Billions Lost through Foreign Gambling Websites

currency iceland

Icelanders spend an estimated ISK 20 Billion [$146 Million, €134 Million] on foreign gambling websites every year. This leads to a tax revenue loss of up to ISK 7 Billion [$51 Million, €47 Million], according to the CEO of one of Iceland’s six legal gambling operations.

Addiction a problem

In an interview with Morgunblaðið, Bryndís Hrafnkelsdóttir, CEO of HHÍ, a gambling operation whose proceeds fund the University of Iceland, said that foreign gambling websites like Coolbet, Bet365, and Betsson operate without public oversight and that their proceeds do not benefit Icelandic society.

“Authorities need to take on illegal gambling, which has been allowed to happen in Iceland for too long,” Bryndís said, adding that gambling addiction is a big problem in Iceland, especially among young men. “The problem doesn’t disappear if we introduce harm reduction for addiction and will only increase if nothing is done. The gamblers will find another way and move from legal gambling to the illegal foreign sites which will cause money to stream out of the country instead of going towards good causes domestically.”

Profits for social causes

HHÍ has been operating for 90 years and funds the building and maintenance of the University of Iceland’s campus. Six Icelandic companies have a license for gambling operations in Iceland and their proceeds all go towards social causes, such as education, youth groups or sporting activities.

Icelandic App To Help People Quit Opiates Getting International Attention

A new Icelandic app, created with the help of doctors and designed to help those prescribed addictive substances such as opiates ween themselves off of them safely, is starting to gain traction abroad, RÚV reports.

Simple but crucial

The app in question, Prescriby, is available in both Icelandic and English, and its implementation is fairly straightforward. By entering the name of the drug in question, the number of weeks it is to be taken, and how many doses per day the app calculates a scheduling of dosages for the patient.

This is critically important, as some medications, like opiates, can cause physical addiction in as little as 30 days of daily use. Sudden cessation can cause withdrawal symptoms, which can lead to relapses or, in the case of long term use, withdrawal can be fatal if not managed correctly.

“Prescriby takes a proactive approach to addictive medication management which is essential to realizing better outcomes for patients and the health care system,” the app’s creators state on their site. “Our program is an adaptive model, combining best practices with clinically validated software that integrates with clinical workflow.”

International traction

The app has been in use at the pharmacy Reykjanesapótek for some time now, and has reportedly been serving patients well. It will also be put into practice in Canada next week, and then in Denmark later in the year.

Kjartan Þórsson, creator of Prescriby and himself a doctor, emphasised the necessity of the app to reporters.

“Most people that I speak with have some kind of story, either about a relative or themselves, who have been sent home with a hundred Contalgin [morphine] tablets, or what have you,” he said. “And there’s no plan in place. We’re letting people get some of the most addictive substances in the world and we don’t even have a plan. So we’re trying to change that.”

2023 Could See a Record Number of Addiction-Related Deaths

The Medical Director of SÁÁ (National Centre of Addiction Medicine) fears that 2023 could see a record number of addiction-related deaths. Among former clients of the Vogur detox centre and rehabilitation hospital, thirty-five people have died so far this year, RÚV reports. The Minister of Health says that action must be taken.

Thirty-five addiction-related deaths this year

As reported by RÚV yesterday, 35 people struggling with substance use have died so far this year. Dr. Valgerður Rúnarsdóttir, the Medical Director of SÁÁ (National Centre of Addiction Medicine), fears that a record number of deaths could occur this year.

As noted by RÚV, social media has been abuzz with rumours about drug-related deaths recently, with some rumours suggesting that 15 people have died from addiction-related problems in the past two weeks, while others maintain that there have been 36 addictio-related deaths since the start of the year.

No confirmed figures for this period are available from the Directorate of Health, which collects statistics on causes of death in Iceland. It is, however, known that thirty-five former clients of the Vogur detox centre and rehabilitation hospital – aged fifty and younger – have died this year.

