Summary report on National Drug Situation by iuq51574



Chapter I. Trends and new developments in drug use and responses..................................... 3
  Drugs and young people ............................................................................................................ 3
  Social processes, cultural context ............................................................................................... 3
  Epidemiological survey data on drug use among youth ................................................................ 4
  Views by Youth upon Drugs and Drug Use ................................................................................ 5
Chapter II: Patterns and prevalence of drug use and related problems ................................. 7
  Morbidity.................................................................................................................................. 7
  Drug profile ............................................................................................................................... 8
  Drug addiction in Prisons ........................................................................................................... 8
  Mortality of drug addicts............................................................................................................ 8
  Drug addiction and AIDS .......................................................................................................... 9
  Criminal offence related to drugs ................................................................................................ 9
  Illicit Drug Transportation ........................................................................................................ 11
  Attitudes and public opinion..................................................................................................... 11
  Drug policy and Strategy ......................................................................................................... 12
  International agreements and legal developments ...................................................................... 13
  Drug prevention strategy.......................................................................................................... 15
  Interinstitutional framework ...................................................................................................... 16
  International Collaboration....................................................................................................... 19
  Drug Demand Reduction activities............................................................................................ 19
  Primary Drug Prevention.......................................................................................................... 19
  Assessment of prevention activities........................................................................................... 20
  Participation in substance abuse prevention by institutions. ........................................................ 22
  Treatment and rehabilitation ..................................................................................................... 23
Chapter III. Established and changing responses to drug misuse ......................................... 24
  Substitution treatment .............................................................................................................. 24
  Methadone.............................................................................................................................. 24
  Risk behaviours patterns (e.g. injecting, sharing) ....................................................................... 25
  Women, children and drugs. .................................................................................................... 26
Annexes .................................................................................................................................... 27
  Summary................................................................................................................................. 27
  Main achievements .................................................................................................................. 27
  Tables ..................................................................................................................................... 29

Chapter I. Trends and new developments in drug use and responses
Drugs and young people

Recently in Lithuania as in other East and Central Europe countries fast economic and social changes
influencing life of people occur. Youth is most vulnerable due to complicated economic, social factors.
Availability of alcohol, tobacco and drugs, lack of information about consequences of these substances
lead to use of alcohol and tobacco products, illegal narcotic and psychotropic substances at early age
and involvement into risky activities related to these substances.

Abuse of psychotropic and narcotic substances among young people becomes a new social phenome-
non at entertainment events, discotheques. Drugs are distributed in discotheques, near schools, on
streets. During entertainment events alcohol beverages and tobacco products are sold. Young people
take interest in the new Western youth philosophy and ideology related to use of drugs - hashish and
marihuana, synthetic drugs of the amphetamine group, Ecstasy, LSD.

The young people also try to use smoking heroine and sniffing cocaine. Trough very short period they
start to use heroine intravenous.

Data based on both observation and the epidemiological investigation demonstrate that abuse of addic-
tive substances among youth becomes a threatening social phenomenon: social, health, legal problems
related to alcohol, tobacco and drug abuse are increasing.

Though tobacco and alcohol are legal substances and have been used by the society for centuries abuse
of these substances incurs huge harm to the society due to health disorders, early deaths, social prob-
lems, economic losses. Currently the abuse level of illegal drugs and psychotropic substances increases
and its harm is unpredictable. It’s threatening that young people who start to use drugs are involved into
illicit drug business.

The tobacco and alcohol industry has been looking for new customers and are misleading young people
with the help of attractive advertising encouraging to use these substances. The market of illegal drugs
and psychotropic substances is looking for ways to penetrate into subconsciousnes’s of a young individ-
ual, and the advertising is not always under control though prohibited by the law.

Social processes, cultural context

Among the persons consuming drugs a few social groups may be distinguished in particular. The biggest
risk group includes urban young people, aged 15-25, that relate consumption of drugs and relaxation in
spare time, fashion, musical culture, that attend discotheques and use the stimulators as experimenting
with drugs; they are from well-to-do families, study or work, are not involved in criminal activities and
don’t consider consumption of drugs to be dangerous or risky.

Another group can be distinguished including schoolchildren sniffing volatile substances. Mainly these
are teenagers from poor and disintegrated families, with parents abusing alcohol. These children can be
easily influenced by the criminal circles.

The third group includes persons dependant on drugs, half of them were imprisoned or committed some
legal violations. The group of social minority -gypsy community in Vilnius is a specific risk group with
such distinguished features as illiteracy, unemployment, isolation from the society. Out of 240 members
of the Gypsy camp in Vilnius 50 inject opiates, they avoid changing their lifestyle leading to high risk for
AIDS infection. Special program for gypsy community social integration and drug prevention has been
prepared by Department of Social Minorities of Lithuanian Government.

Epidemiological survey data on drug use among youth

Since 1995 upon initiative by the Information on Alcohol and Other Drugs Council of Sweden and the
EC Pompidou Group dealing with fight against abuse and illicit trafficking of drugs, the survey on alcohol
and drugs abuse among schoolchildren (ESPAD) were carried out simultaneously in 26 European coun-
tries including Lithuania. Pedagogic’s Institute (at the Ministry of Education and Science), Educational
Research Department. The main objective of this project was to collect comparable data regarding to-
bacco, alcohol and other drug prevalence among schoolchildren in Lithuania, to compare tendencies of
substance abuse in different countries.

3196 students aged 15-16 from high and technical schools participated in the survey. Analysis of the
questionnaires revealed the following information: 25,3% of the participants smoked daily, 94,8% -
used alcohol (over 2/3 used to get intoxicated; used alcohol and “tablets” at the same time), 3.2% -
used illegal drugs (smoked marihuana mainly, used amphetamine, crack, Ecstasy, heroine and LSD),
14,6% - tranquillisers, soporifics, 15% - used to sniff volatile substances, glue, aerosol, few deaths were
registered. The rates of frequent use of inhalants were higher for boys than for girls (17,6% and 14%
respectively). Inhalants were popular among age group of 13-14.

After the survey in 1995, the Pedagogics Institute carried out a few smaller surveys according the same
methodology, which was used on the ESPAD project. Findings of this study provided a valuable source
of information.

