By Villu Kangur, for the Eurasian Harm Reduction Association (EHRA) and the School of Law, Swansea University.
The Republic of Estonia is a country on the eastern coast of the Baltic Sea in Northern Europe. It is bordered to the north by Finland across the Gulf of Finland, to the west by Sweden across the Baltic Sea, to the south by Latvia, and to the east by Lake Peipus and Russia. With a population of 1.3 million people, Estonia is one of the least populous members of the European Union.
According to the general population study on drug use in Estonia4 in 2018, 25% of people aged 16–64 have tried an illegal substance at least once during their lifetime, 7% within the last year, and 3% within the last month. Cannabis was the most commonly used drug, with 24% of the population having tried cannabis during their lifetime. In addition, the use of stimulants (e.g. amphetamine, ecstasy, and cocaine) was reported more frequently than that of other narcotic substances (amphetamine 6%, ecstasy 5%, and cocaine 5% lifetime use). While drug use, including cannabis use, was more common among people under the age of 35, more frequently among men, there was no difference between men and women in the youngest age group (16–24 years).
Estonia has a high prevalence of people who inject drugs (PWID), of whom about half are living with human immunodeficiency virus (HIV). According to a study done between 2010 and 2015, there are an estimated 6,000 to 17,300 PWID. In 2015 the prevalence of PWID was estimated to be 8,600. Among key populations, the prevalence of HIV is 54% among PWID, 13% among prison inmates, 4% among men who have sex with men (MSM), and 13% among sex workers (SWs).
Opioid substitution treatment (OST) with methadone has been available in Estonia since 1999. Currently OST is being offered in nine different institutions across the country (excluding prisons and detention centers, where methadone treatment is also available). In 2018 there were 1,052 registered patients who received OST. OST coverage remains low (under 20%).