Estonia Country Drug Report 2019

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). 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.

Harm reduction interventions

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.

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 Yes No
Bulgaria Yes No No No
Croatia Yes No No No
Cyprus Yes No No No
Czechia 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.