Until 1995 the prevalence of different drugs in Lithuania among students was low in comparison with
other Baltic States or European countries (ESPAD Report, 1995) The survey in 1997 in Vilnius schools
showed the tendency of rapid growth of drug abuse among the schoolchildren aged 15-16 and they
were familiar with most of the drugs. The use of illicit drugs in the same age group (in Vilnius) became
alarming - jumped from 3,2% in 1995 to 26% in 1997 year, i.e. 8 times more. Every fifth participant of
the survey tried to use of marihuana or hashish. Students tried to use ecstasy, LSD, amphetamine and

Use of tranquillisers or sedatives without prescription among students was rather high in 1995 year
(14,6%). According to use of tranquillisers in comparison with other European Countries Lithuania was
in the second place after the Poland. The figures showing consumption of tranquillisers and sedatives in
1998 increased to 23,6%, among girls to 37,3%. The rates of use frequency of inhalants decreased
from 15,7% in 1995 to 12% in 1998.

The survey indicates much higher prevalence of legal substances compared to illicit one. But due to
transfer of cultural patterns as well as social changes the use of illicit drugs among youth picked up
speed during the last 3 years.

The situation regarding alcohol and drug abuse is more threatening in the regions including favourable
geographic transit conditions. One of such places is the city of Klaipeda. In the end of 1998 Klaipeda
was chosen for implementation of the PHARE program TA to DDR project “Primary Drug prevention
of Drug Demand within the local community”. According to this project the survey using the above ES-
PAD questionnaire was carried out in secondary schools in Klaipeda.

                          SURVEY ON ALCOHOL AND OTHER DRUGS USE
                                       OF KLAIPËDA 1998
                                                                                                                               European level

                                                                                                                               Country level
     100                      96,3
                                                                                                                               Data of 9 forms
      80                                            74,1
                                                                                                                               Data of 11 forms
      40                                                          38,7
      20                                                                                                                           15 13,6               16
                                                                                12       13,3                                                                 12,5
                                                                                                                  6,5          8             10,9   9
                                                                                                          4                                                          5,3
                                                                                     1                        2
           Alcohol use during        Drunken during last Smoking during last     Marihuana,            Other illegal drugs         Sedatives            Inhalants
             last 12 month               12 month             30 days             Hashish

The number of respondents: 655 schoolchildren of grades 9 and 11. The survey among schoolchildren
of grades 9 and 11 in secondary schools in Klaipeda demonstrate that harmful habits among the age
group of 15-16 years and among the age group of 16-18 years are wide spread in this region: 35,1% of
schoolchildren smoked on daily basis, even 96,8% used alcohol at least once, 65,9% of the teenagers
had been drunk at least once. 38,7% of the schoolchildren indicated immoderate drinking dangerous to
young people at that age. A problem of illicit drug abuse does exist. The data showed that 27,1 per cent
of students 11th forms used marihuana ands hashish (in 1995 country level 1 per cent, European level 12
per cent), 19,7 per cent or every fifth used illegal drugs, 10,9 used sedatives and 5,3 percent - inhalants.
The diagram above demonstrates comparison of alcohol, tobacco and other drug abuse including the
average in Europe, in the country and the survey results in Klaipeda.

As provided above, the survey results among respondents of grade 9 in Klaipeda look better than those
for the same age group schoolchildren in Vilnius, though the survey results (many items) among respon-
dents of grade 11 exceeds those of Vilnius and surpasses the European average determined in 1995.
Alcohol is abused more (intoxication, hard drinking). Thus legal intoxicants cause a bigger problem than
illegal drugs, any minor legalisation of them might sufficiently worsen the situation and cause extensive

Views by Youth upon Drugs and Drug Use

In 1998, based on the request by the Educational Department of the Municipality of Vilnius the survey
Schoolchildren and Drugs in secondary schools in Vilnius was carried out. The objective was both to
investigate peculiarities of intoxication substance abuse, views upon intoxication and application of pre-
vention measures in schools.

The answers by the schoolchildren why young people use drugs were as follows:
1) Out of curiosity (46,8% boys; 51,9% girls).
2) Want to feel pleasure (44,1% boys; 29% girls).
3) Want to relax (35,1% boys; 26,3% girls).
4) Want to follow their friends (32,8% boys; 36,4% girls).

5) Want to fell oblivion (25% boys; 39,4% girls).
6) In fashion (11,6% boys; 14,8% girls).
The answers by boys and girls are rather similar. However, the girls indicated willingness to follow their
friends in the second place. Different answers were provided to this question by different age groups
though curiosity remained in the first place. If the wish to relax was indicated by 27,3% of the 8th grade
schoolchildren and the wish to follow their friends - by 5,7%, the answers provided by the 12th grade
schoolchildren - 35,8% and 30,6% respectively.

Aiming at finding views upon drugs by schoolchildren certain statements were provided to them to an-
swer whether they agree or disagree.

        Views upon drugs and problems related to them by schoolchildren (%)
Statement                                                 Agree        Disagree
Light drugs should be legalised                           41           56,9
Use of drugs is a personal matter of an individual        74,8         23,9
Drug addicts should be strictly punished                  44,4         53,4
Addiction is not caused by using one or few times         34,4         62,7
Grass smoking is absolutely not harmful                   19           78,9
Light drugs are better than alcohol abuse                 22,3         73,9
Drug abuse is always related to criminal activities       44,8         52,5
Only drugs provide full relaxation                        13,7         84,4
Only cowards do not try drugs                             4,1          94,3
Drug dealers should be strictly punished                  82,1         16,2
Drugs may extend learning challenges                      28,3         68,7

The above results provide contradictory views upon many issues by the schoolchildren. This fact dem-
onstrates that schoolchildren lack knowledge about drugs, their impact on human organism and abuse
consequences. Even 34,4% of the schoolchildren think that addiction is not caused by using one or few
times, and 19% - that grass smoking is absolutely not harmful. Views by the boys are more liberal – the
greater number of them support legalisation of drugs, are against stricter punishment to drug dealers and
think that use of drugs is a personal matter of an individual. Views by the different age groups differ too.
Views by the 8th grade schoolchildren are stricter: 65,1% support punishment to drug addicts (compare:
30,5% of the 12th grade schoolchildren); 63,4% of the lower grade schoolchildren and 32,4% of the
12th grade schoolchildren think that drug abuse is always related to criminal activities. Younger school-
children’s knowledge about drugs are poorer. 21,9% of the 8 th grade schoolchildren think that only
drugs provide full relaxation (the 12th grade schoolchildren - only 9%); 7,1% think that only cowards do
not try drugs (the 12th grade schoolchildren – 2%), and 35,7% think that drugs may extend learning
challenges (the 12th grade schoolchildren – 25,1%).

