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. https://www.e-tar.lt/portal/lt/legalAct/TAR.CF3E2829B861/asr

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. https://www.e-tar.lt/portal/lt/legalAct/TAR.2B866DFF7D43/asr

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) quantity 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. https://www.e-tar.lt/portal/lt/legalAct/TAR.78F86C6BCA72/asr

New psychoactive substances are regulated through amendments of the Schedules of Narcotic and Psychotropic Substances. https://www.e-tar.lt/portal/lt/legalAct/TAR.7B3B40DCD13A/asr

National drug strategy

The National Drug, Tobacco and Alcohol Control and use Prevention Programme 2018-2028 (hereinafter – the Programme) was adopted by the Parliament of the Republic of Lithuania (Seimas) on 13 December 2018. It is a strategic document that provides long-term national goals, priorities and commitment to apply a health-based approach to the use of psychoactive substances (drugs, tobacco and alcohol) and to help people protect or recover their health, well-being and the quality of life. The strategic goal of the Programme is a healthier and safer country where every person is able to receive help while avoiding or reducing alcohol, tobacco or drugs related harm and where opportunities to take care of the health, social and economic well-being of one's own, family or community members are provided. The Programme is accompanied by the Interinstitutional Action Plan for Prevention of Drugs, Tobacco and Alcohol with a duration of three years and which is revised every year. Since 2017 until 2018 this plan was the main national strategic document on drug (together with alcohol and tobacco) policy.

The main pillars of the Programme are supply reduction of legal substances such as tobacco, alcohol, narcotic and psychotropic substances and their precursors, demand reduction of psychoactive substances and harm reduction of drug use and monitoring as cross-cutting issue. 

New developments: due to the reform of strategic planning in Lithuania a new drug policy document is expected in 2022.

Coordination mechanism in the field of drugs

The coordination of drug policy is made at three levels:

1. Parliament Level: the parliamentary committees and commissions meet on a regular basis to discuss draft laws, submit conclusions, scrutinise in the committees issues that require a more detailed analysis, finalise draft laws and other legal acts to be adopted by the Parliament, evaluate the need for new legislation and amendments, discuss the Government programme, as well as programmes of other public institutions. The parliamentary control of the implementation of the Programme is carried out by the Parliament.

2. Levels of the Central Government: The implementation of the Programme is organized and coordinated by the Government of the Republic of Lithuania and the Drug, Tobacco and Alcohol Control Department (Governmental institution).

The Drug, Tobacco and Alcohol Control Department is responsible for the implementation and coordination of the Programme. 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.

The Programme and it’s Interinstitutional Action Plan are implemented by the following public institutions: the Drug, Tobacco and Alcohol Control Department, the Ministry of Defence, the Ministry of Social Security and Labour, the Ministry of Health, the Ministry of Culture, the Ministry of Education, Science and Sport, the Ministry of Justice, the Ministry of Transport and Communications, the Ministry of Foreign Affairs, the Ministry of Finance, the Ministry of the Interior, the Ministry of Agriculture and other institutions that work in the field of ministries listed.

3. Local Municipal Level: the municipalities are invited to implement national programme on drug policy. The Local Municipal Drug Control Commissions are set up in some of municipalities. They are not mandatory. These drug control commissions are established by the municipalities and regional administrations to coordinate the implementation of regional and local municipal programmes on prevention, treatment and harm reduction. These 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 commission is not a part of the municipality administration.

4. NGOs, private sector are invited to join public sector and implement drug policy documents accordingly

Public expenditure

Expenditures in 2021 by each goal of the Interinstitutional Action Plan (thousand EUR):

Goal 1: To reduce the demand for drugs, tobacco, and alcohol – EUR 30 619.0

Goal 2 To reduce the supply of drugs, tobacco, and alcohol – EUR 4 280.0

Goal 3: Treatment, prevention, harm reduction – EUR 11 000.0

33 measures are planned for the implementation of the IAP, for which a total of 34 910.0 thous. EUR has been allocated. Besides, the plan contains 49 measures, which are specified in other strategic documents - 18 355.0 thous. EUR.

