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). Harm reduction is an integral part of Estonian drug policy (as seen in the National White Paper), and aims (among other things) to improve service quality and the range, scale and geographical spread of services. The National Institute of Health Development funds provision of low-threshold harm reduction services to drug users by several non-governmental organisations.
The government funds needle and syringe programmes (NSPs), and around 2 million syringes were distributed in 2017 at 14 fixed and 20 outreach syringe programme sites, mostly located in Tallinn and the eastern part of the country, where the problem of injecting drug use is concentrated. Around 5 500 clients used harm reduction services in 2017, and more than 110 000 service contacts were registered across the country. In addition to clean injecting equipment and condoms, these services provide health education, safer use advice and sexual health counselling. Rapid testing for early diagnosis of human immunodeficiency virus (HIV) and viral hepatitis infections is offered in collaboration with healthcare providers.
Since September 2013, a take-home naloxone programme has been available in the two Estonian counties most affected by opioid overdose deaths involving fentanyl. The programme is now carried out by six community-based providers, and in 2015 it was extended to prisons, so it could be offered to prisoners before release. By the end of 2017, a total of 2 089 participants had been trained and received their first take-home naloxone syringe kits. In 2018, a nasal naloxone spray applicator was also made available. It is hoped that the non-injectable form will help broaden the programme by making it accessible to new providers, including the police and pharmacists.
|Country||Needle and syringe programmes||Take-home naloxone programmes||Drug consumption rooms||Heroin-assisted treatment|