The survey showed that more liberal views and poorer knowledge about drugs and their impact is by
the schoolchildren who are worse learners: 47% speak in favour of drug legalisation, 70,1% - for pun-
ishment of drug dealers. The brilliant students provide answers respectively 38,2% and 87,8%. 43,3%
of the worse learners and 23,3% of the brilliant students think that addiction is not caused by using one
or few times. Even 34,3% of the worse learners and only 8,7% of the brilliant students think that grass
smoking is absolutely not harmful.

However, different views are related to different experience by the schoolchildren. Views by the
schoolchildren who use drugs are more liberal: 71,2% speak in favour of drug legalisation, 88,3% think
that use of drugs is a personal matter of an individual. More schoolchildren who use drugs think that
drug use is not harmful. 55,5% of schoolchildren who use drugs think that addiction may not be caused
by using drugs one ore more times (compare: 30,5% of non-users); 46,2% - that grass smoking is ab-
solutely not harmful (compare: 12,9% of non-users). 40,9% of schoolchildren who use drugs think that
drugs are better than alcohol abuse (compare: 81,2% of drug non-users disagree with this statement).

Sources of knowledge about drugs by schoolchildren were identified. The main information source is the
TV (61,7% of the boys and 59,6% of the girls), in the second place - friends for the boys (52,1%) and
press – for the girls (49,5%). In the third place press was for the boys (42,5 %) and friends – for the
girls (47,6%). Unfortunately, information about drugs is obtained from teachers rarely, and this informa-
tion source was indicated by 11,8% of the girls and 10,1% of the boys. Information sources change
with different age groups as demonstrated in the below Table.

Sources of information about drugs for different age schoolchildren (%)

   Grade         Press         TV          Radio        Friends       Clubs,     Teachers      Other
    VIII         45,5         70,7          5,8          34,4          15,1          13,4       15,1
     IX          47,9         71,3          3,6          41,4           9,0          13,1       14,1
      X          45,6         57,9          1,7          52,4          14,9          12,6       14,9
     XI          44,5         53,0          1,6          56,0          17,1          10,3       17,5
    XII          47,1         49,0          1,6          65,0          17,2           5,5       13,8

The information provided shows that schoolchildren of the 8th-12th grade are less influenced by the TV
programs, and more information is obtained from friends, at clubs, discotheques. Unfortunately, the role
of teachers to provide knowledge about drugs is decreasing. Information sources by worse learners and
good students differ. The brilliant and good students obtain information from the TV and press while the
worse learners – from friends (63,3% of the worse learners indicated this source). The schoolchildren
who use drugs get mostly information from their friends (even 82%), 32,3% of the schoolchildren who
use drugs get this information at clubs and discotheques.

Chapter II: Patterns and prevalence of drug use and related problems


Since 1997 the 10th disease and drug abuse classification is applicable Lithuania.

According to the data by the State Mental Health Care Centre of the Ministry of Health at the health
care institutions 2862 drug addiction cases were registered in the end of 1998, including newly regis-
tered 492 drug addiction cases during the last year. 77,3 drug addiction cases per 100.000 population
accounted in 1998 in the country. In 1998, for different reasons 555 drug addicts were excluded from
the medical data register and in 42 cases it was reasoned by death.

69,5 % (1989) of the observed drug addicts use opiates (injections), different drugs - 16,7% (477) (in-
jections), individuals who use cannabis preparations - 0,9% (27), amphetamines and other stimulants -
2,9% (82), hallucinogenic substances - 0,3% (10), psychotropic substances - 4,5% (129), even volatile
substances, solvents - 5,2% (148), were registered.

The age of drug addicts in comparison with 1997 stay younger and drug abuse cases registered with
health institutions distribute as follows: under 14 years – 1% (28), compared to 1997 it increased 5
times, 15-19 years – 10%. (288), compared to 1997 it increased 2,6 times, 20–24 years – 21%.
(606), 25-35 years - 42,0%, and only 26 % of drug addicts are over 35 years of age.

94,2% of all drug addicts are urban population and 5,8% are rural population. 18,9% of them - women
and 81,1% - men.

According the statistical data analysis the highest rate of drug addiction is in the city of Visaginas - 417,5
per 100 000 population, i.e. 5,4 times exceeding the country level 77,3 - per 100 000 population. This
city is known in Europe because of the Ignalina Nuclear Power Station. The second highest rate of ad-
diction is in the city of Klaipeda (sea-port) 223,4 drug addiction cases per 100 000 population, i.e. 2,9
times exceeding the country level, the third in Druskininkai 216,1 - per 100 000.

Within the last 7 years the number of addicts increased 5 times per 100 000 population (in 1991 - 15,3
cases per 100 000 population, in 1998 - 77,3 cases per 100 000 population), however the level did not
change within the last two years. In 1997 - 77,4 cases per 100.000 population, in 1998 - 77,3 cases
per 100 000 population.

Drug profile

Drug profiles have been changing. The most of drug addicts are using home made heroin or poppy ex-
tract from poppy heads and poppy straw (“himka” in slang) dried poppy straw is prepared in a simple
manner with solvents, and the brown colour solution is injected one or twice a day. 95,4% of drug ad-
dicts use opiates intravenously, 4,6 % - per os. According to data IDU used mixture of poppy extract
with tranquillises or antihistamines.

Traditionally psycho-stimulators, mainly “jeff” produced of medication containing ephedrine, like “So-
lutan”, ephedrine powder “Kristal” is used (up to ten injections a day). In 1996 amphetamine was intro-
duced on the “black market” and is consumed by young people, aged 15-19, in tablets or intravenously.
Among children, aged 9-14, sniffing of volatile substances (mainly glue) is popular.