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. 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) (available at: https://pubmed.ncbi.nlm.nih.gov/33509418/).

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 as transit to Russia. The cocaine is usually transported to Russia via Lithuania. Heroin transported from Central Asian countries to Lithuania through Russia, Belarus or other European countries, supposedly then, via Lithuania as transit country to Kaliningrad region (Russia) and Western Europe countries. Amphetamine and methamphetamine – part of these substances is produced in Lithuania and later transported to the Scandinavian countries, Finland, United Kingdom, Estonia, Russia and Belarus. In addition, these substances can be smuggled into Lithuania from Western Europe. New psychoactive substances are usually imported into Lithuania from China and other Asian countries, but they also come from the Netherlands, United Kingdom, Spain, Germany and Czech Republic.

According to the data of the Customs Criminal Service, 146 pre-trial investigations were started when narcotic and psychotropic substances were sent by post or courier services in 2020; compared to 2019 the number of initiated pre-trial investigations decreased by 49 %. Based on the data of Information Technology and Communications Department under the Ministry of the Interior, 2 963 criminal offences related to unlawful possession of narcotic and psychotropic substances were registered in 2020. Comparing 2019 and 2020 the number of registered drug-related criminal offences continues to decline, this time by 3,8 %. More than half of drug-law offences are linked to the possession of narcotic and psychotropic substances for purposes other than distribution.

As in previous years synthetic cannabinoids and carfentanil remains the most popular substances in Lithuania. In 2019, compared to 2018, the amount of carfentanil seized increased sharply, from 516 g to 3.1 kg, which even exceeded the amount of seized synthetic cannabinoids that have dominated the market in recent years. In 2020 amount of seized carfentanil is still increasing as previous year – from 3,1 kg (2019) to 4 kg (2020). 

The quantity of seized drugs from the circulation each year varies since the quantities depend on the circumstances of detentions: if smuggling with larger quantities is detained or illegal laboratories are disclosed, there is often a sharp increase observed in the quantities. In 2020 the quantity of cannabis and hashish seized decreased in comparison to previous years. New trend in 2019 remained in 2020 – the amount of amphetamine seized exceeded the amount of methamphetamine. In 2020 there was a sharp increase in quantities of cocaine, amphetamine and methamphetamine seizures comparing with previous years. Namely this increase is related to single seizure cases of big amounts of substances, including a detection of a laboratory.

Drug-related infectious diseases

In Lithuania, National Public Health Centre under the Ministry of Health (until August, 2020 the Centre for Communicable Diseases and AIDS (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 prevalence study of HIV, HBV and HCV among people who inject drugs (PWID) was carried out in 2019 (“Prevalence of infections related with the use of narcotic and psychotropic substances among intravenous drug users”). The results of rapid testing have shown the prevalence of HCV was 85,9% among participants, HBV – 4,9%, HIV – 21,2%.

In 2020, according to data of the Centre for Communicable Diseases and AIDS, the number of newly reported HIV positive cases decreased to 139 (151 cases in 2019, 160 cases in 2018, 263 cases in 2017, 214 cases in 2016, 157 cases in 2015). In 2019, out of the total number, 48 cases of newly diagnosed HIV infections (32 percent) were associated to injection-related behaviours (55 persons in 2018, 136 in 2017 and 88 persons - in 2016) and this mode of transmission HIV infection is second in frequency.

Drug-induced death and poisonings

In 2020, 61 drug related deaths (DRD) were registered. The number pf DRD decreased by 20 cases - A continuing decrease started from 2015 with 149 cases to 61 cases in 2020.  The drug-induced mortality rate decreased from 51 deaths per million in 2015 comparing to 22 deaths per million in 2020.

Most of the DRD cases are registered for male - 51 cases compared to 10 DRD cases of females. The average age of person, deceased from drug-related causes is increasing and in 2020 reached 38 years (37 years in 2019 and 36 years in 2018). There was no significant difference between gender, almost half of people died 30-39 years old. Every year approx. half of DRD cases occur in Vilnius - the capital of Lithuania.

