Estonia Country Drug Report 2018

Drug use and responses in prison

According to routine data from the Prisons Department of the Ministry of Justice of Estonia, in 2016 around one third of prisoners had substance use-related health problems and fewer than 2 out of 10 prisoners tested positive for human immunodeficiency virus (HIV) or hepatitis C virus (HCV) infection. Of the 19 newly diagnosed HIV cases among inmates, nine were linked to drug injection. A study carried out in 2016 among a sample of people who inject drugs (PWID) found that more than half of them had been in prison at least once, one third had injected drugs in prison, and half of those had used a syringe that had already been used.

The Ministry of Justice is responsible for administering healthcare and social services in Estonian prisons. Drug treatment in prisons includes detoxification, opioid substitution programmes (OST) and social programmes. OST with methadone is available in all prisons and can be either continued or initiated in prison. In 2016, 119 prisoners received OST. Three prisons have special departments for social reintegration of drug users.

All prisoners are offered HIV testing and screening for tuberculosis, while tests for hepatitis B virus and HCV infections are offered to PWID and people living with HIV/acquired immunodeficiency syndrome (AIDS). Hepatitis B vaccination is available for prisoners who are PWID or people living with HIV/AIDS. Treatment for HIV and HCV infections is available in prisons.

A naloxone programme to reduce drug-related overdoses has been available in Estonian prisons since 2015 and is supported by the Estonian-Swiss Cooperation Programme. In 2016, a total of 57 prisoners received training and 61 kits were distributed after release.

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.