2023-03-292022/23:SoU19 · p.11SoUHealth & social services
Harm reduction in addiction care and preventive work
Harm reduction and preventive work in drug policy
What's at stake: The issue concerns how quickly and in what way care for people with substance abuse and addiction should offer harm-reducing measures, such as medication treatment and needle exchange, which can affect access to care and the number of deaths from overdoses.
Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.
What the vote decides
The question is whether work on harm reduction and drug-preventive efforts in addiction care should be pushed forward through a formal statement now, or whether the matter should await the ongoing government inquiry on drug policy.
Yes Yes — the committee proposal
The committee refers to the ongoing government inquiry on drug policy, which is to propose measures to strengthen preventive work, examine how harm-reducing measures such as opioid-substitution treatment and needle exchange can be expanded and made more accessible nationwide, and propose a national program against fatal poisonings. Pending the inquiry's report, the committee rejects the motions.
No No — the reservations
Reservation 10 (V, C)
The reserving parties want healthcare to be able to offer medication treatment to a greater extent for people with substance-abuse problems, for access to care, treatment and harm-reducing measures to increase, and for the government to ensure that addiction care follows the principle of harm reduction.
Summarised from the committee report. Party labels in the summary come from the report, not from the vote.
What do the votes mean here?
Yes The committee proposal: rejecting the motions (keeping things as they are).
No Backing the counter-proposal: reservation 10 by V, C.
Abstain The party marks a position of its own that is not one of the two final alternatives.
The decision would have held
Explicit commitments that contradicted the vote: LLiberalerna
Ja 246–42Ja 232–56
Counterfactual: the parties above are moved to the position their own documents explicitly point at, carrying their whole contingent present. Every other party keeps its real figures, including dissenters and absentees.
How the AI parties would have voted
For each party: what its own plan – election manifesto and party programme – argues for in this case, next to how the party actually voted. The AI can only answer Yes or No; a party can also abstain.
| AI | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | No | No 0/21/0/3 | match | confidence: medium | not addressed |
| S | No | Yes 93/0/0/14 | differs | confidence: medium | not addressed |
| MP | No | Abstain 0/0/15/3 | differs | confidence: high | explicit |
| C | No | No 0/21/0/3 | match | confidence: medium | not addressed |
| L | No | Yes 14/0/0/2 | differsagainst own programme | confidence: high | explicit |
| KD | Yes | Yes 15/0/0/4 | match | confidence: medium | not addressed |
| M | No | Yes 59/0/0/9 | differs | confidence: low | not addressed |
| SD | No | Yes 65/0/0/8 | differs | confidence: low | not addressed |
Committee proposal
The Riksdag rejects motions 2022/23:596 by Marléne Lund Kopparklint (M), 2022/23:647 by Niels Paarup-Petersen (C) Claims 2 and 3, 2022/23:733 by Anna Starbrink (L), 2022/23:754 by Nicklas Attefjord (MP) Claim 2, 2022/23:894 by Christofer Bergenblock et al. (C) Claim 44, 2022/23:1498 by Lili André (KD) and 2022/23:1927 by Niels Paarup-Petersen and Alireza Akhondi (both C) Claim 1.
Original (Swedish)
Riksdagen avslår motionerna 2022/23:596 av Marléne Lund Kopparklint (M), 2022/23:647 av Niels Paarup-Petersen (C) yrkandena 2 och 3, 2022/23:733 av Anna Starbrink (L), 2022/23:754 av Nicklas Attefjord (MP) yrkande 2, 2022/23:894 av Christofer Bergenblock m.fl. (C) yrkande 44, 2022/23:1498 av Lili André (KD) och 2022/23:1927 av Niels Paarup-Petersen och Alireza Akhondi (båda C) yrkande 1.
Riksdag decision: The Riksdag rejected approximately 80 proposals in motions submitted during the general motion period 2022. The motions concerned, among other things, the overarching policy for alcohol, narcotics, doping, tobacco and gambling, the so-called ANDTS policy (Alcohol, Narcotics, Doping, Tobacco and gambling). The Riksdag points out that work is already underway to review ANDTS policy. Other proposals concerned changing alcohol legislation, particularly regarding the regulations for serving permits. In this case too, the Riksdag refers to work already underway.
