In Luxembourg, drug use among prisoners has been assessed and the drug related problems, including mental health disorders, social problems and infectious diseases, were found to be manifold compared with the general population.
According to a study published in 2007, over half of problematic drug users (56 %) who had been in prison in the past reported illicit drug use during imprisonment, with around one third reporting injecting drug use. Just over one quarter of prisoners who had ever injected drugs reported needle sharing in prison, which is lower than the rate observed in 1998. Rates of HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection were higher among respondents who were recruited in prisons and had ever injected drugs than among those who were recruited in outpatient or inpatient treatment settings.
Health strategies and policies for prisons were established in Luxembourg in 1997 and a pilot project, Global Drug Care Programme in Prison, was set up in 1999. In 2007, the project became a routine programme in national prisons (Programme TOX). The programme was designed to implement primary prevention measures and address illicit drug use and infectious diseases. The basic principles of the TOX programme are voluntary participation, cooperation, transparency, quality of service, determination of realisable objectives and empowerment of participants.
The implementation of health responses in prison is centred around three pillars: psychosocial care, coordination of interventions and prevention of sexually transmitted diseases. Health responses for prisoners include detoxification treatment and psychosocial guidance. Detoxification treatment is either the responsibility of the prison medical unit or is provided by external units of general hospitals in accordance with strict rules and procedures. Psychosocial and therapeutic care is provided by both staff of the prison medical unit and specialised external agents from accredited drug agencies.
Opioid substitution treatment is provided to prisoners who were receiving it prior to incarceration and may be followed by maintenance, dose reduction or detoxification treatment. It may also be initiated in prison. In 2015, a total of 173 prisoners received OST.
A special programme targets female prisoners exclusively and becomes operational when a minimum number of females enrol. Drug-free zones are also available.
A structured syringe distribution programme was officially launched in 2005. In 2015, 40 kits were distributed and around 2 000 syringes were exchanged. Other harm reduction interventions include the provision of ascorbic acid, filters, sterile physiological water and antiseptic wipes. Continuity of care and resocialisation measures are ensured by the intervention of social workers from external field agencies.
In 2015, a total of 173 prisoners received opioid substitution treatment