Pure heroine for smoking and cocaine are the new drugs introduced last years in country and consumed
by young people.

Drug addiction in Prisons

According the data of the Medical Department of the Ministry of Interior in 1998 in the Lithuanian pris-
ons 65,8 drug addiction cases per 1 000 prison population were registered (6580,0 for 100 000 or 85
times exceeding the country level). 7 HIV positive cases were registered. The prisoners have used the
some drugs as widespread in country.

Mortality of drug addicts

In 1998, 42 drug addicts(in 1997-29) died: suicides - 2, accidents - 8, infectious diseases - 3, somatic
diseases - 7, disclosed reasons - 22. The data is not reliable, and the number of deaths related to drug
abuse is much higher.

Families try to conceal the actual death reason trying to avoid condemnation and legal consequences.
Cases are known when drug abusers replaced drugs with alcohol or used other drugs in addition. One
death case of 2 children was registered in Klaipeda.
Currently more attention to drug case is paid by forensic experts when assessing death cases (blood
tests, signs of injections).

According the data of the Ministry of Interior in 1998, 60 deaths related to drugs were registered, and if
to include the death cases indirectly related to drugs the number increased to 135 death cases (81 cases
in 1997). By observation of medical staff 10 % of deaths are directly or indirectly related to drug abuse.

In Lithuania mortality caused by external reasons and intoxication occupies the third place following dis-
eases of blood circulation and vessels and oncological diseases. It is related to substance abuse – both
legal (alcohol and tobacco) and illegal.

Drug addiction and AIDS

According to the decree by the Health Ministry of Lithuania all drug addicts must be checked for HIV
infection one or two times a year. HIV infections by 31/12/1995 was reported 40 cases. First HIV-
infected intravenous opiates drug user was detected in Klaipeda city (seaport) in September 1996.

At the end of 1998, 135 HIV/AIDS cases were disclosed, 123 of them man and 12 women, 21 -
AIDS, 11 died from AIDS. The main way of infection was definite among IDU (63 intravenous drug
addicts), i.e. 46,4 % of all HIV positive cases, and nearly all of them are from the Klaipeda region.

Klaipeda seaport have special geographical position. It is very closely situated to the Kaliningrad Dis-
trict (Russian enclave). There are 2575 cases of HIV positive registered and 1617 of them are drug ad-

October 1, 1999 177 HIV positive cases were registered in Aids centre.

Criminal offence related to drugs

According to the Ministry of Interior within the last 4 years the situation in terms of drugs worsened
fiercely. In 1997 the level of criminal offence (630) related to drugs increased 8 times compared to the
level of 1990 (76). In 1998 the level of crime situation was the same -629 criminal offences related to

Organised crimes related to drugs became international. Every ninth criminal offence was committed by
a group, every second – by persons earlier imprisoned. 381 criminal offence cases were performed by
persons who neither worked nor studied, 18 criminal offence cases – by teenagers (in 1997 - 10), in-
creased 80 %. Illicit narcotic drug trafficking, production, possession, acquisition, transportation, ship-
ment and trade in illicit drugs predominate among criminal offence cases and account for as follows: in
Vilnius – 30%, in Klaipeda – 13%. In these cities the trade network exists. 435 persons were perse-
cuted legally.

According to the Ministry of Interior and Municipal Police dens of drug addicts and drug seizure cases
are disclosed. Based on the decree by the Minister of Interior during the “Aguona” operation police
searches for poppy and cannabis fields to destroy them. During this operation abandoned farms, dens,
areas of summer homes are examined.

In 1998, 3 500, 2 sq. m. of poppy fields (in 1999 - 33 697 sq. m.) and 511,5 of cannabis fields were
destroyed. In 1999 were destroyed 1842 sq. m. cannabis fields or 3,6 times more than in 1998.

In 1998, 2836 persons were persecuted legally for the cultivation of drug raw materials, in 1999 such
persons were 4224 or 49% more than in 1998.

148 persons including 15 teenagers committed administrative violations intoxicated with drugs or toxic
substances (in 1999, 219 persons including 27 teenagers).

In 1998, 3037 persons including 18 were teenagers were persecuted legally because administrative vio-
lations related to drugs (in 1999 - 4503 persons). .425 drug abusers including 30 children were dis-
closed. Legal persecution was instituted to 92 including 4 teenagers. Penal provisions were applied to
126 persons including 6 children.

In 1997-1998 the following drugs were withdrawn from the illicit trafficking:
No     Name of drug                   seized in 1997          seized in 1998            per cent
                                      quantities              quantities                increase +
                                                                                        decrease -
1      Opioides
1.1.   Poppy heads and straw          1291kg            1525 kg                         + 18
1.2.   Opium extract                  86,04 l           49.49 l                         - 42
1.3.   Opium                          236 gr.           101,3 gr.                       - 68
1.4.   Acetylopium                    16,461            182,38 gr.                      +
1.5.   Heroin                         89,3 gr.          422,62 gr.                      + 373
1.6.   Methadone                      252 pills, 10 ml, 13 pills 0,04 gr.               -
                                      0,34 gr.
1.7.   Monoacetylmorphi               4,41 gr.          -                               -
2.     Cannabis
2.1.   Marihuana                      8 kg. 63 gr.            30 kg. 357 gr.            + 251
2.2.   Hashish                        78,4 gr.                3 kg 780 gr.              + 4721
3.     Cocaine                        2 kg 49 gr.             10 kg 780 gr.             + 306
4.     Psychotropic substances
4.1.   Amphetamine                    171 gr. 5641 pills      12,84 gr. 142 pills       -
4.2.   Ecstasy                        1641 pills              831 pills                 - 49
4.3.   Ephedronum                     1348 ml.                994,9 ml.                 - 26
4.4.   Phencyclidine (PCP)            2,21 gr.                -                         -
4.5.   LSD                            2 marks                 342 marks                 + 17000
4.6.   Relanium                       123 amp                 671 amp.                  + 445
4.7.   Rodedorm (nitrazepam)          143 pill.               566 pills                 + 295
4.8.   Oksazepam                      -                       43                        +

Average Street Prices on the Drugs

poppy heads and straw                     from 2 to 20 litas for glass (about 5$)
opium extract                             4 to 10 litas per 1 ml (2,5$; daily dose -up to 15 ml(38$)
marihuana                                 15 to 25 litas per 1 gr. (6$)
hashish                          60 litas per 1 gr. (15$)
amphetamine                               30 litas per 1 pill. (7,5$)
ecstasy                                   40 to 60 litas per 1 pill. (10-15$)
heroin                                    40 - 60 litas per 1 dose (10-15$)
cocaine                          350 - 400 litas per 1 gr. (100$)
LSD                                       50 - 60 litas for mark (12,5-15$).