Counter-proposals
- The counter-proposal wants to review alcohol legislation and abolish the requirement for an attached kitchen at serving establishments. (V, C) — Reservation 10
Plan vs actual vote
Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.
The plan requires that care is provided according to need and that you have the right to help quickly regardless of ailment, and that healthcare is equal and accessible throughout the country.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan requires that care is provided according to need and that you have the right to help quickly regardless of ailment, and that healthcare is equal and accessible throughout the country. It also sees drug use as a social problem where the most vulnerable are hardest hit, which speaks for expanded medication-assisted treatment and harm-reduction measures instead of repression. Harm reduction as a guiding principle is not explicitly mentioned, which is why the conclusion is derived.
Original (Swedish)
Planen kräver att vård ges efter behov och att du har rätt till hjälp snabbt oavsett åkomma, samt att sjukvården är jämlik och tillgänglig i hela landet. Den ser också droganvändningen som ett samhällsproblem där de mest utsatta drabbas hårdast, vilket talar för utbyggd läkemedelsassisterad behandling och skademinimerande insatser i stället för repression. Skademinimering som styrande princip nämns inte uttryckligen, varför slutsatsen härleds.
- vulnerable are hardest hitdecisive»Droganvändningen är jämt fördelad över alla samhällsklasser men det är de mest utsatta i samhället som drabbas hårdast.« (2022 manifesto ↗)“Drug use is evenly distributed across all social classes, but it is the most vulnerable in society that are hardest hit.”
- quick care according to need»Du ska ha rätt till hjälp snabbt oavsett om du har brutit benet eller blivit utbränd.« (2022 manifesto ↗)“You shall have the right to help quickly regardless of whether you have broken your leg or burned out.”
- equal and accessible healthcare»Sjukvården måste vara jämlik, jämställd och tillgänglig, oavsett var i landet du bor och oavsett vem du är.« (2022 manifesto ↗)“Healthcare must be equal, equitable, and accessible, regardless of where in the country you live and regardless of who you are.”
- substance abuse as a social problem»Därför måste kriminaliteten ses just som ett samhällsproblem, inte något som händer på vissa platser.« (2022 manifesto ↗)“Therefore crime must be seen precisely as a social problem, not something that happens in certain places.”
The programme demands that all residents throughout the country have equivalent access to healthcare and care, which is the core of the counter-proposal's demand that medication-assisted treatment and harm reduction measures be made available.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The programme demands that all residents throughout the country have equivalent access to healthcare and care, which is the core of the counter-proposal's demand that medication-assisted treatment and harm reduction measures be made available. Children and young people should also have a childhood free from drugs, and the plan wants to combat both crimes and their causes. Harm reduction as a governing principle is not explicitly mentioned, which is why the conclusion is derived.
Original (Swedish)
Programmet kräver att alla invånare i hela landet har likvärdig tillgång till vård och omsorg, vilket är kärnan i motförslagets krav på att läkemedelsassisterad behandling och skadereducerande insatser görs tillgängliga. Barn och unga ska dessutom ha en uppväxt fri från droger, och planen vill bekämpa både brotten och brottens orsaker. Skademinimering som styrprincip nämns inte uttryckligen, varför slutsatsen är härledd.
- equivalent healthcare throughout the countrydecisive»Alla invånare i hela landet ska ha likvärdig tillgång till skola, vård och omsorg.« (party programme ↗)“All residents throughout the country shall have equivalent access to school, healthcare and care.”
- childhood free from drugs»och till en trygg uppväxt fri från droger och våld.« (party programme ↗)“and to a safe childhood free from drugs and violence.”
- combat causes of crime»Bekämpa både brotten och brottens orsaker.« (2022 manifesto ↗)“Combat both crimes and their causes.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The party programme sees abuse as an illness and wants to shift focus from punishment to care, with needle exchange programmes and medication as examples, and establishes that abuse policy shall be based on the methods research has shown most effective to reduce harmful effects.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme sees abuse as an illness and wants to shift focus from punishment to care, with needle exchange programmes and medication as examples, and establishes that abuse policy shall be based on the methods research has shown most effective to reduce harmful effects. Medication-assisted treatment and harm reduction across the country is precisely this. The counter-proposal's demands are therefore supported.
