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 Parliament of the Republic of Lithuania, by Resolution No XIV-1982 of 23 May 2023, approved the National Agenda for Drug, Tobacco and Alcohol Control, Prevention of Consumption and Harm Reduction up to 2035 (hereafter - National Agenda). The National Agenda is a strategic planning document that outlines the long-term state strategic goals, objectives, tasks, task implementation directions, impact indicators aimed at applying a health-based approach to psychoactive substance use and assisting individuals in protecting or restoring their health, well-being, and quality of life.

The purpose of the Agenda is to establish long-term, balanced state policy goals, objectives, implementation directions, and impact indicators that would help reduce the demand, supply, and harm of drugs, tobacco, and alcohol to individuals, society, and the state.

The principles guiding the Agenda are: promotion of human rights; education and protection of society; individual approach; service quality; balanced policy and responsible governance; comprehensiveness and continuity; partnership

The Agenda provides an integrated assessment of issues related to the use of all psychoactive substances and their potential solutions. It also recognizes that the use of psychoactive substances should primarily be assessed as a matter of ensuring human physical and mental health, as well as the social well-being of both the individual and society.

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

Drug use among the general population and young people

National general population surveys on drug use in Lithuania were carried out in 2004, 2008, 2012, 2016 and 2021. The 2008, 2012, 2016 and 2021 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. In 2021, from September 17 to November 14, a total of 2,501 permanent residents of Lithuania aged 15-64 were surveyed using direct standardised interviews. Respondents were selected using a multi-stage probability sampling method. According to the data from the survey conducted in 2021, 14.1% of Lithuanian residents aged 15-64 used drugs at least once in their lifetime compared with 11.5% in 2016. In 2021, 4.5% of residents reported using drugs in the last 12 months, while 1.6% had used drugs in the last 30 days. Drug use was more common among males than females: 21.2% of males and 7% of females reported lifetime drug use, and 7.2% of males and 1.9% of females used drugs in the last 12 months. While the prevalence of drug use in Lithuania is increasing, it is still half as low as the EU average: 14.1% of Lithuanian residents aged 15-64 have used drugs at least once in their lifetime, compared to 28.9% of EU residents. In Lithuania, as in other EU countries, drug use is more common among young adults.

According to the data from the European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted every four years in European schools, in 2019, 19% of surveyed 15-16 year old Lithuanian students had tried some kind of drugs at least once in their lifetime: 21% of boys and 18% of girls. Among those who used drugs at least once in their lifetime, the majority of students mentioned using cannabis. In 2019, 18.1% of students had used cannabis at least once in their lifetime (compared to 17.7% in 2015). A higher share of boys (20%) than girls (17%) had tried cannabis at least once in their lifetime. In 2019, the prevalence of cannabis use in Lithuania was higher than the average of participating countries in the ESPAD survey (15.1%). In 2019, substances other than cannabis were used at least once in their lifetime by 5.5% of 15-16 year old Lithuanian students. After cannabis, the second most prevalent substance was ecstasy, used at least once in lifetime by 3% of students. LSD or other hallucinogens were in third place with a prevalence rate of 2.6%, followed by amphetamines (2.3%). Lifetime use of cocaine was 2.2%, hallucinogenic mushrooms – 1.2%, and other drugs were used at least once in their lifetime by less than 1% of students.

According to the Health Behaviour in School-aged Children (HBSC) survey, lifetime cannabis use among 9th grade students slightly decreased from 18.0% in 2018 to 16.3% in 2022, while last month prevalence remained the same (7.3% in 2018 and 7.5% in 2022).

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 Department of Informatics and Communications under the Ministry of the Interior of the Republic of Lithuania data, criminal activities related to the illegal circulation of drugs and psychotropic substances in 2022 accounted for approximately 6.9% of all registered criminal offenses (in 2021 - 7.5%). In 2022, in total were registered 2,577 criminal offenses related to the unlawful possession of drugs or psychotropic substances without the intent to distribute them (in 2021 - 2,328). In 2022, in total were registered 579 criminal offenses related to the unlawful possession of narcotic or psychotropic substances with the intent to distribute them, including 103 criminal offenses involving a very large quantity (in 2021 - 748, including 158 a very large quantity cases).

In 2022, the following illegal substances were seized from the illicit circulation in Lithuania: 1.1 kg of heroin (in 2021 - 1.7 kg); 22.7 kg of cocaine (in 2021 - 4.6 kg); 219.5 kg of cannabis (in 2021 - 253 kg); 1.2 kg of hashish (in 2021 - 186.7 kg); 1.8 kg of methamphetamine (in 2021 - 24.6 kg); 94.7 kg of amphetamine (in 2021 - 25.3 kg); 52.9 kg of MDMA (in 2021 - 7.1 kg).

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.

