Estonia Country Drug Report 2018

Harm reduction

The National Health Plan 2009-20 provides the overall strategic guidance for implementing harm reduction in Estonia, and puts an emphasis on the reduction of drug-related infectious diseases and drug-induced deaths among people who inject drugs (PWID). The National Institute of Health Development funds provision of low-threshold harm reduction services to drug users at several non-governmental organisations.

Harm reduction interventions

The government has funded needle and syringe programmes since 2003, and their coverage and quality has improved over the years. Around 2.1 million syringes were distributed in 2016 at 15 fixed and 23 outreach syringe programme sites, mostly located in Tallinn and the eastern part of the country, where the problem of injecting drug use is concentrated. In addition to clean injecting equipment, these services provide counselling and health education. Free diagnostic testing for drug-related infectious diseases is provided at human immunodeficiency virus (HIV) testing centres and other locations in nine Estonian cities.

Since September 2013, a take-home naloxone programme has been available in the two most affected counties of Estonia and in 2015 the programme was extended to prisoners before release. As part of the programme, opioid users and their relatives are taught how to recognise an overdose, administer the antidote naloxone and provide first aid until the emergency services arrive. In 2016, more than 400 participants were trained and received their first take-home naloxone syringe kits. In that year, 167 repeat prescriptions of naloxone were given out and the use of 128 kits was reported.

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.

Availablity of selected harm reduction responses in Europe
Country Needle and syringe programmes Take-home naloxone programmes Drug consumption rooms Heroin-assisted treatment
Austria Yes No No No
Belgium Yes No No No
Bulgaria Yes No No No
Croatia Yes No No No
Cyprus Yes No No No
Czech Republic Yes No No No
Denmark Yes Yes Yes Yes
Estonia Yes Yes No No
Finland Yes No No No
France Yes Yes Yes No
Germany Yes Yes Yes Yes
Greece Yes No No No
Hungary Yes No No No
Ireland Yes Yes No No
Italy Yes Yes No No
Latvia Yes No No No
Lithuania Yes Yes No No
Luxembourg Yes No Yes Yes
Malta Yes No No No
Netherlands Yes No Yes Yes
Norway Yes Yes Yes No
Poland Yes No No No
Portugal Yes No No No
Romania Yes No No No
Slovakia Yes No No No
Slovenia Yes No No No
Spain Yes Yes Yes No
Sweden Yes No No No
Turkey No No No No
United Kingdom Yes Yes No Yes

Estonia main page

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.