Original (Swedish)
Partiprogrammet ser missbruk som en sjukdom och vill flytta fokus från straff till vård, med sprututbytesprogram och medicinering som exempel, och slår fast att missbrukspolitiken ska utgå från de metoder forskningen visat mest effektiva för att lindra skadeverkningarna. Läkemedelsassisterad behandling och skademinimering i hela landet är exakt detta. Motförslagets krav stöds därför.
- abuse as illness, care before punishmentdecisive»Den enskildas missbruk är en sjukdom och vi vill se« (party programme ↗)“An individual's abuse is an illness and we want to see”
- needle exchange and medication»och att få ett värdigt liv genom sådant som sprututbytesprogram och medicinering. Målet är ett« (party programme ↗)“and to have a dignified life through things like needle exchange programmes and medication. The goal is a”
- harm reduction according to research»lindra skadeverkningarna av missbruk och beroende, både för samhället och för individen Förebyggande arbete ska premieras. Alla som har behov« (party programme ↗)“reduce the harmful effects of abuse and addiction, both for society and for the individual. Preventive work shall be prioritized. Everyone who has a need”
- increased access to care»satsa på primärvården och öka tillgången till vård för psykisk ohälsa.« (2022 manifesto ↗)“invest in primary care and increase access to care for mental illness.”
The stance rests on the quoted commitment in the party's own documents; the actual vote deviated. Click the quote to verify it in the document.
The party programme establishes that people with substance abuse problems shall receive the support they need and that healthcare shall be based on science and proven experience throughout the country, which speaks for more medication-assisted treatment and better access to harm reduction measures.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme establishes that people with substance abuse problems shall receive the support they need and that healthcare shall be based on science and proven experience throughout the country, which speaks for more medication-assisted treatment and better access to harm reduction measures. The election manifesto furthermore wants the person seeking help to be met with a simple and unified pathway into healthcare. According to the plan, criminal policy shall also help people towards a new life situation, not just punish.
Original (Swedish)
Partiprogrammet slår fast att personer med missbruksproblem ska få det stöd som behövs och att vården ska vila på vetenskap och beprövad erfarenhet i hela landet, vilket talar för mer läkemedelsassisterad behandling och bättre tillgång till skademinimerande insatser. Valmanifestet vill dessutom att den som söker hjälp möts av en enkel och samlad väg in i vården. Kriminalpolitiken ska enligt planen också hjälpa människor till en ny livssituation, inte bara bestraffa.
- support for substance abusedecisive»psykisk ohälsa eller missbruksproblem måste ha inflytande över sitt liv och få det stöd som behövs.« (party programme ↗)“psychological ill-health or substance abuse problems must have a say in their lives and receive the support they need.”
- evidence-based healthcare»God vård och omsorg i hela landet, baserad på vetenskap och beprövad erfarenhet« (party programme ↗)“Good healthcare and care throughout the country, based on science and proven experience”
- one pathway into healthcare»Den som söker hjälp ska ha en enkel och samlad väg in till vården.« (2022 manifesto ↗)“The person seeking help shall have a simple and unified pathway into healthcare.”
- care before exclusion»stimulera dem som har begått olagliga handlingar till en ny livssituation utan brottslighet« (party programme ↗)“stimulate those who have committed unlawful acts towards a new life situation without criminality”
The party programme explicitly establishes that policy shall be based on a harm reduction principle, that the goal is a zero vision against drug-related suffering and death and that addiction care shall reduce suffering through, among other things, substitution treatment.
Plan documents: party programme
Reasoning and quotes
The party programme explicitly establishes that policy shall be based on a harm reduction principle, that the goal is a zero vision against drug-related suffering and death and that addiction care shall reduce suffering through, among other things, substitution treatment. The counter-proposal's demands for more medication-assisted treatment and addiction care guided by harm minimization are thus the plan's own line. The plan simultaneously maintains zero tolerance towards drug handling, which does not conflict with the demand.
Original (Swedish)
Partiprogrammet slår uttryckligen fast att politiken ska utgå från en skadelindringsprincip, att målet är en nollvision mot drogrelaterat lidande och dödsfall och att missbruksvården ska minska lidandet genom bland annat substitutionsbehandling. Motförslagets krav på mer läkemedelsassisterad behandling och en beroendevård styrd av skademinimering är därmed planens egen linje. Planen håller samtidigt fast vid nolltolerans mot narkotikahanteringen, vilket inte står i strid med kravet.