The prices vary in relation to the quantity and each seller. Earlier the sellers were more specialised and
dealing with one brand of drugs while at present the same sellers retail different drugs. The sellers act in
discotheques and other entertainment places, bars, streets etc.,

90% of drug addicts don’t work and have no constant means of subsistence. The prices of drugs show
permanently increasing demand for drug addicts to get money to buy drugs. They earn money by illegal
and criminal way. Some drug addicts as women earn on drug by prostitution.

Illicit Drug Transportation

As Lithuania is situated in the centre of Europe, our country has become a transit route from East to
West including that of illicit drug trafficking from Eastern to Western Europe and due to Lithuania's fa-
vourable geographical location, the developed road network, sea and air routes. More than 14 000 of
different transport and tourism companies are registered in Lithuania.

From the East the poppy straw and heads, opium, heroin, marihuana, hashish, ephedrine hydrochlo-
ride are introduced to Lithuania. The most known way is transportation of drugs by train from the Rus-
sian Federation to the Kaliningrad region. By this way the transportation of drugs is going from Kazakh-
stan, Kirghizastan, Azerbaijian, Tadjikistan and Afghanistan, Pakistan, and Turkey. By the cars the
drugs are transported from Ukraine to Kaliningrad.

Another direction of transportation of drugs may be mentioned as follows: from Ukraine through Byelo-
russia, Lithuania, Latvia, Estonia towards Sankt Peterburg. A heroine laboratory existing in Ukraine
form a threatening situation because the heroin could be transported over through Lithuania to Scandi-
navian countries.

From the West different illicit drugs such as cocaine, marihuana, amphetamines, LSD, ephedrine, ec-
stasy are introduced to Lithuania. In Lithuania many people are engaged in trading second - hand cars.
Such cars are mostly purchased in the Netherlands and Germany. Persons dealing with drugs are using
this means of second-hand cars in numerous cases without knowing by the owners.

Narcotic drugs from the Netherlands, Poland, Germany, Bulgaria are transported also by cargo lorries,
because inspection of cargo in the customs frequently is superficial.
Though growing of poppies and cannabis plants was prohibited in Lithuania by the Law On Control on
Narcotic Drugs and Psychotropic substances (adopted beginning of 1998) in 1998 fields of poppies
and cannabis decreased however in 1999 were exposed more violations related to growing of drug raw
materials then in 1998. Cannabis fields were destroyed 3,6 times more in 1999 than in 1998.

Attitudes and public opinion

In the course of recent years the community started to pay considerably more attention to the dug prob-
lems. Last year the society is very concern on narcotic drugs use habits among young people. In recent
years more attention to the drug issues including drug prevention and control is paid by the Seimas (Par-
liament) and the Government of the Republic of Lithuania.

For formation of the public opinion Mass Media play a significant role. Phare project Multidisciplinary
training on the Global Approach to Drugs Phenomena in 1997 created the bottom for collaboration with
Mass Media on community awareness rising The training’s according to this project were dedicated for
journalists - Radio, TV, daily news, magazines. Outcomes were successful The network of journalists
writing on drug problems was established. Mass media started actively participate in the community
awareness rising on drugs related problems and forming of drug policy. The opinion on global approach
to drug phenomena was formed among journalists and transformed to society. For example, the Phare
project TA to DDR on community drug prevention was gone in Klaipeda city (July 1998 - September
1999) during this time about 180 articles were published (gathered and registered) on drug related
problems in local daily news with supporting DDR policy, additional two broadcast and two telecasts 1-
2 times in week reported on drug prevent activities.

Earlier solely one approach was demonstrated towards drug addicts, i.e. a drug addict is an extremely
dangerous person socially who may attack and rob, and the background for this approach is the fact
that drug addiction was met then mainly in prisons and was not observed in public life. Drug addiction
used to be an alien problem to the society, it was never discussed in an open manner, drug abuse ex-
isted in the underground circumstances. Now the community has more information and knowledge,
faces this problem in reality, treatment and rehabilitation problems are considered publicly. Assistance to
drug addicts is being provided.

Drug policy and Strategy

Political developments in 1998

Prevention of harmful habits including drug abuse was declared as priority in the Governmental Action
Plan of Lithuania (1997-2000), approved July 14, 1997.

The Plan of Main activities for Drug Control and Drug Prevention for 1998-2000 was approved by the
Government in January 1998 and formed the foundation of National Drug Prevention strategy.

In February 1988, the Governmental Drug Control Commission made a statement about the situation
and needs for future development of Drug policy and strategy in the country to the newly elected Presi-
dent, Chairman of the Seimas, Prime Minister and other Authorities also to Mass Media. The statement
was taken into consideration and actions for development of Drug policy followed

The Health Committee of the Lithuanian Parliament discussed drug policy March 25, 1998, and de-
cided to establish the Co-ordination Board on Drug Prevention, Treatment and Rehabilitation within the
Ministry of Health. The Co-ordination Board by the decree of the Ministry of Health was formed June
23, 1998.

According to plan of reform of health care system since April 1998 alcohol, tobacco and drug related
problems have been authorised to competence of the Public Health Department of the Ministry of

In May 1998 the Third Regional European Conference according to the plan of activities of the PHARE
program Precursor Control Project “On Drugs Precursors” was arranged in Vilnius. Representatives
from countries of the EU and CEEC took part in this Conference.

