Facts and Numbers

National drug laws

The Law on Control of Narcotic and Psychotropic Substances establishes the principles of the classification of narcotic and psychotropic substances, which are their harmful effect upon human health, when they are being misused, and whether they can be used for health care purposes.

The Criminal Code of the Republic of Lithuania is the main law that establishes grounds for and conditions of criminal liability for the persons who have committed criminal acts.

Since January 1, 2017 illegal acquisition and possession of small quantity of narcotic or psychotropic substances is considered as criminal act – misdemeanour (under the Criminal Code). Previously it was an administrative violation along with misdemeanour and the court use to decide regarding person’s liability in each case. Possession of not large (more than small, but not large) amount of illicit drugs with no intent to distribute them is a criminal offence, with a sentence of up to 2 years’ imprisonment.

Drug traffickers may be sentenced to between 2 and 8 years’ imprisonment, which increases to 8–10 and then 10–15 years, depending on the quantities involved and the presence of aggravating circumstances (such as the involvement of minors or an organised group).

The Ministry of Health orders defines small, large and very large quantities of all drugs.

New psychoactive substances are regulated through amendments of the Schedules of Narcotic and Psychotropic Substances.

National drug strategy

The National Programme on Drug Control and Prevention of Drug Addiction, 2010–16 was endorsed by the Lithuanian Parliament on 10 November 2010. The overarching goal of the programme is to reduce the supply and demand for illicit drugs and psychotropic substances and their precursors, as well as the spread of drug addiction, by strengthening individual and public education, health and safety. Several priorities are included in the national programme addressing: drug demand reduction among children and youth in particular; drug supply reduction; drug use monitoring; information; and coordination and international cooperation. The programme is constructed around two pillars covering the areas of supply and demand reduction and two cross-cutting themes focus on coordination and cooperation, and information and research. It is primarily concerned with illicit drugs.

The new National Programme is under the preparation processes.

Coordination mechanism in the field of drugs

On 1 April 2011 the Drug Control Department under the Government of the Republic of Lithuania (originally established on 1 January 2004) was absorbed into the new Drug, Tobacco and Alcohol Control Department. As a result of the merger of the Drug Control Department and the State Tobacco and Alcohol Control Service, the functions of the latter institution also became the responsibility of the Drug, Tobacco and Alcohol Control Department.

The Drug, Tobacco and Alcohol Control Department is responsible for the implementation and coordination of the National Programme on Drug Control and Prevention of Drug Addiction. The main priorities: participating in formulating public policy on drugs, tobacco and alcohol control and its implementation; coordinating and monitoring the activities of national authorities involved in precursor, chemical, tobacco and alcohol control; preparing national alcohol, tobacco, drug control and prevention programmes and coordinating their implementation; organising and coordinating the risk assessment of new psychoactive substances; performing the licensing of the wholesale production of tobacco and alcohol and the licensing of precursors; and functioning as the Reitox national focal point in the EMCDDA’s Reitox network.

Usually, in municipalities’, drug control and drug use prevention is coordinated by municipality drug control commissions. The commission usually consist of representatives of local institutions (the police, educational institutions, doctors, social workers, etc.), and the chairperson is usually the mayor or vice-mayor. The municipal commissions coordinate different actions, such as prevention, treatment and harm reduction. There were no discussion regarding draft programme since submission of the last program.

Drug use among the general population and young people

Three national general population surveys on drug use in Lithuania were carried out in 2004, 2008, 2012 and 2016. The 2008, 2012 and 2016 surveys were carried out in line with the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) guidelines, and were conducted among randomly selected people aged 15–64.

According to 2016 survey, prevalence of single-time use of drugs and psychotropic substances is 11.5 percent among the population aged 15-64, 3.1 percent of the Lithuanian population used drugs and psychotropic substances in the last year. Drugs and psychotropic substances were used by 1.3 percent of the population in the last month. Cannabis is the most popular drug (illegal) in Lithuania. 10.8 percent of the population aged 15-64 used it at least once in their lifetime. In the recent years following the survey, cannabis was used by 2.7 percent of the population, in the last month - by 1.1 percent of the population in Lithuania. The indicators concerning other drugs and psychotropic substance use are not significant. For example, 1.2 percent of the Lithuanian population used amphetamine at least once in their lifetime, 1.7 percent used ecstasy and 0.7 percent of the Lithuanian population used cocaine at least once in their lifetime.