- harm reduction principle shall guide policydecisive»Politiken ska utgå från en skadelindringsprincip.« (party programme ↗)“Policy shall be based on a harm reduction principle.”
- zero vision against drug deaths»nollvision mot drogrelaterat lidande och drogrelaterade dödsfall.« (party programme ↗)“zero vision against drug-related suffering and drug-related deaths.”
- evidence-based addiction care»Missbruks- och beroendevården ska vara vetenskapligt grundad.« (party programme ↗)“Addiction and substance abuse care shall be scientifically based.”
- zero tolerance for narcotics»Nolltolerans ska råda mot narkotika i alla led av hanteringen.« (party programme ↗)“Zero tolerance shall prevail against narcotics in all aspects of handling.”
The stance rests on the quoted commitment in the party's own documents; the actual vote deviated. Click the quote to verify it in the document.
The plan establishes that addiction care shall be aimed at breaking dependency and providing conditions for a new drug-free lifestyle, and that the goal of drugs policy is a drug-free society with drug-free environments.
Plan documents: party programme
Reasoning and quotes
The plan establishes that addiction care shall be aimed at breaking dependency and providing conditions for a new drug-free lifestyle, and that the goal of drugs policy is a drug-free society with drug-free environments. Directing addiction care to follow the harm reduction principle replaces this goal. The requirement for increased access to care across the country, however, has support in the plan.
Original (Swedish)
Planen slår fast att missbrukarvården ska inriktas på att bryta beroendet och ge förutsättningar för en ny drogfri livsstil, och att målet för narkotikapolitiken är ett narkotikafritt samhälle med drogfria miljöer. Att styra beroendevården att följa principen om skademinimering byter ut detta mål. Kravet på ökad tillgång till vård i hela landet har däremot stöd i planen.
- care that breaks dependencydecisive»Missbrukarvård ska inriktas på att bryta beroendet« (party programme ↗)“Addiction care shall be aimed at breaking dependency”
- drug-free society»Målet med narkotikapolitiken ska vara ett narkotika« (party programme ↗)“The goal of drugs policy shall be a drug-free”
- drug-free environments»drogfria miljöer ska främjas« (party programme ↗)“drug-free environments shall be promoted”
- accessible care across the country»hög kvalitet och erbjudas och vara tillgänglig i hela landet« (party programme ↗)“high quality and offered and be available across the country”
flags: motförslaget innehåller delar som planen stöder
The plan promises over 50 reforms to strengthen social services, schools and addiction care and states that everyone has the right to equal care in good time.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan promises over 50 reforms to strengthen social services, schools and addiction care and states that everyone has the right to equal care in good time. Increased access to medication-assisted treatment across the country aligns with that commitment. The plan's narcotics line is meanwhile repressive, which makes support for harm reduction as a steering principle weak.
Original (Swedish)
Planen lovar över 50 reformer för att stärka socialtjänst, skola och missbruksvård och slår fast att alla har rätt till likvärdig vård i rätt tid. Ökad tillgång till läkemedelsassisterad behandling i hela landet ligger i linje med det åtagandet. Planens narkotikalinje är samtidigt repressiv, vilket gör stödet för skademinimering som styrande princip svagt.
- strengthened addiction caredecisive»Det handlar om över 50 reformer för att stärka socialtjänst, skola och missbruksvård.« (2022 manifesto ↗)“It involves over 50 reforms to strengthen social services, schools and addiction care.”
- equal care throughout the country»Alla har rätt till likvärdig vård – som kan ges i rätt tid och håller hög kvalitet.« (2022 manifesto ↗)“Everyone has the right to equal care - which can be given in good time and maintains high quality.”
- preventive efforts»Samtidigt behövs satsningar på socialtjänsten och skolan för att på sikt förhindra att fler dras in i kriminalitet.« (2022 manifesto ↗)“In the meantime, investments in social services and schools are needed to ultimately prevent more people from being drawn into criminality.”
