Sweden has a long tradition of treating drug use primarily as a criminal and social problem. Since drug criminalisation was first codified in 1988, the country has pushed forwards a plan to create a “drug-free society” for decades, leading with policies of zero-tolerance towards use and an abstinence-focused approach to treatment.
But even within these controlled environments, people continue to use drugs; and without options to support safer drug use, people continue to die.
For those of us working directly with people who use drugs, the consequences of Sweden’s drug policy are not abstract. Every day we meet people who are afraid to seek help, who have experienced stigma in healthcare, who struggle to find proper treatment options, and who are at the mercy of illegal and increasingly dangerous drug markets.
For almost two decades, Sweden had a drug user union. From 2002, the Svenska Brukarföreningen (SDUU) fought for the rights of people who use drugs, running five city chapters as well as national organisation. The organisation stopped their operations in 2020 due to financial issues.
The new Drug User Union, called the Föreningen för Human Ruspolitik Sverige (Association for Humane Drug Policy) came together for the first at the Nordic Reform Conference in September 2025 organised by the Association for Safer Drug Policies and Foreningen Tryggere Ruspolitikk. However, FHR only formally launched earlier this August, establishing one single national organisation rather than city chapters, and integrating old SDUU members.
Our pillars of advocacy
Our work is built around four closely connected priorities:
- A humane drug policy;
- Person-centred Opioid Agonist Therapy (OAT) care – known as LARO in Sweden;
- Supervised consumption rooms and drug checking;
- Genuine user involvement in decisions about treatment and drug policy.
This is why we believe that people who use drugs must have a meaningful voice in shaping drug policy. Swedish drug policy needs to move away from punishment and towards health, human rights and evidence.
Sweden’s commitment to a drug-free society has increasingly come at odds with growing drug-related deaths and mounting global evidence of drug policy reform’s efficacy in dealing with drug-related issues.
People who use drugs face a highly criminalised environment, with high penalties for drug possession. This can mean that seeking help is complicated by fear of judgement, police involvement or criminal consequences.
We believe that people should be able to seek healthcare without being treated as criminals.
A humane drug policy does not mean pretending that drugs are harmless. It means recognising that people will continue to use drugs and that the most effective response is one that keeps people alive, reduces harm and gives people opportunities to improve their lives.
Sweden has made progress in some areas of harm reduction. Needle and syringe programmes now exist across the country; access to OAT and take-home naloxone programmes has also greatly improved in the past decade. These developments demonstrate that Sweden can change when there is a willingness to put public health before ideology.
But much more needs to be done.
Person-centred OAT care
One of our most important priorities is improving our OAT system. Treatment should be built around the individual person, not based on a rigid system where everyone is expected to respond in the same way.
People have different histories, different bodies, different patterns of drug use and different treatment needs. There should therefore be greater access to different medication options within OAT, allowing treatment to be adapted when one option does not work well enough. We also believe there needs to be greater access to individual risk-benefit assessments when additional treatment is needed.
For some patients, anxiety, insomnia or other problems can make it difficult to remain in treatment. In carefully assessed individual cases, additional medications — including medicines such as benzodiazepines where clinically justified — should be considered as part of a broader treatment plan.
This is not an argument for indiscriminate prescribing. It is an argument for enabling doctors and patients to make individual, evidence-informed decisions about risks and benefits.
The goal should be to make healthcare a realistic alternative to the illegal drug market.
If a person cannot get treatment that meets their needs, they may eventually return to an unregulated market where the contents and strength of drugs are unknown. A treatment system that is flexible enough to meet individual needs can therefore also be a harm reduction intervention. People should be able to choose healthcare over an illegal market.
Supervised consumption rooms and drug checking
We also believe Sweden needs to introduce supervised drug consumption rooms. A person using drugs alone in a public toilet, stairwell or private room may have nobody nearby who can respond if they overdose. In a supervised consumption facility, trained staff can intervene immediately and connect people with healthcare and other support.
These facilities are not about encouraging drug use. They are about preventing avoidable deaths and creating a point of contact with people who may otherwise remain outside the healthcare system.
Drug checking is another important part of harm reduction. Today, people can buy substances on an illegal market without knowing exactly what they contain or how strong they are. The risks have increased as drug markets have become more unpredictable.
Providing people with information about the contents of drugs does not mean encouraging their use. It means giving people information that can help them make safer decisions.
We believe Sweden should move from a model where people are expected to simply avoid drugs to one where society also takes responsibility for reducing the risks faced by those who do use them.
People who use drugs must have a voice
The final part of our work is perhaps the most important: meaningful user involvement.
People who use drugs are often discussed by politicians, doctors, researchers and authorities. Yet the people with direct experience of drug use and drug treatment are too often missing from decision-making spaces.Their voices should not be treated as an optional addition to policy discussions. They should be part of the decision-making process.
Lived experience is knowledge. People who have experienced OAT first-hand know what works and what doesn’t. People using harm reduction services know what the barriers are to increasing access. People who have experienced stigma in healthcare know what needs to change so they feel more welcoming.
That is why we work to strengthen the Swedish drug user movement and create opportunities for people who use drugs to organise, speak publicly and influence policy.
We also want to strengthen international cooperation with drug user organisations, harm reduction groups and human rights organisations. Conferences and international meetings allow us to share experiences, learn from developments in other countries and bring the Swedish experience into the wider international drug policy debate.
A different direction for Sweden
We do not believe there is a single solution to every problem related to drugs. But we do believe there is a better direction than what Sweden’s taken. Our country needs a drug policy based on humanity rather than punishment, healthcare rather than fear, and evidence rather than ideology.
It needs treatment that acknowledges individual needs. It needs more harm reduction that reflects drug market realities. It needs supervised consumption rooms and drug checking. And it needs to recognise people who use drugs as experts by experience and as citizens whose voices matter.
People who use drugs are not simply statistics or problems to be solved. They are people with families, relationships, hopes and futures. Each life lost represents an ended member of our community. If Sweden is serious about reducing drug-related deaths and improving public health, it must listen to the people most affected by its policies, and build a field where those most impacted have a real chance to shape their future.
