The National Health Plan 2009-20 provides the overall strategic guidance for implementing harm reduction in Estonia, and puts emphasis on the reduction of drug- related infectious diseases and drug-induced deaths among PWID. Several non-governmental organisations (NGOs) are funded by the NIHD to provide low-threshold harm reduction services to drug users.
The government started funding NSPs in 2003, in the framework of the national HIV/acquired immune deficiency syndrome (AIDS) prevention programme; their coverage and quality has improved over the years. Around 2.1 million syringes were distributed in 2015 through a total of 37 syringe programme sites located in the capital city and the eastern part of the country. In addition to clean injecting equipment, these services provide counselling and health education. Diagnostic testing for drug-related infectious diseases cannot be offered by NGOs because of legal provisions that exclude them from offering medical services. However, the harm reduction programmes refer their clients to free testing services at AIDS prevention centres and other locations in nine Estonian cities.
Since 2013, a take-home naloxone programme has been available in the two most affected counties of Estonia. As part of the programme, opioid users and their relatives are taught to recognise an overdose, administer the antidote naloxone and provide first aid until the emergency services arrive.
Taking into account that tuberculosis remains a significant health challenge among people who live with HIV, free tuberculosis screening is provided on a regular basis for high-risk groups not covered by health insurance, such as PWID, residents of shelters and prisoners.
Since 2013, a take-home naloxone programme has been available in the two most affected counties of Estonia
Availability of selected harm reduction responses
NBYear of data 2016.