“We know that these people are struggling with addiction, and there is every chance that these deaths are related to their addiction, Valgerður Rúnarsdóttir, the Medical Director of SÁÁ (National Centre of Addiction Medicine), told RÚV.

Read More: In Harm’s Way (Opioid Addiction in Iceland)

When asked if these figures, which have done the rounds on social media, were accurate, Valgerður responded thusly: “Yes, I think these figures are real. But I hope that they don’t reflect an ongoing trend for the rest of 2023.

Valgerður fears that if this trend continues, many more people will die this year than when compared to the last five. It is difficult to say what explains the rising numbers.

“However, we know that there is a large increase in opioid addiction, especially among this younger group. It is a very dangerous addiction. These strong painkillers, Oxycontin and Contalgin, which are primarily being used in Iceland, they’re extremely lethal.”

Harm reduction

Frú Ragnheiður is a specially-equipped medical reception vehicle that cruises the capital area six evenings a week and operates according to the philosophy of “harm reduction.” It focuses on the consequences and risks of drug abuse over abstinence. The past few days have seen an uptick in the number of people seeking Frú Ragnheiður’s services, according to Hafrún Elísa Sigurðardóttir, harm reduction team leader at the Red Cross.

“People are scared and want to be informed. We try to educate our clients as much as we can regarding dose sizes and the effects that these substances have on users. We also encourage them to carry Naloxone (a drug designed to rapidly reverse opioid overdose) with them at all times,” Hafrún told RÚV.

Rumours on social media have also claimed that there are now substances in circulation where the morphine-related drug Fentanyl is being mixed with other substances, such as LSD, Oxycontin, and cocaine. Such drugs have proven extremely dangerous, for example, in the United States.

Hafrún told RÚV that it was impossible to confirm that such substances were in circulation, but that the team at Frú Ragnheiður was concerned. As were its clients.

“We need to listen”

When asked to respond to the rising number of addiction-related deaths, Minister of Health Willum Þór Þórsson told RÚV that it was “sad.”

“We have to listen. Something in our society is changing. It’s obvious,” Willum observed.

The minister also stated that more needed to be done. For example, the withdrawal treatment provided at the Vogur detox centre and rehabilitation hospital ​​needed to be strengthened.

“We have been talking about decriminalisation for a long time. I think we need to go a step further in harm reduction measures; we have discussed morphine clinics. It is an obvious prevention against the risk of infection and a great support for people to have a consumption space. We need to find a place for that.”

Risk of Overdose Rises Following Closure of Iceland’s Only Safe Injection Site

Iceland’s only safe injection site, a temporary project operated by the Icelandic Red Cross, shuttered on March 6. A Red Cross employee told RÚV such sites decrease the risk of overdose among intravenous drug users in addition to saving funding within the healthcare and social service system. Over 100 individuals used the safe injection site within the last year, many of them unhoused, during over 1,200 visits.

Ylja, as the safe injection site was called, opened in May of last year and was a temporary pilot project operated by the Icelandic Red Cross. Like safe injection sites abroad, Ylja offered a safe environment for those 18 years of age and older to inject intravenous drugs under the supervision of trained nurses, who ensured sanitation, safety, and infection prevention practices were followed. Safe injection sites are a harm reduction service that can prevent overdose and death among users of intravenous drugs. They can also connect clients to other essential services they may require.

Assists a marginalised group and saves public funds

“We need housing and the funding to pay for it, in order to operate a safe injection site. There is a lack of political will to approve it,” stated Marín Þórsdóttir, the department head of the Icelandic Red Cross’ capital area department. In 2015 and 2022, the Icelandic parliament shelved bills to decriminalise drug possession for personal use. Minister of Health Willum Þór Þórsson promised to submit a new, revised bill last autumn but has yet to do so.

Marín adds that with Ylja’s closure, the Red Cross loses staff that is specialised in harm reduction, primarily nurses. While operating a safe injection site requires considerable funding, Marín says it ultimately saves public funds. “We are tending to a very marginalised group that receives little service, experiences perpetual discrimination in society, and it’s just savings, both within our healthcare and social services system by having a safe injection site and assisting people with harm reduction resources.”

