What can Americans learn from the Nordics about the opioid problem?

On the EDGE: An opinion column about issues in Norway and the United States
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It is estimated that nearly 93,000 Americans died from opioid overdoses last year.

Swarthmore College

Last year, the United States experienced “the highest number of overdose deaths ever recorded,” according to the National Institute on Drug Abuse. The National Center for Health Statistics reported that opioids were behind most of the 93,000 deaths. Public health experts believe the new spike is related to the anxiety associated with the COVID-19 pandemic. However, the sad fact is that the opioid crisis has been unfolding for years.

As we search for solutions, we can do more than regulate the pharmaceutical companies. We can take a cue from the Nordic countries, who for years have exceeded larger and wealthier countries as “the world’s happiest peoples” by being adventurous and willing to change policies and structures until they find what works.

Norway, for example, changed its approach to drug addiction early this year. Norwegians had a major public debate supported by research studies. They faced the reality that, although they had fewer overdose deaths than Americans do, they still had more than Swedes and Danes did and something needed to change. As a result, the center-right government in Oslo shifted its policy on drugs from a crime problem to a public health problem.

The business news outlet Bloomberg told the story: “Norway to Decriminalize Personal Drug Use in ‘Historic’ Shift,” by Ott Ummelas, Feb. 19, 2021, bloomberg.com. Norwegian police will continue to intervene against drug trafficking, but they’ll lead addicts to qualified people who can offer a chance for health.

We could do worse than follow the Nordic inclination to face the truth, hard though that may be. In Sunday School as a boy, I learned a Bible verse that said, “The truth shall set you free.” A recent University of Pennsylvania study reported by The Washington Post showed that opioid overdoses spiked in communities where automobile factories have closed.

According to Atheendar Venkataramani, the study’s lead author and a professor in the university’s Perelman School of Medicine, economic instability can affect people’s mental well-being and drive up the risk of substance abuse. “Our findings confirm the general intuition that declining economic opportunity may have played a significant role in driving the opioid crisis,” Venkataramani wrote.

This new finding opens another door for Americans, another chance to learn from our Nordic cousins. Our hearts may go out to those caught in the crisis. But this is complicated: how can we deal with a public health crisis rooted in modern economics? Aren’t factory shutdowns the result of globalization and accelerating technological change? What can we do about that?

Denmark, Norway, and Sweden have economic policies that reduce addiction and suicide

I found good news in researching some small countries that are even more at the mercy of global market forces: Denmark, Norway, and Sweden. These countries have highly successful economic policies that reduce addiction and suicide. Although it’s hard to believe, considering they endure long, dark winters, they even top the charts as “the world’s happiest peoples.” How do they do this?

A century ago, they were in such economic trouble that they hemorrhaged their own people, with Scandinavians fleeing to Canada and the United States. Those who remained decided to innovate, big time. They tried what today’s entrepreneurs might call “creative destruction,” reorganizing their economies to put people first. Outsiders looking at the Scandinavian innovations as “lab experiments” might find ideas we can use.

Denmark, Sweden, and Norway chose in the 1920s and ’30s to invent an alternative economic model that put the well-being of the people first, instead of the well-being of capital; economists call it “the Nordic model.”

The idea was that if a country’s working families were backed by assured health care, education, good affordable housing and childcare, healthy environments, time for leisure, and job security, they would be productive workers. The money to pay for this investment would come from those with far more money than they needed. 

The result was shared prosperity.

On many economic indicators, Nordic social democracies out-performed the countries that adhered to a free-market capitalist approach. Far from the stereotype of becoming “nanny states,” the Nordics have had higher participation in the labor force than the United States and higher labor productivity; Norway even has more startup companies per capita than the United States.

If an economy isn’t working well, adjust it!

This experiment produced a lot of “get-up-and-go” workers who, with high rates of unionization and abundant support for technical education, became the “goose that laid the golden egg.” 

I interviewed one Norwegian CEO who told me how pleased he is with the system: “I can count on my workers to come through when I promise to meet deadlines, because we’re a team and they’re well-treated and know what they’re doing.” 

An Inc. Magazine reporter asked a Norwegian CEO who pays about half his yearly income in taxes what he thought about that. “The tax system is good—it’s fair,” he said. “What we’re doing when we are paying taxes is buying a product. So, the question isn’t how much you pay for the product; it’s the quality of the product.”

The principle of job security was bedrock. Free vocational training and higher education upgraded the skills of the labor force and supported workers who wanted to move to new jobs. Families had something to count on and could plan their futures. The broken dreams and grim prospects of workers in the U.S. Rust Belt didn’t show up in Scandinavia. 

By the 1980s, however, the world was changing for Scandinavia, too. Technological development and globalization accelerated. Goods made elsewhere became cheaper than the Scandinavians could make them. Nordic governments subsidized local industries to prevent factory shutdowns. 

Yes, they were prioritizing workers ahead of capital, as the model promised, but at an increasing cost to the nation as a whole. 

Denmark was the first country to try something different. (Nordics aren’t afraid to experiment!) Borrowing from a Dutch idea and making it more robust, the Danes adopted “flexicurity” In the 1990s. The government would no longer subsidize a factory to keep it open. The factory owners would be free to take their capital and do something else with it. The Danes’ new deal was that if a factory closed, direct support for workers would come from the government. 

Flexicurity meant job training for other jobs, a high level of wage maintenance while workers were training and looking for their new jobs, and relocation support if they needed to move. In other words, even for 50-year-olds, job loss did not mean permanent unemployment for the rest of the workers’ lives. For many workers, it meant a fresh start.

It reminds me of President Franklin Delano Roosevelt’s thinking in the 1930s with his New Deal: If an economy isn’t working well, change it! 

Once Denmark adopted flexicurity, Sweden and Norway followed. In 2007, the Council of the European Union looked at results and recommended flexicurity for all the EU member countries.

Although the proposed Green New Deal for the United States has been seen as a way to deal with the climate emergency, it’s sufficiently holistic to be a possible bridge to flexicurity for Americans. The bottom line is the same: hope for those at risk of being left behind. 

The American opioid epidemic – and rising suicide rates – need an energetic response. The United States is far wealthier than the Nordic countries were when they decided to restructure their economies. The Scandinavians had less to spread around for their vision of shared abundance, but they decided to think big and risk by acting on their deepest values.

Can we be that bold and caring?

This article originally appeared in the Oct. 22, 2021, issue of The Norwegian American.

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George Lakey

George Lakey is author of Viking Economics,/em>, which the (London) Times in its Higher Education edition declared “Book of the Week.” It’s available in paperback. He went to a university in Northern Norway to keynote a convention of Nordic economists. He began his study of sociology at the University of Oslo. Recently retired from Swarthmore College, he lives in Philadelphia.