Lithuania has participated in the European School Survey Project on Alcohol and Other Drugs (ESPAD) since 1995. Surveys were performed in 1995, 1999, 2003, 2007, 2011 and the most recent was done in 2015. Data from the 2015 ESPAD survey showed stable situation in lifetime prevalence rates for cannabis. 2015 ESPAD Lithuanian survey showed 11 % for last year prevalence of cannabis use (13 % in 2011; 12 % in 2007; 11 % in 2003; 10 % in 1999), and 4 % for last month prevalence (5 % in 2011; 5 % in 2007; 6 % in 2003; 4 % in 1999). Both, among the juveniles who attempted to use marijuana/hashish at least once in their lifetime and, in particular, among those who attempted to use it in the last 12 months and in the last month, boys exceeded the number of girls. The use of this drug, compared to other drugs, among boys is more popular than among  girls in Lithuania. 2015 ESPAD survey showed lifetime prevalence of cannabis use among boys - 20 % and girls - 15 %, last year prevalence of cannabis use: boys - 13 % and girls - 10 %, and last month prevalence: boys - 5 % and girls - 3 %.

A study in nightclub settings from 2008 indicates that use of illicit substances among clubbers is higher than among the general population. Nearly a third of clubbers have used an illicit substance in the past, with cannabis, ecstasy and amphetamines being the most popular substances used. The new study is currently performed in the country and the results will be out during 2018.

High-risk drug use

Up to 2012 the EMCDDA defined problem drug use as injecting drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis were not included in this category. However, in 2012 a new concept of ‘high-risk drug use’ was adapted. The new concept includes ‘problem drug use’, but is broader (mainly in its inclusion of high-risk use of more substances).


The first available national study of high risk drug users (HRDU) was implemented in 2010 – a capture–recapture study based on data from the Ministry of Health, Ministry of Justice and Ministry of Interior – to estimate the number of problem opiate users between 2005–07. According to the study, in 2007 there were around 5 458 problem opiate users in Lithuania (range: 5 314 to 5 605), a rate of 2.4 per 1 000 population aged 15–64.


In 2017, Republic centre of addictive disorders within the international HA-react project have performed the newest HRDU study* while using the data from 2015-2016. Various indirect calculation methods were used in order to find the number of high-risk drug users in the country. Results showed that there were between 4 854 and 8 652 high-risk opioid users in Lithuania in 2015/2016. As for subnational data - It has been estimated that there were between 2 755 and 3 904 high-risk opioid users in Vilnius in 2016 (7.5 to 10.6 per 1000 inhabitants aged 15–64). Study also aimed to find the number of IDUs in the country – there were between 8371 and 10 474 IDUs. This population for Vilnius city was estimated to range between 3 239 and 4 572 individuals. 


National estimates of high-risk amphetamine (including methamphetamine) users were also calculated and ranged between 4 742 and 7 000 individuals.

Study also aimed to evaluate the scale of harm reduction interventions provision. It was found that one IDU in Lithuania, on average, have obtained 19 – 29 needles via needle and syringe programs in 2015/2016. It was also estimated that 13.8 – 25.5 percent of high-risk opioid users were in the opioid substitutional treatment during the same period.  

* Reference: Thanki, D., Mravčík, V., Běláčková, V., Mačiulytė, D., Zábranský, T., Širvinskienė, A., Subata, E., Lorenzo-Ortega, R. (2018 m.). A multi-method estimation of high-risk drug use prevalence and coverage of needle and syringe programs and opioid substitution treatment in Lithuania in 2015–2016).

 

Drug markets and drug-law offences

Lithuania is considered a transit country for the trafficking of illicit substances between west European and east European countries, mainly by land. Cannabis products arrive in Lithuania from the Netherlands or Spain, mainly in transit. The cocaine is usually transported to Russia via Lithuania. Heroin transported from Central Asian countries to Lithuania through Russia and Belarus, supposedly then, through Lithuania as transit country to Kaliningrad region (Russia) and Western Europe countries. Amphetamine and methamphetamine – part of these substances are produced in Lithuania was later transported to the Scandinavian countries, Britain, Russia and Belarus. In addition, these substances can be brought into Lithuania from Western Europe. New psychoactive substances imported into Lithuania are usually expected from China and other Asian countries, but according to the Customs Criminal Service, taking into account the information contained in these materials they also come from the Netherlands, United Kingdom, Spain, Germany and Czech Republic.