- restrictive drug policy»Återinföra de specialiserade narkotikapoliserna« (2022 manifesto ↗)“Re-introduce the specialized narcotics police”
flags: citat_migrerat
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan requires strengthened resources to psychiatry, that mental ill-health is detected and treated early and that effective treatment measures are offered to a greater degree, and that care shall be evidence-based.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan requires strengthened resources to psychiatry, that mental ill-health is detected and treated early and that effective treatment measures are offered to a greater degree, and that care shall be evidence-based. Increased access to medication-assisted treatment and harm reduction measures throughout the country follows that direction. The plan does however not address drug policy, so the conclusion is derived.
Original (Swedish)
Planen kräver stärkta resurser till psykiatrin, att psykisk ohälsa upptäcks och behandlas tidigt och att effektiva behandlingsåtgärder erbjuds i högre grad, samt att vården ska vara evidensbaserad. Ökad tillgång till läkemedelsassisterad behandling och skademinimerande insatser i hela landet följer den linjen. Planen behandlar dock inte narkotikapolitiken, varför slutsatsen är härledd.
- access to effective treatmentdecisive»Effektiva behandlingsåtgärder, i form av exempelvis samtalsterapi, bör i högre grad erbjudas för att den psykiska hälsan hos patienten inte ska riskera att försämras.« (2022 manifesto ↗)“Effective treatment measures, in the form of for example talking therapy, should to a greater degree be offered so that the patient's mental health does not risk deteriorating.”
- evidence-based care»landstingen ska tillhandahålla evidensbaserad vård« (party programme ↗)“county councils shall provide evidence-based care”
- resources to psychiatry»Stärka resurserna till psykiatrin« (2022 manifesto ↗)“Strengthen resources to psychiatry”
- early detection and treatment»Tidigt upptäcka och behandla psykisk ohälsa« (2022 manifesto ↗)“Detect and treat mental ill-health early”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
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Sources and documents
- The committee report on riksdagen.se (2022/23:SoU19)
- Committee report full text (HA01SoU19)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2022/23:103 — Regler för alkoholservering av Oliver Rosengren m.fl. (M)
- Motion 2022/23:1055 — Införande av åldersgräns vid köp av produkter och artiklar som innehåller lustgas av Azadeh Rojhan (S)
- Motion 2022/23:1065 — Gårdsförsäljning av alkoholdrycker av Camilla Brunsberg (M)
- Motion 2022/23:1083 — En moderniserad alkohollag av Gustaf Göthberg m.fl. (M)
- Motion 2022/23:1124 — En hållbar besöksnäring av Elisabeth Thand Ringqvist m.fl. (C)
- Motion 2022/23:1373 — Barns rätt till frihet från alkoholreklam på sociala medier av Anna Wallentheim (S)
- Motion 2022/23:1498 — Stärkt narkotikaförebyggande arbete i Sverige av Lili André (KD)
- Motion 2022/23:1536 — Avskaffat krav på matservering för alkoholtillstånd av Bo Broman (SD)
- Motion 2022/23:1548 — Förbud mot filtercigaretter av Patrik Björck (S)
- Motion 2022/23:1573 — Statens statistikansvar på alkoholområdet av Camilla Brodin (KD)
- Motion 2022/23:1604 — En tobaksfri uppväxt av Catarina Deremar (C)
- Motion 2022/23:1609 — Gårdsförsäljning av öl, vin och cider av Stina Larsson m.fl. (C)
- Motion 2022/23:1635 — Företag inom besöksnäringen av Martina Johansson (C)
- Motion 2022/23:1647 — Gårdsförsäljning av Kerstin Lundgren (C)
- Motion 2022/23:1672 — En levande landsbygd för Sveriges bästa av Annie Lööf m.fl. (C)
- Motion 2022/23:1771 — Utredning om hälsovarningar på alkoholprodukter av Jytte Guteland m.fl. (S)
- Motion 2022/23:1776 — Barns rätt till frihet från reklam på sociala medier av Jytte Guteland m.fl. (S)
- Motion 2022/23:1855 — Gårdsförsäljning i Sverige av Sten Bergheden (M)
- Motion 2022/23:1927 — Utvärdering av den svenska missbrukspolitiken av Niels Paarup-Petersen och Alireza Akhondi (båda C)
- Motion 2022/23:1930 — Försäljning av öl och vin i licensierade livsmedelsbutiker av Niels Paarup-Petersen m.fl. (C)
Source: The Swedish Parliament