Ten years ago, Norway had one of the highest overdose mortality rates in Europe. They therefore decided to change tactics, and stopped trying to tackle the problem by simply banning and criminalising the use of hard drugs. Since 2022, a treatment programme for opioid addiction based on the medical prescription of heroin has been undergoing trials in Oslo and Bergen – practices already in place in Switzerland, Denmark, the Netherlands, Germany, Luxembourg and the United Kingdom. Kjersti works at one of the two clinics that treat drug users and provide them with doses of heroin.
© Victoria Stampfer — Sphera Network
OSLO, 8 JULY 2026
The clinic opens at 8am. This morning I saw Nils*. When he’s in a good phase, which he’s been for some time now, he comes here in the morning, gets his heroin injection, and then goes to work— he cleans the streets with an NGO that offers work for people with addiction backgrounds. Then he comes back in the afternoon to take his second shot and heads to his apartment. He does this 5 days a week.
When Nils first started here, he was constantly psychotic. He was very, very confused, and could walk around without clothes on in the streets. He was also under the delusion that there was something underneath the building that he needed to get. Nils still has big cognitive problems, due to past overdoses, but he dresses like you and me and lives a much more stable life than a few years ago.
When you have an opioid dependency, it’s really hard to live a stable life.
With heroin, you first have to find and pay for the illegal drug, and you need 5 or 6 doses a day.
In Norway we’ve been giving substitution therapies for opioid dependence for at least 25 years now. These therapies greatly enhance the lives of people with opioid dependency. It reduces the risk of death, of illness, and overall drug consumption. But for some people it doesn’t work. So for them, we are trying something different (since 2022, clinics in Oslo and Bergen have been trialling a heroin-assisted treatment programme, in which patients are given prescribed doses of heroin, editor’s note).
Our clinic is open from 8am to 5pm, every day, all year round. The first patients come in at 8, they go to the waiting area where they can pour themselves a cup of coffee or have something else to drink. Adjacent to this waiting area, is the nurses’ room. If they need any other medication, if they’re on antibiotics or anything else, they will get it there. We try to give as comprehensive care as we can in our clinic, and we also have two social workers helping with housing services or social benefits, for instance.
Each time a patient comes in, a nurse carries out an evaluation of how much medicine they need and how much heroin they need. We have to find out if they’ve already taken heroin or other medication before they arrived. And sometimes you have to reduce the doses so that they don’t have an overdose here.
When the assessment is done, they go into our injection room, where there are booths with syringes, needles and alcohol. The heroin clinic is located within the specialist addiction ward in the hospital. So it’s a very sterile environment.
And there, they’re delivered their daily dose of pure heroine in a syringe.
They set their injections themselves. Quite a few of them have damaged their veins throughout the years and find it really hard to find a good spot to set their dose intravenously. So we often have to say “Okay, you’ve tried so many times now that you need to set it in a muscle instead.” We give them some guidance. And the injection is observed by a nurse as well.
Eventually, they head to the observation area where there’s some food and drink and where they can sit. We ask them to stay here for at least 20 minutes so that we can monitor any risk of overdose or other problems and we can intervene when necessary. After that, they leave and they come back again in the afternoon to get a second dose and medication that will last until the morning.
Even if we notice a stabilization in drug consumption, the key to this treatment is still heroin. That is why the patient comes in the first place. In the field of addiction, we haven’t been open enough to acknowledge that for people with huge traumas, with lots of anxiety and depression, it’s not just the physical effect they’re craving for, it’s the relief, the 20 minutes when their thoughts and emotions are gone.
Many of our patients have described that when they’ve had methadone treatment or ordinary substitution therapies, they don’t get that daily escape they’re looking for.
Here they get it, but they can only come twice a day. That’s the paradox of this treatment. It is offered to the patients that have the most severe addiction problems, meaning people who also lead very hard lives often with lots of somatic diseases, unstable living conditions, psychiatric diseases… and to ask them to come to the clinic every day throughout the year, twice a day, really is hard work for them. It’s not for everyone and it does not work with everyone.
But this structure is also the key. By seeing the patients that often, we develop relationships and we come into a position where we can build trust and help with all sorts of other things. It’s not just about heroin, but about the life you’re able to build outside the clinic.
Many of those who’ve been here for some time have become stabilized. They’ve come from being very marginalized to having a stable housing situation, having daily activities, reconnecting with their families… Of course it takes time, sometimes a year or two before we see changes. And of course it goes up and down. It’s not a cure. But then we just have to remember how it was two years ago.
*the name was changed
— KJERSTI
Toolkit:
🛠️ Resources for finding help:
🇫🇷 In France, Drogues Info Services is the national remote support service for drugs and addiction, offering a helpline and an online chat service. The centres for addiction treatment, support and prevention (CSAPA), listed on the ANPAAwebsite, also offer support to people struggling with all forms of addiction.
🇩🇪 In Germany, you can find an addiction support centre on the sozial plattform
🇮🇹 ITARDD (Italian Harm Reduction Network) coordinates and supports risk-reduction efforts in drug-use settings, such as festivals, free parties, and music events, and also operates street outreach teams.
🇨🇭In Switzerland, the SafeZone.ch platform offers free and anonymous online consultations on addiction to those affected, including parents, loved ones, professionals and anyone interested – Arud is one of the leading institutions in the field of addiction medicine in Switzerland – Le Quai 9 is a drug consumption room that has been open in Geneva since 2001.
Our picks
A book, a documentary and a series to encourage further reflection:
“Go Ask Alice” is one of those books that marks a whole adolescence. Written as a diary, it makes painfully real what goes on inside the head of someone caught in addiction. You feel her fighting the whole way through, between relapses and flickers of hope. A raw, deeply human read.
— Recommended by Dorine, project manager
”All the beauty and the bloodshed” by Laura Poitras is a beautiful and gut-wrenching documentary that dives into the famous photograph Nan Goldin’s battle against an American big pharma company involved in the opioids crisis in the US. Nan Goldin’s work is beautifully intertwined with protest images and trial extracts. Recommended by Agathe, impact and marketing manager
— Recommended by Agathe, impact and marketing strategy
“Dopesick” is a genuine thriller. The cinematography is stunning, and the series skillfully weaves together the political, financial, and judicial threads of the opioid crisis. The result: the actual care and medicine at the heart of the story end up almost forgotten along the way.
— Recommended by Dorine, project manager