A tendency has been noticed when illicit trafficking is carried out on internet through social media (for example, Facebook).  Here like-minded groups organise themselves where open promotion of narcotic and psychotropic substance use is promoted.

According to data of the Customs Criminal Service, in 2016, 274 pre-trial investigations were started when narcotic and psychotropic substances were sent by post or courier services; compared to 2015 the number of initiated pre-trial investigations increased by 169%. Based on the data of Information Technology and Communications Department under the Ministry of the Interior (hereinafter – the ITCD at the MOI), in 2016 was registered 2288 criminal offences related to unlawful possession of drugs and it is 236 offences less compare to 2015. More than half of drug-law offences were linked to the possession of psychotropic substances for purposes other than distribution.

Based on criminal investigations in 2016, it was observed that there was a continuing increase cases when carfentanil was removed from illegal circulation in Vilnius. According to Lithuanian Police Forensic Research Centre studies, in 2016 of the total number of illicit trafficking cases, about 97,6 g (18,8 g in 2015) of carfentanil-containing narcotic substances were withdrawn in total 108 cases (44 cases in 2015).

In 2016, in total 1245 drug seizure cases of all scheduled substances were registered. The total seized drug quantity varies from less than 1 kg to more than 500 kg. The majority of the seizures were among the cannabis (654 seizures) which were removed from illegal markets in Lithuania. As for the highest quantity – 550,5 kg of hashish was seized.   

Drug-related infectious diseases

In Lithuania, the Centre for Communicable Diseases and AIDS under the Ministry of Health (CCDA) collects aggregated nationwide diagnostic data on human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), acute hepatitis B virus (HBV) and hepatitis C virus (HCV) infections.


The most recent bio-behavioural seroprevalence study of HIV, HBV and HCV among people who inject drugs (PWID) was carried out in 2014 (“Prevalence of infections related with the use of narcotic and psychotropic substances among intravenous drug users”). The results have shown the prevalence of anti-HCV was 77% among participants, HBsAg – 10.5%, antiHIV – 12.5%.


In 2017 there was an increase in newly diagnosed HIV cases – CCDA have reported 263 cases (in 2015 – 157, in 2016 – 214). This is the highest increase during the last 15 years. More than half of newly diagnosed HIV cases were spread through injecting drug use (51.7%).

 

Drug-induced death and poisonings

In 2017, in Lithuania the  number of drug related deaths (DRD) decreased by 24 perc. - from 109 in 2016 to 83 in 2017. A continuing increase started from 2012  with 70 cases to 115 cases in 2015.  The drug-induced mortality rate among adults decreased (aged 15–64) from 58 deaths per million in 2016 comparing to 45 deaths per million in 2017.

Most of the DRD cases in 2017 were male - 67 cases and 16 DRD cases of females. Comparing to 2016, death cases among females rose in 10 perc. - in 2016 9 perc. of death cases  detected among females while in 2017 – already 19 perc. In 2017 the biggest part of DRD cases moved into the older age group – 30-39, accounted for  58 perc. of all DRD cases. Half (43 cases) of DRD cases occured in Vilnius, the capital of Lithuania.

The most part of deaths usually was related to opiates. In 2017 opiates were found in 46 cases, in 34 cases the substances were mixed or unspecified and 3 cases  -  related to deaths with non-opiates. In 41 DRD cases (49 percent of deaths cases with known toxicological analysis) showed also alcohol inclusion.

According to data of the Institute of Hygiene, in the past two years  the number of contacts to the health care establishments (inpatient and outpatient treatment) due to poisoning with drugs or psychotropic substances is decreasing – by 13 percent in  2016 compared to 2015 and even 31 perc. in 2017 compared to 2016. In total, persons contacted health care centers 389 times due to diagnosis of poisoning with drugs. In   2013 - 2015 the number of contacts was increasing and in 2015 accounted for 599 cases.

According to age distribution, in 2017, the biggest number of poisonings was in young subgroup aged from 25 to 34 (147 cases). Average age of people who contacted treatment centres due to poisoning with drugs was 29 years. The highest number of acute overdose is still related to overdoses caused by heroin (28.3 perc. of all acute overdose cases). Acute overdose with cannabis is the second most common substance related to poisoning with drugs (68 cases and 17.5 perc. of all cases).