June 24, 1998, Association between the European Union and the Republic of Lithuania adopted Deci-
sion No 98 of the Association Council on the terms and Conditions for the participation of the Republic
of Lithuania in Community programmes in the fields of health and social policy as follows: Article 1.
Lithuania shall participate in the European community programmes Prevention of AIDS and other com-
municable diseases, Drug dependence etc.

The Lithuanian Health Programme for 1998-2010 was confirmed by the Lithuanian Parliament July 2,
1998 with the chapter on Drug Demand Reduction activities. Drug demand reduction in community is
very important issue.

In 1998 the implementation of the Phare TA to DDR Subregional project “Primary Drug Prevention of
Drug Demand within the Local Community of Klaipeda” started after preparation period. The project
was widely introduced for society.

The International Conference “On Perspective of Drug Prevention and Drug Free Treatment” took
place October 9-10, 1998 in Vilnius. The conference was organised by non-governmental organisations
with support of the Ministry of Health and the Lithuanian Seimas Health Committee. The Conference
accepted the Resolution concerned about worsening of Drug situation in the country and expressing
criticism on development of Harm reduction programmes on the spot of drug free treatment and others.

November, 1998 the 6 members of the Health Committee of the Lithuanian Seimas were invited to
Study Visit to Stockholm for getting acquainted with the Swedish model of Drug Policy and Drug pre-
vention, also to learn the care system for drug addicts. The attention of politicians to drug problems in-

The Lithuanian National Health Education Centre in collaboration with the Phare project TA to DDR
took initiative in organising activities in Lithuania dedicated to the European Drug Prevention Week (16-
22 November, 1998).

The Conference “Drugs Health and Society” was organised by the Association of Dependence Disor-
ders psychiatrists.

December 17, 1998 the Chairman of the National Health Council made a statement on the health status
of the population in the country and the reform process in the health sector. Prevention of substance
abuse among young people was declared as the main problem and area of action priority for the Lithua-
nian Government and the Ministry of Health.

December 21, 1998, the Health Committee of the Lithuanian Seimas discussed accomplishment of the
Health Part of the European agreement to become a member of the European Community and accepted
the special Resolution for the Government regarding Drugs: for strengthening of Interinstitutional co-
ordination and confirmation of the National Drug Prevention Strategy.

The Lithuanian Government 10 May, 1999 accepted the Resolution No. 547 “On Resolution of Lithua-
nian Government from February 28”, 1995 No. 282 “On Confirmation of the Governmental Drug Con-
trol Commission and statute” Composition of Governmental Drug Control Commission and it statute
partially were changed. The residence of the Commission stay in The Ministry of Health.

September 6, 1999 “The National Drug Control and Drug Addiction prevention Program for 1999-
2003” was approved by Lithuanian Government, Resolution No. 970 of (State News no 76). The
problems of implementation of the National Program is connected with economical situation of Lithuania
of today’s.

International agreements and legal developments

In 1994 Lithuania became party to the UN Single Convention on Narcotic Drugs of 1961 and the UN
Convention of Psychotropic Substances of 1971.
March 12, 1998, the Lithuanian Parliament adopted the Law on Ratification of the UN Convention of
1988 “On the fight against illicit trafficking of narcotic drugs and psychotropic substances”. The above
mentioned 1988 UN Convention came into force September 6, 1998.
Decree No. 239 by the Ministry of Health, 1997 04 28, approved the list of narcotic drugs and psy-
chotropic substances in compliance with the lists of controlled narcotic drugs and psychotropic sub-
stances by the UN conventions.

The Law on Control of Narcotic Drugs and Psychotropic Substances No. VIII-602 was adopted by
the Seimas (Parliament) January 8, 1998. This law prescribes the basis for classification of narcotic
drugs and psychotropic substances, licit trafficking when used in health care establishments, for veteri-
nary and scientific purposes, in compliance with the provisions of international agreements. In Lithuania
this law prohibits growing of drug raw materials - poppies and cannabis.

So far licit drug trafficking has been regulated by degrees of the Ministry of Health and resolutions by
the Government based on provisions of the UN Conventions.

Law on Amendments to the Administrative and Penal Codes regarding illicit trafficking of psychotropic
substances were introduced in February, 1998.

The Law on Narcological supervision No VII-156 was adopted by the Seimas 25 March 1997. The
Law regulates health care of narcological patients, as well as persons abusing alcohol, narcotic drugs
and psychotropic substances, aiming at checking the disease and social consequences to it, to reduce
harm to the patients and surrounding people. This law provided basis for prevention of narcological dis-
eases, early identification of diseases, health care of the patients, integration to the society.

Narcological care aims at integration of narcological patients into the society as soon as possible through
specialised organisation of health care arrangements for narcological patients.

April 1997, the Law on Prevention of Money Laundering of the Republic of Lithuania was approved by
Seimas and respective implementation acts drafted. This law became effective 1 January, 1998.

Lithuania has ratified the Council of Europe convention on Laundering, search, seizure and confiscation
of Proceeds from crime, December 22, 1994.

November 14, 1996, the Lithuanian Government together with other Baltic Countries, the European
Commission and UNDCP representatives signed the Riga Declaration on the Fight Against Money

October 12, 1998, the Ministry of Health confirmed a List of precursors.

June 2, 1999 the Law on Precursors Control No VIII-1207 was adopted by Lithuanian Parliament.
This law regulates activities, procedure and control in relation to precursors in the Republic of Lithuania
and external trade. This Law aims at assurance that precursors are not used for manufacture of illicit
narcotic drugs and psychotropic substances. The law was prepared on the basis of requirements UN
1988 Conventions “On the fight against illicit trafficking of narcotic drugs and psychotropic substances”
and European Union Regulations on Precursors trade. The law came into force October 1, 1999.

Seimas of Republic of Lithuania July 1, 1999 adopted Law on amendment to Penal Code article 232 10
On illicit trafficking of precursors of I category.