Read more: In Harm’s Way

Economic and social factors appear to impact drug use in Iceland, according to the research of Dr. Arndís Sue-Ching Löve, an assistant professor at the University of Iceland. Her studies show that cocaine use decreased in Iceland during the COVID-19 pandemic, but increased again last year to around pre-pandemic levels. The increase may be partially explained by increased prosperity: a similar pattern was seen before the banking collapse in Iceland.

More Unhoused People Spending Majority of Year in Shelters

homelessness in reykjavík

The number of unhoused individuals dwelling in emergency shelters has increased. These individuals are also dwelling in shelters for longer than before, RÚV reports.

An inquiry from a representative of the People’s Party

As noted in a response from the Reykjavík City Welfare Council to an inquiry from a representative of the People’s Party, the number of unhoused individuals dwelling in emergency shelters for a large part of the year has increased significantly over the past two years. There were 317 people dwelling in the city’s shelters in 2020; last year, that number had risen to 390.

Discussions have begun between the City of Reykjavík and the Ministry of Health to find appropriate resources for this group.

“The city’s policy is that unhoused individuals requiring great, complex services should not stay in emergency shelters for more than three months a year on average. The trend has reversed in recent years, with the number of people staying in emergency shelters for more than 90 days having increased: up from 44 in 2020 to 76 in 2022. There has also been a significant increase in the number of people staying in emergency shelters for the majority of the year. In 2020, there were thirteen who stayed there for more than six months, while in 2022 there were 29.”

The welfare council’s response states that the government is currently looking for ways to respond to this development. It is often the case that those staying in emergency shelters need nursing care. Discussions are underway with the Ministry of Health to find these individuals suitable care.

A certain sign of a “lack of resources”

Last November, RÚV spoke to Svala Jóhannesdóttir, a harm-reduction expert and one of the founders of Matthildur (an organisation for harm reduction), who stated that the fact that people struggling with addiction were increasingly looking to parking garages for shelter showed “a lack of resources for the unhoused.”

The article noted that for seven hours a day, unhoused men had no shelter, with the parking garage on Vesturgata having become a popular site of injection for individuals struggling with addiction. The garage is adjacent to a health clinic, which hired a security guard after an employee was assaulted in the parking garage.

“This is a natural manifestation of a certain lack of resources that exists in services to unhoused individuals in the capital area. Nobody looks in a car basement or a parking garage unless they have nowhere else to seek shelter,” Svala observed.

In Harm’s Way

Gunni Marís On Thursday, November 25, 2021, I left a COVID testing clinic near the Kringlan shopping centre in Reykjavík. Stepping into my car, the phone rang and an unknown number appeared on the screen. I listened as the voice of an old acquaintance, meek but quietly upbeat, worked its way through the speaker. We […]

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Will Submit a Revised Decriminalisation Bill this Autumn

Minister of Health Willum Þór Þórsson

Iceland’s Health Minister Willum Þór Þórsson says he will submit a revised bill to decriminalise possession of illegal substances in small quantities, RÚV reports. Willum has faced criticism for withdrawing his decriminalisation bill from Parliament’s spring agenda. He says the bill is now being reviewed by a group that includes specialists on the matter.

Read More: Disappointment as Health Minister Shelves Decriminalisation Bill

MPs and rights organisations have criticised the Minister’s decision to drop the bill from Alþingi’s spring agenda. Willum says that the working group will collect data, define terminology, and better organise the issue. They are expected to finish their work by the end of this month. He added that while there has not been consensus on the bill within Parliament, he believes the working group will help solve existing disagreements.

“I have put the matter into a very broad consultation, which is what is often called for, and then I intend to introduce it in the autumn session, which is only five months away,” the Health Minister stated.