In 2017, the number of registered cases of children’s poisonings (under 18 years of age) with drugs, compared to the previous year decreased by 20 perc. In 2017, children contacted heath care centres 56 times. Most frequently persons under 18 years of age contacted health care centres due to poisonings with cannabis - 34 cases.

Since 2010, data on drug-induced deaths is submitted by the General Mortality Register (GMR) of the Institute of Hygiene. Drug-induced deaths are those lethal cases where the direct cause of death recorded on the death certificate is  use of narcotic and psychotropic substances. The national focal point receives full data from the GMR and is able to extract and report data according to EMCDDA definitions and recommendations. Since 2017 GMR also receives toxicological data from the State Forensic Medicine Service

The national focal point receives data from the Institute of Hygiene on  the number of contacts to the health care establishments (inpatient and outpatient treatment) due to poisoning with drugs or psychotropic substances.

Data are also collected on deaths among persons registered in the Lithuanian health care institutions due to mental and behavioural disorders who used drugs and psychotropic substances, to record mortality trends among this population.

Treatment demand

The data collection for treatment demand in Lithuania is performed through Monitoring information system of persons who apply to health care institutions for mental and behavioral disorders and use of narcotic and psychotropic substances (ASIS) under the State Mental Health Center.


According to ASIS, in 2017, in Lithuania, inpatient and outpatient treatment centers provided treatment in total for 1697 persons (in 2016 – 2384, 2015 – 2549, in 2014 – 2159, in 2013 – 2209) having contacted health care facilities for mental and behavioral disorders, mostly male and applied for opioid addiction treatment. In 2017, there were 242 new clients applying for treatment (in 2016 – 328, 2015 – 395, in 2014 – 341, in 2013 – 341).


Opioid users were remaining as the vast majority of the new entrants (mainly heroin users) – 57.2% in 2017 (in 2016 – 53.4%, 2015 – 66.1%). In 2017, among all clients, the vast majority of the opioid users, as well as in 2016, remain in the age group of 30–34 years old. Males remain dominant in the treatment system among all clients – 1400 in 2017 (82.5%) (1618 or 67.9% in 2016, 1822 or 71.5% in 2015). Injecting behavior also remains as the main mode of drug use among all treatment clients – 1258 in 2017 (74.1%) (1768 or 74.2% in 2016, 1999 or 78.4% in 2015).


In 2017, the opioid substitutional treatment (OST) was applied in total for 1136 patients and it is about 7.7 % lower as in comparison with 2016 (in 2016 – 1231, in 2015 – 1393, in 2014 – 1036). In 2017, the majority of OST clients – 797 patients – were getting treatment with methadone (in 2016 – 726, in 2015 – 670), 339 – with buprenorphine (in 2016 – 505, in 2015 – 718).

 

Treatment responses

The Law On Neurological Care of the Republic of Lithuania  regulates health care for drug and alcohol addicts, abusers of psychotropic and other substances with psychological effects. The Law provides the basis for prevention and early diagnosis of drug problems and health care of patients, and their integration into the society. Human rights to health care services may not be limited due to the fact that a person is a drug addict or substance user. 


The non-anonymous health care for drug addicts is financed by the state and it is free of charge for drug addicted person. The person also could get anonymous drug addiction treatment, but in this case treatment services are not covered by the government budged and must be paid by the client himself. Coordination, implementation and provision of drug treatment are conducted at the national level by the Ministry of Health. The main funding bodies of the different treatment services are the national budget, the national health insurance and municipal budgets.


Drug treatment in Lithuania is provided mostly by public and private agencies. Outpatient drug treatment is provided by primary healthcare institutions and through private medical institutions having obtained a special license. Republic Center for Addictive Disorders (note: in 2017 it was reorganized from 5 regional public specialized Centers for addictive disorders that now functions under the Republic center as branches; branches are still located across the country) provides outpatient and inpatient services for addict patients. The Republic Center for Addictive Disorders offers treatment from one to three months by group psychotherapy, acupuncture and counselling, also provide opioid substitution treatment services. Inpatient treatment, such as withdrawal treatment and residential treatment, is delivered by the hospital-based residential drug treatment units and therapeutic communities, while detoxification services are available through toxicological units in general hospitals or in private toxicology centres. Special treatment programmes are available for children who are dependent on psychoactive substances, including one long-term and one medium term rehabilitation communities. In addition, 16 long-term rehabilitation centres are operating across the country.

