Pubdate: Thu, 08 Aug 2002
Source: New York Times (NY)
Copyright: 2002 The New York Times Company
Contact:  http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Warren Hoge

IN SCENIC NORWAY, FEARFUL DEATH SCENE OF ADDICTS

OSLO, Aug. 2 - It is a sunny morning, and the Oslo Fjord dances with 
reflections. Festive pennants flutter from a departing North Sea ferry, 
bicyclists pedal past the colonnade of the stock exchange building and 
sleek trams glide by, filled with downtown workers.

Oslo, capital of oil-rich Norway, is springing to daily life, but there is 
little movement from shabby clutches of people who have also become part of 
this harborside landscape. They slump in a row by a derelict corrugated tin 
warehouse and lie curled up on the surrounding docks. Their bodies are 
emaciated, and their faces are as spent and vacant as any that Edvard 
Munch, the Norwegian artist of angst, ever painted. Many are asleep, others 
nod their heads listlessly.

One young man in black shirt and trousers does not stir. He is the latest 
entry in a tabulation this prosperous city takes no satisfaction in 
topping: Europe's drug overdose capital.

A report from the Council of Europe's narcotics-monitoring Pompidou Group 
says Oslo is first among 42 European cities in seizures and deaths caused 
by drugs. Oslo had 115 such deaths last year, down from a peak of 134 in 
1998, but still the highest on the Continent. In Norway as a whole, the 
toll is rising, with 338 deaths in 2001, up from 75 in 1990.

The figures are starkly at odds with the travel brochure image of Norway as 
a land of serene mountains and fjords, and with customary survey results 
like a human development report by the United Nations last month that found 
it to be first in the world in income, health care, life expectancy and 
education.

The overdose findings have caused a debate here that has pitted the 
region's traditional notions of clean-living morality against its instincts 
for protecting social outcasts.

While politicians dither, addicts by the hundreds openly buy drugs in 
Oslo's central plaza and walk the two blocks back to the fjordside shooting 
gallery, pull out their tourniquets and needles and get high in public.

"I've overdosed, and all these people have too, many times," said 
Christian, 32, a lank-haired blond in white tennis shorts and polo shirt 
who said he had been addicted for 19 years. He held a cotton swab to his 
ankle where he had just injected himself with his morning hit - the first, 
he said, of what could be seven shots to get through the day.

"I come here because these people are my friends, and if I pass out, one of 
them will call for help," he said. "What none of us will do is shoot up alone."

As he spoke, a team of ambulance paramedics succeeded in reviving the man 
in black. "That guy called them," Christian said, pointing at a man 
stretched out on the pavement clutching a cellphone.

The main reason the overdose and death rates are so high here is that 
Norwegian addicts inject heroin rather than smoking it, as is common 
elsewhere in Europe. Norway's 14,000 heroin users then up the odds even 
higher by mixing the drug with alcohol and the nervous system depressant 
Rohypnol.

Asked to explain why these dangerous practices caught on here, Norwegians 
refer to their particular history of hard drinking and of zealous 
temperance movements, which brought a ban on alcohol in the 1920's and have 
restricted liquor sales to this day.

A habit emerged during prohibition of drinking the strongest liquor 
possible - and lots of it - the moment one got hold of it. Roar Staale 
Alstadius, a health worker with the city's overdose team, said the parallel 
between the bigger rush from injected heroin and binge drinking could 
explain why Norway's heroin users take drugs intravenously.

Norway's first generation of addicts, in a market where the drug was rare 
and expensive, also chose the method that produced the biggest hit from the 
smallest amount.

Norway compounded the problem by being slow to turn to the heroin 
substitute methadone for treatment. "Norwegians believe in self-sufficiency 
and independence," Mr. Alstadius said. "The idea was always you had to 
fight to get yourself off drugs; you had to work for it, not just trade one 
dependency for another."

Some methadone was made available in 1997, but waiting periods have 
stretched past two years. Parliament is expected to approve a measure in 
October to make methadone available to more than 2,000 people by the end of 
this year.

Views about how to counteract addiction vary here, as in most places. Arne 
Huuse, the director of the National Criminal Investigation Service, said in 
an interview that he would like to put addicts on a northern island until 
they are clean. The other end of the spectrum is a group of outspoken 
professors at the University of Oslo who want drugs furnished free to 
addicts and their use decriminalized.

The official goal remains making Norway drug free, but the government also 
tries to reduce the harm to users by providing them with housing, benefits 
and clean conditions for taking drugs.

Police cameras monitor the drug trafficking in a tree-lined area of the 
Central Station park known as plata (the slab). But though possessing, 
using and peddling heroin are all illegal and subject to harsh punishment, 
officers are sent in only when scuffles break out or obviously under-age 
people appear.

Every night a "needle bus" parks at a downtown intersection to provide 
users with antiseptic syringes, and this month a pilot project "injecting 
room" opens in a Norwegian church mission blocks from the harbor.

"We are a very rich country," said Kjell Erik Oie, director of health and 
welfare for the mission. "We have lots of money and cars, and we change 
houses and flats the way some people change shirts. We can't ignore the 
poor conditions under which these people live."

The city ambulance service says keeping the drug users to one area helps 
protect them. "When the police used to chase them from one place to 
another, we couldn't find them as easily, and when we did, it was in places 
like schoolyards and playground sandboxes," said Arne Henriksen, director 
of emergency medical services.

Morten Mjelve, assistant director general of the city Department of Social 
Affairs, said, though, that his office opposed leaving the users in one 
known place because it gave young people an easy way to get drugs. "They 
all know where plata is; they go there on weekends, and while they don't 
get heroin, they get what they call `party packs' - collections of things 
like Ecstasy, cannabis, amphetamines, GHB and Rohypnol," the last two 
associated in the United States with date rape - "and they become potential 
recruits for harder drug taking."

Knut T. Reinaas, leader of the League Against Intoxicants and adviser to 
the city government, said he knew addicts who had experienced 20 overdose 
seizures but were still shooting up. "Remember," he said, "the crossover 
world between life and death is the very place they want to reach."
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MAP posted-by: Larry Stevens