The latest data on drug use and related problems among prisoners in Luxembourg were published in 2007. According to the study, over half of problem drug users who had been in prison in the past reported illicit drug use during imprisonment, with around one third reporting injecting drug use.
Health strategies and policies for prisons were established in Luxembourg in 1997 and since 2007 have been a routine programme in national prisons (Programme TOX). The implementation of health responses in prison is centred around three pillars: psychosocial care, coordination of interventions and prevention of sexually transmitted diseases. At admission, new inmates are seen by medical staff, who propose a voluntary HIV test and simultaneous screening for other infectious diseases such as syphilis and hepatitis A, B and C.
Health responses include detoxification treatment and psychosocial guidance. Detoxification is either the responsibility of the prison medical unit or provided by external units of general hospitals in accordance with set rules and guidelines. 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 (OST), mainly with methadone and to a lesser extent with buprenorphine, is provided to prisoners who were receiving it prior to incarceration. It may also be initiated in prison. In 2016, a total of 205 prisoners (13 % of inmates in one national prison and 15 % in the other) received OST. A special programme targets female prisoners exclusively; it 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 2016, 31 kits were distributed and 1 612 syringes were exchanged in the prison setting. Other harm reduction interventions include the provision of ascorbic acid, filters, sterile physiological water and antiseptic wipes. A programme on safe tattooing was introduced in 2017. Continuity of care and social reintegration measures are ensured by the intervention of social workers from external field agencies.
The national after-prison reintegration strategy promotes further development of synergies with external drug care agencies aiming at a comprehensive concept of throughcare in terms of psychosocial measures, substitution treatment and economical start-up help.