The most part of deaths usually was related to opiates. In 2020 opiates caused 17 deaths out of 44 cases of deaths caused by drug poisoning. 7 people died because of poisoning of other synthetic drugs followed by 7 deaths caused by poisoning by other and unspecified drugs. 

According to data of the Institute of Hygiene, 306 persons addressed health care facilities (inpatient and outpatient) due to poisoning with drugs in 2020. The number is 26 cases larger than it was a year ago. The majority (214) of patients got outpatient health care services, as one third (110) persons were treated in hospitals. 26 persons were treated for poisoning with drugs for more than one time during 2020.

Male were more likely to poison with drugs and psychotropic substances as 245 male and 61 women addressed health care facility for this reason in 2020. The tendency is stable throughout several years, as in previous year 219 male and 71 female; 2018 – 328 male and 82 female, 2017 – 293 male and 66 female were diagnosed with poisoning with drugs. The highest number of poisonings are due to cannabis (93 cases), followed by opioids (74 cases) and other and unspecified drugs (62 cases).  

In 2020, the number of registered cases of children’s poisonings (under 18 years of age) with drugs is increasing and accounts for one third of all cases. Children addressed health care facilities for drug poisoning 124 times (as in 2019 – 104, 2018 – 123, 2017 – 56 times). Number of children (103) who poisoned with drugs is smaller than number of times they addressed health care facilities for poisoning with drugs, which shows that 17 children poisoned themselves more than once in a year. The majority of children (80), who were registered with drug poisoning diagnosis, were boys, compared to 23 girls. Most frequently persons under 18 years of age contacted health care centres due to poisonings with cannabis - 57 cases (2019 – 42 cases, 2018 – 41 case). Furthermore, 10 children were treated in hospital for other reasons, but also were registered with cannabis poisoning diagnosis.

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 behavioural disorders and use of narcotic and psychotropic substances (ASIS) under the State Mental Health Centre.

According to ASIS, in 2020, in Lithuania, inpatient and outpatient treatment centres provided treatment in total for 555 persons (in 2019 – 806, in 2018 – 1305, in 2017 – 1679, in 2016 – 2384, 2015 – 2549, in 2014 – 2159, in 2013 – 2209) having contacted health care facilities for mental and behavioural disorders, mostly male and applied for opioid addiction treatment.

In 2020 the vast majority of the patients who have applied for the treatment related to opioid use, most of them - heroin users (79,1 percent). Males remain dominant in the treatment system among all clients – 442 in 2020 (79,6%) (636 or 78,9% in 2019, 1076 or 82,5% in 2018, 1400 or 82,5% in 2017, 1618 or 67.9% in 2016, 1822 or 71.5% in 2015).

In 2020, the opioid substitutional treatment (OST) was applied in total for 1044 patients (in 2019 – 1033, in 2018 – 1275, in 2017 – 1136, in 2016 – 1231, in 2015 – 1393, in 2014 – 1036). In 2020, the majority of OST clients – 816 patients – were getting treatment with methadone (in 2019 – 821, in 2018 – 497, in 2017 – 339, in 2016 – 726, in 2015 – 670), 228 – with buprenorphine type medicines (in 2019 – 212, in 2018 – 497, in 2017 – 339, in 2016 – 505, in 2015 – 718).

Treatment responses

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 Centre for Addictive Disorders (note: in 2017 it was reorganized from 5 regional public specialized Centres for addictive disorders that now functions under the Republic centre as branches; branches are still located across the country) provides outpatient and inpatient services for addict patients. The Republic Centre 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.

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 2020 there were 13 low-threshold units, including two mobile outreach needle/syringe exchange points, operating in eleven 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 2020, low-threshold units distributed 245 592 syringes (in 2019 – 241361, in 2018 – 241953, in 2017 – 251370) in 2016 – 240 061). According to the research, performed in 2017, the coverage of needle and syringe programs is insufficient in Lithuania – one injecting drug user on average gets around 19-29 syringes per year. In addition, the number of clients’ visits since 2014 was increasing – in 2020 there were 49766 visits (in 2019 – 49386, in 2018 – 48885, in 2017 – 48519, in 2016 – 46238, in 2015 – 38325, in 2014 – 32004).