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.
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.
|Country||Needle and syringe programmes||Take-home naloxone programmes||Drug consumption rooms||Heroin-assisted treatment|