Estonia Country Drug Report 2019

Drug use and responses in prison

According to routine data from the Prisons Department of the Ministry of Justice of Estonia, in 2017 around one third of prisoners had a diagnosed drug dependency, mainly related to opiates and polydrug use. Fewer than 1 out of 10 prisoners tested positive for human immunodeficiency virus (HIV) and for hepatitis C virus (HCV) infection. 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, of whom one third had injected drugs in prison, with half of these having 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 2017, 87 prisoners received OST, a reduced number compared with the previous year. In 2017, one prison began to offer clean needles and syringes, and other injecting equipment, to prisoners upon their release, but less than 10 released prisoners used this service. Condoms are available only in prison shops and are free of charge in long-term visiting rooms.

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 in prison is available to 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. Coverage of training and the distribution of kits remains low. In 2017, a total of 32 prisoners received a naloxone kit on their release, a decrease in the number from the previous year.

Since 1 October 2017, smoking has been banned in Estonian prisons. Prisoners, prison staff and visitors are not allowed to smoke in prison grounds, whether indoors or outdoors.

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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.