For years, Sweden has prided itself on its strict drug policies and low reported rates of substance use. Yet a groundbreaking nationwide wastewater analysis conducted this summer challenges that narrative—and exposes significant gaps in how the country tracks drug consumption.
The Limits of Traditional Surveys
Official statistics on drug use in Sweden rely heavily on self-reported surveys and police data, both of which suffer from well-documented limitations: underreporting, sampling bias, and lag times. “No one truly knows how much drug use there is in Sweden,” say researchers at RISE Research Institutes of Sweden. “Traditional methods simply don’t capture the full picture.”
To address this blind spot, public broadcaster SVT partnered with RISE in July 2025 to launch the most comprehensive wastewater drug monitoring effort in Swedish history. Over a single weekend, samples were collected from 49 wastewater treatment plants across 36 municipalities—spanning major urban centres, mid-sized towns, and rural communities. This synchronized, nationwide snapshot offers unprecedented insight into the real-time consumption of illicit and prescription drugs.
Cocaine in Coastal Resorts, Amphetamine in Struggling Towns
The findings reveal a complex and uneven drug landscape:
- Strömstad, a coastal town near the Norwegian border, recorded the highest per capita levels of cocaine—surpassing Stockholm, Gothenburg, and Malmö. Experts attribute this anomaly to cross-border tourism, particularly from Norway, where alcohol and drug regulations are stricter. Strömstad’s nightlife economy appears to serve as a magnet for recreational drug use.
- Amphetamine use is most pronounced not in major cities, but in smaller municipalities facing socioeconomic strain. While Gävle has long been dubbed “Europe’s amphetamine capital” due to its consistent high readings since 2013, the new data shifts that title to Söderhamn—which recorded even higher concentrations. Notably, towns like Orsa and Vimmerby also exceeded Gävle’s levels, suggesting that Gävle’s reputation may stem more from its early adoption of wastewater monitoring than from uniquely high consumption.
“Gävle was simply measuring longer and more consistently,” explains Louise Karlsson, a senior researcher at RISE. “When we expand monitoring to more locations, the picture changes dramatically.”
- Eskilstuna emerged as Sweden’s hotspot for cannabis and tramadol, a prescription opioid often misused for its euphoric effects. The city, along with Karlstad, ranked among the top ten for more than half of the 12 substances analysed—including cocaine, amphetamine, MDMA, and benzodiazepines. This pattern points to broader polydrug use in certain mid-sized urban centres, possibly linked to economic distress, limited healthcare access, or entrenched local drug markets.
A European Context
Wastewater-based epidemiology (WBE) is now a standard tool across the European Union, coordinated by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Sweden’s new data can be directly compared with results from cities like Amsterdam, Lisbon, and Warsaw. Preliminary comparisons suggest that while Sweden’s overall drug consumption remains lower than in Southern and Western Europe, regional disparities within the country are stark—and growing.
Policy Implications
These findings carry urgent implications for public health and law enforcement. Reliance on outdated or incomplete data risks misallocating resources—focusing on high-profile cities while neglecting struggling towns where drug use may be more prevalent but less visible. Moreover, the prevalence of prescription drugs like tramadol underscores the need for tighter controls on pharmaceutical distribution and better addiction services outside metropolitan areas.
As Sweden debates reforms to its drug policy—including potential decriminalization models and harm reduction strategies—the wastewater data provides an objective, real-time foundation for evidence-based decisions. “This isn’t just about numbers,” says Karlsson. “It’s about understanding where help is needed most.”
RISE and SVT plan to repeat the nationwide measurement annually, creating a longitudinal dataset that could transform Sweden’s approach to drug monitoring. For the first time, policymakers may have the tools to move beyond assumptions—and confront the true geography of drug use in modern Sweden.
— Nordic Business Journal continues to monitor developments in public health, policy, and social trends across the Nordic region.