Icelandic Police Struggle to Reach Marginalised Group Exposed to COVID-19

Police officers in masks

A group of active drug users gathered in a house that later caught fire last week, Vísir reports. Two in the group tested positive for COVID-19 after the incident and police are working to find others in the group who may have been exposed. It’s proved a challenging task, as some of the individuals are homeless.

Capital area police have been working to find and contact nearly 20 individuals who could have been exposed to the SARS-CoV-2 virus at the apartment. “We’ve been contacting their groups and trying to meet them, invite them to get tested and try to explain to them what resources are available and then also try to inform them if they have been exposed and should be in quarantine, what that means and so on,” stated Ásgeir Þór Ásgeirsson, Chief Superintendent of the Capital Area Police.

Police have offered housing to those who must quarantine in a newly-opened government quarantine facility, the third to be established in the capital area. The new facility is specifically intended to house marginalised groups such as homeless individuals and those struggling with addiction. Ásgeir stated that police are doing everything they can to reach members of the group and ensure they receive the same service as others.

Healthcare Limited for Marginalised Groups

Guðmundur Ingi Þóroddsson, chairman of prisoner’s association Afstaða is concerned about the situation of active drug users, homeless people, and former prisoners in Iceland, particularly in light of the pandemic. “They have limited access to general health services and there are no treatments available for this group,” he stated, adding that there are indications that drug use has increased, illegal drugs have become more expensive and it has become more difficult for those using drugs to access healthcare. Though he says the opening of the quarantine facility for marginalised groups is a step in the right direction, the state and other municipalities need to follow suit.

Harm Reduction Initiative Expands to Suðurnes Peninsula

frú ragnheiður á suðurnesjum - skaðaminnkun red cross

A harm-reduction initiative run by the Icelandic Red Cross has now expanded its services beyond the capital area – to the Suðurnes peninsula, Southwest Iceland. Frú Ragnheiður, as the project is called, provides healthcare services, needle exchange services, and counselling to individuals with addiction. A statistic on the project’s Facebook page states that 61% of the initiative’s clients are homeless and another 10% live in subsidised or temporary housing.

Frú Ragnheiður’s services are mobile, operating out of an ambulance which will now be servicing the Suðurnes peninsula in addition to the capital area. The ambulance will travel around the peninsula on Monday and Thursday evenings from 6.30pm-9.00pm. Individuals located on the Suðurnes peninsula who would like to access its services are encouraged to send a message to (+354) 783 4747 as early as possible on those days to make an appointment. The ambulance meets clients at a location of their choice and its services are confidential.

In 2019, the initiative provided services to 514 individuals, an increase of 20% from 2018. Many of those visited more than once, and total visits numbered 4,149. The Suðurnes peninsula is the second-largest population centre in Iceland after the Reykjavík capital area, with around 20,000 residents.

Not Everyone on Waitlist for Detox Clinic Needs to Be, Says Minister

As of March, 530 people were on the waitlist for admission to Vogur, the hospital and detoxification clinic run by Iceland’s National Center of Addiction Medicine (SÁÁ), RÚV reports. Of those 530, 115 individuals were slated to be admitted within the next three weeks. Minister of Health Svandís Svavarsdóttir says, however, that the list could be significantly shortened, as not everyone on the list has a genuine need for inpatient treatment.

Svandís outlined her reasoning in her response to an inquiry from Centre Party MP Sigurður Páll Jónsson.

A least a third of those who go on Vogur’s waitlist opt not to enter treatment for a variety of reasons. As such, Svandís says that it’s likely that not everyone currently on the list needs inpatient treatment to address their addiction problems. In some cases, she asserted, milder solutions may suffice, and these could be employed where appropriate to reduce the waitlist.

There are also people on the list, reported Svandís, who registered without a prior professional assessment. The Minister wants to change this and require that anyone on the waitlist for inpatient treatment first undergo a professional assessment to confirm that they do indeed need to enter the inpatient facility. Doing so, she concluded, would ensure that only those who truly need to undergo inpatient treatment make use of these limited services.