Scientific Background

Opioid overdoses are a significant health problem in Norway. Despite public health and harm reduction efforts, heroin use and overdoses are still of major concern with an estimated 7,300-10,300 injecting drug users and approximately  260 reported overdose deaths annually.  The training of lay persons with the use of naloxone nasal spray can increase knowledge and availability of this life-saving drug (1). The efficacy and feasibility of naloxone administration by non-health personnel has been demonstrated by several community’s programs (2,3).

Given the compelling evidence supporting peer-administered nasal naloxone interventions, the Norwegian government has supported this initiative.


Project in Norway

This  project is part of the Norwegian government’s 5-year overdose strategy. In attempts to reduce fatal and non-fatal overdoses, a pilot project was implemented in various low-threshold facilities from 2014-2016 in Norway’s two largest cities, Oslo and Bergen. Since the start of the project, it has been expanding and is now available in over 100 distribution locations throughout 30 municipalities.

Staff at existing facilities, such as shelters, needle exchange sites, a consumption room, and day centers are taught to be trainers, being able to distribute naloxone to existing clients.

Other groups who are in contact with people at risk for overdosing have also been trained in the use of naloxone (for example: family support organizations, police, security staff, and others). The project is open to essentially anyone who is interested in learning how to respond.

The Norwegian Health Ministry and Directorate of Health are responsible for this important initiative, and their support has been imperative for the project. The Norwegian Centre for Addiction Research (SERAF) has designed and implemented the project, and is responsible for the continued monitoring and evaluation of this initiative.


Naloxone nasal spray

Given the many benefits of a nasal spray preparation, (reduced stigma; easier administration; reduced risk of transmission of HCV & HIV), Norway has decided to use a nasal spray for the project. The project distributes Nyxoid 1.8 mg single dose nasal sprays presription free to participants.

The Norwegian University of Science and Technology (NTNU) is currently researching naloxone nasal spray.


For more information, please contact:

Philipp Lobmaier MD, PhD
Project Leader
Norwegian Centre for Addiction Research
Tlf. +47 233 68 956

Thomas Clausen MD, PhD
Project Leader
Norwegian Centre for Addiction Research

Desiree Madah-Amiri
Norwegian Centre for Addiction Research
Tlf. +47 233 68 984



  1. Lobmaier PPK, Dalsbø TK, Clausen T. Nasal naloxone may reduce the risk of death from heroin overdose. Nor J Epidemiol 2011; 21 (1): 107-111.
  2. Walley AY, Xuan Z, Hackman HH, et al. Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. BMJ. 2013;346:f174.
  3. Enteen L, Bauer J, Mclean R, et al. Overdose prevention and naloxone prescription for opioid users in San Francisco. J Urban Health. 2010;87(6):931-41.