In 2022, the number of newly reported HIV positive cases was 252. Out of the total, 32 persons (12.7 %) were injecting drug users (IDU) in age from 20 to 59 years.

In 2022, 7 people with acute HBV were registered, out of them 1 case was linked to IDU. In 2022, in total 14 people with acute HCV were registered, out of them 2 cases were linked to IDU. 

Drug-induced death and poisonings

Since 2010, data on drug-related deaths (DRD) from the General Mortality Register (GMR) is provided by the Institute of Hygiene. The national focal point analyses the and reports the available DRD 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 admissions to the health care facilities (inpatient and outpatient treatment) due to poisoning with drugs or psychotropic substances.

According to the data provided by the Institute of Hygiene, in 2022, 87 DRD cases were registered in Lithuania. In 2016-2020 the number of DRDs was decreasing in Lithuania, but in 2021 the trend changed and the number of DRD cases is increasing again – from 47 cases in 2020 to 62 cases in 2021 and 87 cases in 2022. In 2022 the number of DRDs increased by 40.3% (or 25 cases) compared to 2021. Most of the DRD cases in 2022 were males (77 males and 10 females), and this trend has remained relatively stable for many years. In 2022 the average age of DRD cases was 2 years younger than in 2021 (41.3 years in 2021 and 39.2 in 2022), but, in general, the share of older adult deaths is increasing. In the latest years the majority of DRD cases were over 34 years of age, while in 2011-2013 only one third were over 34 years of age. Since 2015 the share of DRDs in the age group younger than 25-year-old remains lower than 10%. Opioids remain the primary substance group involved in most of the DRD cases (with available toxicology results), but heroin has been replaced by carfentanil and methadone. The number of DRD cases (from GMR) with synthetic opioid carfentanil is increasing (in 2021 – 16, in 2022 – 31). In the second place remains methadone, detected in 17 cases in 2022 (in 2021 – 15).

According to the data provided by the Institute of Hygiene, in 2022, the number of persons who were admitted to health care facilities (inpatient or outpatient treatment) due to poisoning with drugs and the number of admissions increased compared to 2019-2021. There were 449 drug poisonings registered in health care facilities in 2022 (381 persons with drug poisoning) (in 2021 – 377 admissions and 313 persons), of which 123 poisonings were with cannabis, 110 with opioids, 104 with “other and unspecified drugs”. As in the previous years, there were several times more drug poisonings among males than among females. On the other hand, the number of poisonings among females increased greatly in 2022 compared to the previous years, especially among those under 18-year-old. In 2022, 284 males and 97 females were admitted to health care facilities due to drug poisonings (in 2021 – 256 males and 57 females). In 2022, half of all females with drug poisoning were minors (50.5%), while among males 23.2% were minors. In 2022 due to drug poisoning minors were admitted to health care facilities 133 times, which accounts for 29.6% of all registered drug poisonings that year (in 2021 – 96 admissions or 25.4% of all poisonings, in 2020 – 124 admissions or 36.7%). In 2022, poisonings among minors were caused mostly by cannabis – 68 cases (in 2021 – 40, in 2020 – 57, in 2019 – 42).

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 Institute of Hygiene.

According to the ASIS data, the majority of individuals treated in 2022 were opioid users (about 80.9 %). The number of individuals treated for opioid use in 2022 was 347 (compared to 364 in 2021, 455 in 2020 and 649 in 2019). Additionally, the most common substances for which individuals received treatment were: cannabis (25 cases in 2022, 35 cases in 2021, 27 cases in 2020, 51 cases in 2019); stimulants (17 cases in 2022, 26 cases in 2021, 22 cases in 2020, 30 cases in 2019); sedatives and tranquilizers (17 cases in 2022, 21 cases in 2021, 28 cases in 2020, 48 cases in 2019) and cocaine (16 cases in 2022, 8 cases in 2021, 12 cases in 2020, 15 cases in 2019).

 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

Low-threshold programmes for injecting drug users were first launched in Lithuania in 1997. A special decree of the Ministry of Health, adopted in 2006, provided a background for the expansion of the programmes and set the minimum criteria for services.

According to the Republic Centre for Addictive Disorders, in 2022 there were 11 low-threshold units, including two mobile outreach needle/syringe exchange points, operating in nine municipalities 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 2022, low-threshold units distributed 380 346 syringes (in 2021 – 264 647, in 2020 – 245 592, in 2019 – 241 361, in 2018 – 241 953, in 2017 – 251 370, in 2016 – 240 061). The coverage of needle and syringe programs is insufficient in Lithuania – one injecting drug user on average gets up to 43 syringes per year. In addition, the number of clients’ visits since 2014 was increasing – in 2022 there were 63554 visits (in 2021 – 54621, in 2020 – 49766, in 2019 – 49386, in 2018 – 48885, in 2017 – 48519, in 2016 – 46238, in 2015 – 38325, in 2014 – 32004).