In Lithuania, a special decree adopted by the Ministry of Health in 2006 consolidated the legal basis for the implementation of harm reduction for people who inject drugs (PWID) and defined a mandatory package of services. The legislation aims to facilitate the development of harm reduction services in Lithuania and to ensure that PWID can exchange needles and syringes and obtain condoms, disinfectant tissues, health educational and informational material, counselling and other services at low-threshold units. Harm reduction programmes are financed mainly by state and municipal budgets with some contributions from non-governmental organisations (NGOs), but government funding is limited and funding from the municipalities is highly variable. Public budgets assure around one fifth of the costs of harm reduction services. The material required for the testing of infectious diseases in low-threshold cabinets is entirely funded by the NGOs that manage them.
In 2017, there were 13 low-threshold units, including two mobile outreach needle/syringe distribution and exchange points, operating in 10 cities in Lithuania. These units are mostly operated by NGOs or under the remit of municipal social services. In seven cases, they are integrated within a public drug treatment institution. Low-threshold units typically offer the following: needle and syringe programmes (NSPs); distribution of condoms; health education and information; and personal hygiene and care services. Owing to legal regulations that limit provision of point-of-care testing at low-threshold units to medical staff of healthcare institutions, only 5 of the 13 low-threshold units are able to offer infectious diseases testing. Clients testing positive are referred to healthcare institutions for treatment.
In 2017, around 250 000 syringes were distributed by harm reduction services, which represents an increase of 40 % since 2014; the increase may have resulted from the opening of new facilities in 2015 and 2016. Syringe coverage remains low, estimated at around 19-29 syringes per person who injects drugs.
In August 2016, the Vilnius Centre for Addictive Disorders started implementing a small-scale pilot initiative involving the distribution of the overdose reversal drug naloxone. Under this programme, naloxone ampoules are given to patients who have finished a drug treatment programme and received training in emergency response and in the administration of the medical product.
Universal vaccination against hepatitis B virus (HBV) has been provided since 1998 to infants and 12-year-old children; however, special HBV immunisation programmes targeting PWID are not available.
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