 

Harm reduction responses

In 1997, the Vilnius Centre for Dependence Diseases, in cooperation with the Open Society Foundation in Lithuania, was the first to commence low-threshold programmes for injecting drug users. A special decree of the Ministry of Health, adopted in 2006, provided a background for the expansion of the programmes and also sets the minimum criteria for services.


According to Communicable Diseases and AIDS Centre, in 2017 there were 13 low-threshold units, including two mobile outreach needle/syringe exchange points, operating in nine cities in Lithuania. Low-threshold units provide various services for injecting drug users – they may exchange needles and syringes, and obtain condoms, disinfectant tissues, bandages and educational/informational material etc. They may also have a short consultation with a social worker and obtain information about the availability of healthcare and social assistance.


In 2017, the number of distributed syringes increased, compared to 2016 – from 251 370 to 240 061 respectively. In addition, the number of clients’ visits increased from 46 238 visits in 2016 to 48 519 visits in 2017

 

Prevention

All National Drug Control and Drug Addiction Prevention Programmes  (1999 – 2003, 2004-2008, 2010-2016) implemented in Lithuania emphasised the necessity to develop quality of the health care and social services, as well as  accessibility to the individuals dependent on drugs and psychotropic substances. As well each year the Interinstitutional Action Plan of Drug, Tobacco and Alcohol Prevention of the Republic of Lithuania is drafted and approved by resolution of the Government of the Republic of Lithuania. The above plan covers a three year period. The plan is preceded by the analysis of the situation and prepared seeking to ensure coherent, consistent and focused implementation of the prevention measures for control and use of psychoactive substances (drugs, tobacco and alcohol), to strengthen the systems of law enforcement, healthcare, education, social protection, control and other public institutions, to encourage them to engage in  close cooperation among themselves and with the public, non-governmental organisations,  to develop intolerance of the public for illegal distribution and use of drugs and psychotropic substances, tobacco products and alcoholic beverages,  aiming at more efficient application of joint prevention measures for use of drugs and psychotropic substances, alcohol and tobacco, instead of the individual measures as it used to be the case up to now.

To ensure the adequate implementation of the prevention, treatment and rehabilitation programmes (services) various methods may be used, and one of the choices is accreditation of such services and their providers.

In 2016,   amendments to Law No I-1489, of the Republic of Lithuania, On Education regulates the notion of the prevention programme for the first time, and from September 1, 2017, the schools were obliged to provide conditions to each schoolchild to participate on a permanent basis  in at least one coherent, long-term  prevention  programme developing social and emotional competencies, covering prevention of violence, alcohol, tobacco and psychoactive substance use, encouragement of healthy lifestyle, the pedagogical staff is obliged at least once every four years  to raise their qualification in the area of development of social and emotional competencies of the schoolchildren.          

The Ministry of Education and Science approved the list of recommended prevention programmes including national programmes, international programmes and adapted foreign programmes. The specialised medical help to persons with dependence disorders is provided by the health care establishments possessing a valid license for mental health care. The scope, types, duration and etc.  of the services of treatment and rehabilitation of dependence disorders was established by Resolution No 204, of   May 3, 2002, of the Minister of Health of the Republic of Lithuania On the Approval of Standard of Treatment and Rehabilitation of Dependence Disorders.

Public expenditure

Expenditures in 2018 goal of the interinstitutional Action Plan of Drug, Tobacco and Alcohol Prevention is:

Goal 1: to reduce supply of drugs, tobacco and alcohol – EUR 5050,4.

Drug-related research

Scientific research and the development of information systems and training on research are two priorities within the national programme on drug addiction, prevention and control. Drug-related studies also prioritised according to the need for information – information of some of the indicators are outdated, therefore, current studies focuses on the evaluation of problem drug users, prevalence and infectious disease situation among prison population.

Research is mainly funded by relevant ministries and public authorities, performed by universities or other scientific/academic institutions, also by independent scientist. The Drug, Tobacco and Alcohol Control department is one of the Government institutions, who is active in the drug situation monitoring area, also organise various studies and surveys in drug area (e.g. General population survey, Survey on drug use among high school students etc.). Such researches mainly (as priority) are organised with the purpose to collect national epidemiological data following EMCDDA recommendations for 5 epidemiological indicators.

More information in:

EMCDDA publication Lithuania Country Drug Report 2017:  http://www.emcdda.europa.eu/system/files/publications/4518/TD0616152ENN.pdf

EMCDDA webpage:

http://www.emcdda.europa.eu/

Last updated: 06-12-2018
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