in this group are alcohol dependent (Directorate of Health, 2016). Drinking habits of adolescents from families with low social status (parents with lower education and parents who are unemployed) are also more risky; they begin to drink alcohol earlier, drink more often and are more often intoxicated than other adolescents (Pape, 2017).

International comparison

The registered alcohol consumption in Norway was the lowest among the Nordic countries in 2016, see figure 5. Denmark had the highest registered consumption, with 9.4 litres per inhabitant in the 15 years and older age group. 

The registered alcohol consumption in Norway is lower than in most other European countries, see Figure 6.

Alcohol_Figure3_FHR.jpg

Figure 5.  Registered consumption of alcoholic drinks in litres of pure alcohol per inhabitant in the 15 years and older age group in the Nordic countries, 1985-2016. Source: Nomesco - Yearbook of Nordic Statistics. 

Alcohol_figure4_FHR.jpg

Figure 6.  The registered consumption of alcoholic drinks in litres of pure alcohol per inhabitant in the 15 years and over age group in selected European countries, 2013.Source: WHO.

Alcohol consumption among European adolescents

In 2015, compared to other countries in Europe, 15-16 year-olds in Norway were among the lowest groups in terms of ever drinking, drinking during the last 30 days, and having drunk five alcohol units or more during the last drinking episode in the last 30 days. Results from all the European participating countries can be found on the ESPAD website.

Illicit drug use: Status and trends

Data sources and definitions

Data on illicit drug use in the population are collected from annual surveys carried out by the Norwegian Institute of Public Health in collaboration with Statistics Norway and the European School Survey, ESPAD. Seizure statistics from Kripos contain both customs and police seizures, plus several studies also provide information, see references.

We define narcotics as illicit drugs. Some prescription medicines are defined as psychoactive substances and some are sold illegally.

  • Cannabis is the most used illicit drug by the Norwegian population.
  • Cocaine is the second most used illicit drug, followed by ecstasy/MDMA and amphetamines. This is shown by studies both in the general population and in the nightlife arena. There is believed to have been an increase in the use of ecstasy/MDMA in recent years, which is reflected in an increase in seizures.

Use of illicit drugs

Cannabis

Cannabis is the most widespread illicit drug in Norway. Figure 7 shows the results from the annual population surveys for the period 2014-2016. In the age group 16-64 years:

  • Approximately one in five people (20 per cent) reported ever having used cannabis
  • Approximately 4 per cent reported having used cannabis during the last 12 months
  • Less than 2 per cent reported having used cannabis during the last 4 weeks
Alcohol_figure6_FHR.jpg

Figure 7. Percentage of 16-64 year-olds who reported using cannabis in their lifetime, during last 12 months and last 4 weeks, 2014–2016. Source: Norwegian Institute of Public Health; NIPH.

More men than women use cannabis. In 2014-2016, a quarter (25 per cent) of men reported that they had ever used cannabis compared to a sixth of women (17 per cent), see Figure 8. The proportions who reported cannabis use in the last 12 months and last 4 weeks were around twice as high among men compared to women.

Alcohol_figure9_FHR.jpg

Figure 8. Percentage of men and women 16-64 years who reported using cannabis in their lifetime, last 12 months and last 4 weeks, 2014, 2015 and 2016 combined. Source: Norwegian Institute of Public Health; NIPH.

Cannabis use among adolescents and young adults

Cannabis use is most common in the youngest age groups, see figure 9.

Alcohol_figure10_FHR.jpg

Figure 9. Percentage by age groups who reported having used cannabis during the last 12 months and last 4 weeks, 2014, 2015 and 2016 combined. Source: Norwegian Institute of Public Health; NIPH.

 

About 7 per cent of 15-16 year-olds report ever having used cannabis, according to the European School Survey, ESPAD from 2015 (figure 9). Two per cent of 15-16 year-olds reported that they had used cannabis during the last 30 days.

Since 2000, there has been a decline in the proportion of 15-16 year-olds who report having used cannabis, see figure 10. This trend is confirmed by other studies from Norway (e.g. NOVA, 2012).

Alcohol_figure8_FHR.jpg

Figure 10.  Percentage of 15–16 year-olds who reported having used cannabis ever and during the last 30 days, 1995–2015. Source: Norwegian Institute of Public Health.

Cocaine, amphetamine and ecstasy/MDMA use among adolescents and young adults

Between 4 and 7 per cent in the 16-34 year age group report ever having used stimulants in the form of cocaine, amphetamines or ecstasy / MDMA. This is shown in the annual population surveys from 2014-2016, see the figures in Figure 11. Both cocaine and ecstasy / MDMA account for an increasing proportion of police and customs seizures in recent years (Kripos, 2016).

Alcohol_figure7_FHR.jpg

Figure 11. Percentage of young adults aged 16-34 years who reported having used psychoactive substances ever and during the last 12 months. 2014, 2015 and 2016 combined. Source: Norwegian Institute of Public Health; NIPH.

Use of illicit drugs in nightlife settings

The use of illicit drugs in the nightlife seems high compared to the general population, according to a survey carried out among people outside venues during the evening / night in Oslo (Nordfjærn, 2016):

  • 67 per cent of the 1099 respondents had used an illicit drug once or more and 43 per cent had used something during the past year.
  • 25 per cent had used cocaine once or more and 14 per cent had used it during the past year.
  • 19 per cent had used ecstasy / MDMA once or more and 11 per cent had used it during the past year. 

The percentage who reported having used illicit drugs was higher among men than among women and higher among younger people than the older. The average age in the sample was 27 years. 

Trafficking and availability

There has been a decline in the number of drug seizures in the last two years (Kripos, 2016). The decline came after an increase over a six-year period and may reflect changes in the smuggling of various drugs and priorities in the police and customs. Changes from one year to another must be interpreted with caution since natural variations and large individual seizures can have a major impact on the statistics. 

Cannabis use among European adolescents

Among Norwegian adolescents, cannabis use is low compared with other countries in Europe, according to figures from the European School Survey, ESPAD. Approximately 35 per cent of 15-16 year-olds in countries like France and the Czech Republic reported having ever used cannabis in 2015, compared to 7 per cent in Norway (ESPAD, 2016, NIPH, 2016).

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