The control of precursors Lithuanian Government assigned to Ministry of Health

The Parliament of Lithuania ratified the UN Convention on Protection of Children Rights that obliges to
protect children against drugs article 33. The Law on children right’s protection No 1-1234 was
adopted 14 03 1996. One of the articles proclaim protection of children against drugs, poisonous and
other substances. A child should be protected against production, selling or distribution otherwise of
drugs, poisonous and other substances. For involvement of a child into substance abuse administrative
or penal liability is imposed

October 2, 1998, the State News promulgated Decree No 544 of September 25, 1998 by the Ministry
of Health prescribing implementing regulations on the Law on Narcological Supervision: “The order
aiming at medical and social influence means on active estimation of social and health situation of a per-
“The order for health care institutions on provision of information about narcological patients and per-
sons who abuse psychoactive substance, their health status, prognosis, health care service provided”;
“The order on rendering narcological care service in primary health care institutions and secondary or
tertiary level of health care institutions”:
“The criteria for length of narcological inclusion of narcological patients”.

The Law of the Health Care System was discussed by the Lithuanian Seimas December 1, 1998, and
later edited. According to this Law the National Health Council will take part in co-ordination of the
Drug, Alcohol and Tobacco control policy and prevention.

The law on Health Care Institutions introduced new nomenclature of budgetary Dependence Disorders
Centres in 1998.

The Mental Health Centre and dependence disorders centres should be financed from State or Munici-
pal Budget.

Drug prevention strategy

The National Drug Control and Drug addiction prevention programme 1999-2003 was approved by
Government September 6,1998 resolution 970. The program was prepared of joint committee founded
by Governmental Resolution No. 91 January 23, 1998.

This Program complies with the Governmental Program 1997-2000, National Health Program, 1998,
Resolution of Baltic Assembly “On the Fight against Drugs”, with guidelines by the UN International
Drug Control program and WHO, taking into account proposals by public institutions and organisations.
National Drug prevention program reflect drug situation in country, indicate directions for achievements
of Drug Demand Reduction and Drug Supply Reduction trough different measures and with participa-
tion of different Institutions.

The National programme on drug control and drug prevention is interdepartmental strategy. The carry-
ing out foresee an interdepartmental principle. Co-ordination of this program is fixed to the Governmen-
tal Drug Control Commission. The Ministry of Health according to the volume of planed measures is the
main executor of National Drug Control and Drug prevention program. The Co-ordination Board by the
order of Minister of Health was established to co-ordinate implementation of health part on it.

Other programs related to drug prevention or substance abuse prevention among young people adopted
in 1998-1999.

The National Health program 1998-2010 was approved July 1998. Program definite the health policy
in Lithuania regarding substance prevention measures;

The State Tobacco control program 1998-2010 was approved by the Government of Lithuania, De-
cree No. 945, of 30 07 1998. This program is connected to drug program due to prevention activities
among young people.

The State Alcohol Control program 1999-2011 was approved by the Government of Lithuania 25 02
1999. Due to prevention activities among schoolchildren drug abuse in the early age call to drug preven-
tion program.

The State Mental Health program was approved by Government in 1999 for prevention of mental and
dependence disorders, suicides.

The State AIDS prevention programme 1999-2001 on prevention of AIDS/HIV with the inclusion of
intravenous drug uses was adopted.

For implementation of program finances are planed.

Interinstitutional framework

Governmental, non-governmental including youth and children organisations are engaged in prevention
of drug and other substance abuse prevention.

The National Health Council

The National Health Council established at and approved by the Parliament of the Republic of Lithuania
(Decree No. VIII-612 of 05 01 1998) aims at the strengthening of public health and population in-
volvement in solving health problems and the co-ordination of activities by NGO’s, state and municipal
institutions in these areas: the health education policy, alcohol control policy, tobacco control policy,
drug control policy. The National Health Council reports to the Parliament. Act as advisory board for

The state tobacco control agency

The State Tobacco and Alcohol Control Agency approved by the Parliament of the Republic of Lithua-
nia (Decree No. 683 of 12 06 1996), together with respective ministries and other governmental or-
ganisations aims at formation and implementation of the state tobacco and alcohol control policy. This
Agency controls the implementation of the Laws on Tobacco and Alcohol Control of the Republic of
Lithuania. The Agency was established at and reports to the Government of the Republic of Lithuania.

The Governmental Drug Control commission

The Governmental Drug Control Commission including representatives of 11 ministries and institutions
established by the Government (Decree No. 282 of 28 02 1995) aims at co-ordination of activities by
the institutions and organisations responsible for control of narcotic drugs and psychotropic substances
and their raw materials, also drug abuse prevention.

Each ministry or institution have its assignment and task. Demand for the co-ordination of drug control
and prevention increased accompanied by the increased scope of work by the Governmental Drug
Control Commission. The Commission collects data and information on drug related phenomena and
acts in compliance with the regulation of the Governmental Drug Control Commission.
The Commission actively participated in formation of drug policy, assessment of drug situation, co-
operates with NGO’s, mass-media, drafting of laws and other important documents related to drug
control and prevention, operates with international organisations such as the UNO, EU, EC Phare pro-
gram, Nordic countries, WHO dealing with drug control and prevention.

The Governmental Drug Control Commission of new composition was approved by the Government of
the Republic of Lithuania (Decree No. 547, 10 05 1999). Government fixed responsibility for the co-
ordination of implementation of the National Drug Control and Drug addiction prevention programme to
Governmental Drug Control commission. The Commission on Drug situation reports to the Government.

Focal Point formal act in the Governmental Drug Control Commission. The budget for strengthening of
Focal Point is fixed: 1999 - technical support, 2000 introducing of additional staff.

The Drug Commission of the State Medicine Control agency

The Drug Commission for licit drug control was established at the State Medicine Control Agency in
1995, by Decree of the Minister of Health. The Commission carries out control of narcotic drugs and
psychotropic substances used for medical and scientific purposes, issues licenses for activities related to
narcotic drugs and psychotropic substances, issues permits for taking these substances in and out,
keeps records, provides reports to the UN International Drug Control Committee, prepares relative
documents. For better implementation of the Law on Precursors Control this Commission will be

The Co-ordination Council for Drug abuse prevention, treatment and Rehabilitation by Minis-
try of Health

The Co-ordination Council for Drug abuse prevention, treatment and rehabilitation was established at
the Ministry of Health, by Decree of the Minister of Health June, 1988. The Co-ordination Council is an
advisory/expert body including specialists of drug abuse prevention, rehabilitation, drug prevention and
control, policy makers. The Co-ordination Council provides proposals to the Ministry of Health regard-
ing the implementation of drug prevention, treatment and rehabilitation measures, considers and ap-
proves drug prevention, treatment and rehabilitation methodology, plans based on submitted materials,
provides conclusions and recommendations.

