The Lithuanian Prison Department manages the penal system, which accommodates close to 6 500 prisoners in its institutions. The available data indicate that the Lithuanian prison population rate is the highest in Europe.
Medical services for prisoners are provided by healthcare services established in each prison and at the prison hospital. All new prisoners are assessed through repetitive criminal behaviour risk assessment methodologies, which include the assessment of substance use. At the end of 2017, it was reported that the proportion of prisoners diagnosed with mental and behavioural disorders as the result of narcotic or psychotropic substance use was more than 1 in 10. The number of prisoners with narcotic or psychotropic substance use disorders has decreased since 2009. This could be attributed to numerous factors, including a general decrease in the prison population, enhanced control of drug use in prison and under-diagnosing. Based on the results from the 2017 survey, lifetime prevalence before imprisonment was highest for cannabis and amphetamines; other substances, including methamphetamines, heroin, cocaine and ecstasy, were reported by one fifth of the respondents and synthetic cannabinoids by 16 % of respondents. The use of multiple psychoactive substances was also common. There were almost 300 prisoners infected with human immunodeficiency virus (HIV) in 2017, of whom one third were diagnosed for the first time while in prison. Almost three quarters of prisoners infected by HIV are located in one particular prison in the country, and the main mode of transmission is drug injection.
Drug treatment activities in prisons are focused on the socio-psychological rehabilitation of dependent prisoners. Four prisons have residential rehabilitation centres and one prison has a day centre. In 11 prisons, Alcoholics Anonymous and Narcotics Anonymous groups operate and follow the 12-step Minnesota Programme.
Opioid substitution treatment was introduced in prisons in 2018, after an outbreak of HIV infection in prisons in 2017; it is available in three pre-trial detention facilities and prison hospital to prisoners who were already receiving it prior to arrest. Free voluntary testing for infectious diseases is available in prisons, accompanied by health education measures to reduce behaviours associated with the risk of contracting HIV, hepatitis B and hepatitis C virus infections. Treatment for HIV is also available to those in prison. There is no unified system for referral processes in the country.