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Harm reduction overview for Estonia

Map of Estonia

1. National context

The Government started funding syringe exchange in 2003, within the framework of the national HIV/AIDS prevention programme. In addition, harm reduction measures were specifically mentioned in the National Strategy for the Prevention of Drug Dependency 2004–12 and are continuously funded by the National HIV/AIDS Strategy 2006–15. As a consequence, the coverage and quality of needle and syringe programmes has improved over the years. Non-governmental organisations (NGOs) are the most active institutions providing services for drug users, and they aim to reduce drug-related harm via activities such as counselling, HIV testing and needle and syringe programmes. New national guidance recommends annual HIV testing for the 18- to 49-year-old population attending primary care. Free testing and counselling is available at AIDS prevention centres and other locations in nine Estonian cities, but diagnostic blood-testing services cannot be offered by NGOs due to legal provisions.

Taking into account that tuberculosis remains a significant health challenge among people who live with HIV, free screening for tuberculosis is provided on a regular basis for high-risk groups not covered by health insurance, such as PWID, residents of shelters and prisoners.

Around 2.2 million syringes were distributed in 2013 through a total of 37 syringe exchange sites (13 stationary and 24 outreach programmes, all operated by NGOs). The prison population, sex workers and men who have sex with men are also seen as target groups and are provided with specific harm reduction services. In 2013, the National Institute for Health Development launched the take-home naloxone pilot programme to respond to the high rate of drug-related deaths in the country. As part of the programme, opioid users and their relatives are taught to recognise overdose, administer the antidote naloxone and provide first aid until emergency services arrive.

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2. Responses to prevent and reduce drug-related infectious diseases

Needle and syringe programmes Country  data
Availability of  NSP programmes  Full
% NSP availability at NUTS3  60 %
Drug use equipment distributed at specialised drug agencies (standard prevention material)
availability of alcohol pads  No
availability of dry wipes  No
availability of containers  No
availability of water  No
availability of condoms  Yes
availability of foil  No

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
For an explanation of terms used, see the definitions of terms.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Testing, vaccination and treatment of infections Country  data
Availability of Hepatitis C testing in the community  Rare
Availability of universal hepatitis B immunization programme  Yes
Hepatitis B vaccination programme specific for high risk groups  No
ARV treatment of HIV infection  Extensive

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Health promotion responses Country  data
Availability of individual counselling programmes  Extensive
Availability of programmes for practical advice and training on 'safer use/safer injecting'  Limited
Involvement of peer educators in the response to infectious diseases prevention  No

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.

Drug Treatment

See the country specific treatment profile.

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3. Responses to prevent and reduce drug-related deaths

Availability of drug-related death responses in the community Country  data
Availability of overdose information materials  Extensive
Availability of individual overdose risk assessment (provided by trained drugs or health workers)  N.Av.
Availability of overdose response training  Limited

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Availability of drug consumption rooms Country  data
Number of facilities n.av.
Number of cities n.av.
Number of consumptions per year n.av.

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2011.
N.Av. stands for ‘The intervention is not available in the country’.

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4. Responses to prevent and reduce drug-related harms in recreational settings

Provision of specific responses implemented in night clubs and festivals Free, accessible, cold water Immediate First Aid ‘Chill out’ rooms Information material Outreach work Amnesty bins
Night clubs  Limited  Extensive  Limited  Rare  Rare  :
Festivals  Rare  Full  Limited  Rare  Rare  :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2011.
Provision expert rating scale:

  • Full – in nearly all night clubs/festivals.
  • Extensive – a majority of night clubs/festivals provide the intervention (but not nearly all of them).
  • Limited – more than a few night clubs/festivals provide the intervention (but not a majority of them).
  • Rare – just a few night clubs/festivals provide the intervention.

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5. References and links

Related EMCDDA resources

 

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The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Monday, 01 June 2015