The National Public Health Promotion Centre

The National Public Health Promotion Centre was established as a public health care institution subor-
dinate to the Ministry of Health. The Centre is responsible for creation and implementation of different
health promotion and education programmes for awareness rising in society including drug, alcohol and
tobacco abuse prevention measures.

The implementation of the State Tobacco Control program is fixed to the Public Health Promotion Cen-
tre. The establishment of Resource centre on DDR in this institution was supported of Phare TA to
DDR project.

National Medicine Library

Establishment of the Documentation centre on Dependence problems is planed in National Medicine
library according to National Programme. The finances in accordance with the National programme is
fixed for it. The process of establishment of DC going

The State Mental Health Center

The State Mental Health Centre was as new institution for public health care was established January 1,
1999. The State Mental Health Centre is responsible for the secondary and tertiary prevention of de-
pendence diseases, also records of the above diseases. The Centre was fixed by the Ministry of Health
to implement the State Alcohol Control Program.

The Lithuanian AIDS prevention centre

The Lithuanian AIDS Prevention Centre is responsible for HIV/AIDS prevention in the country includ-
ing prevention of AIDS/HIV among intravenous drug addicts and implements harm reduction measures.
Centre have established rehabilitation department for drug addicts.

The Pedagogics institute

The Pedagogics Institute by the Ministry of Education and Science is responsible for preparation, as-
sessment and implementation of drug prevention programs for schools, participates in the international
survey regarding the substance abuse level, co-ordinates the UNDCP program for drug prevention in
schools for schools in the Baltic countries.
The Commission of experts at the Ministry of Education and Science co-ordinates substance abuse
prevention and health education activities.

Drug Trafficking Investigation Division

Drug Trafficking Investigation Division for co-ordination of measures on illicit dug trafficking was estab-
lished in the Ministry of Interior, Police Department , Organised Crime Investigation Service. This Unit
co-operates with the Border Police, the Municipal Police, the Customs Department, analyses the data,
carries out the investigation, operations, situation assessment, co-operates with respective structures of
other countries and international institutions, co-ordinated support programmes on Drug Supply Reduc-

The State Council of Youth affairs

The State Council of Youth Affairs established at the Government of the Republic of Lithuania aims at
assistance to solve psychological and other youth problems. Each year the State Council of Youth Af-
fairs finances drug prevention projects: in 1997 funds were provided to 4 projects, in 1968 – to 12 pro-

Youth and children Non’governmental organisations.

The role of NGO’s including youth and children non-governmental organisations and even children tem-
perance movement increases for drug, alcohol and tobacco prevention in the community. The above
organisations include: the Lithuanian Temperance Society “Baltu ainiai”, Vyskupo Motiejaus Valanciaus
Temperance Society “Valanciukai”, the Christian Youth Union “Zingsnis”, the Youth Psychological Aid
Centre in Vilnius and hot telephone lines in other towns (15 in total), the Spiritual Guidance Youth Cen-
tre in Klaipeda. In major cities and Druskininkai parents of drug addicts established their groups, clubs
of anonymous alcoholics, families of drug addicts were established throughout the country. Organisa-
tions to support alcohol and drug addicts are established: the organisation of addicts at the AIDS Reha-
bilitation Centre and others. The organisations are financed by international and public funds, support
will be provided by the National Drug Prevention Program. In 1998 the Youth Psychological Help Cen-
tre published a guide book including organisations that provide social and psychological help.

International Collaboration

International co-operation started after Lithuania regained its independence and contributed much to the
drug policy development in Lithuania. Scandinavian countries were the first ones to support and render
assistance to Lithuania. In 1993, the Nordic Drug Control Committee organised a Baltic - Nordic con-
ference on drug matters. Then co-operation with other countries started - the UNDCP, having its re-
gional office in Riga, the INCB. A very important input to the development of international co-operation
was the European Union PHARE Program “Fight against drugs in Eastern and Central Europe”. After
Lithuania became a member of the Council of Europe co-operation with the Pompidou Group started.
Lithuania is the member of WHO The Ministry of Interior of the Republic of Lithuania co-operates with
the Interpol, the Lithuanian Customs is a member of the World Customs Organisation, the Mini Dublin
Group acts in Vilnius, public organisations more and more actively co-operate with respective European
organisations drug prevention field.

Lithuania is an associated member of the EU is under preparation to membership. Baltic countries es-
tablished the Baltic Assembly and co-operate in the drug related fields. November 1997, the resolution
regarding drugs was adopted by Baltic Assembly.

Lithuania is party to all three UN Conventions: the Single Convention on Narcotic Drugs of 1961, the
Convention on Psychotropic Substances of 1971, the Convention on Fight Against Illicit Trafficking of
Drugs and Psychotropic Substances of 1998. Lithuania also co-operates with other organisations in
fight against drugs, such as “European Cities against Drugs”, Vilnius signed Stockholm Declaration, rep-
resentatives of the different International organisations reside in Lithuania.

Drug Demand Reduction activities

Primary Drug Prevention

In the National Drug Control and Drug addiction prevention programme 1999-2003. Primary drug pre-
vention in community is declared as priority among other Drug Demand Reduction activities in country.

According to the Public Health Promoting Centre information, 28 428 health education events for youth
were recorded in 1998 including alcohol and drug prevention – 7.5%, smoking prevention – 6.8%.
Health education publications included alcohol and drug prevention – 14% of the publications, harm
incurred by smoking – 11%.

The review of primary drug prevention measures and programs under implementation in Lithuania en-
ables to draw a conclusion that the majority of them are applied for schoolchildren.

In most cases the prevention measures are integrated into school curriculum. In 1994 in Lithuania gen-
eral programs of secondary comprehensive schools included an integrated health education program. It
aimed at health prioritisation in the system of values, to introduce awareness of health, to provide
knowledge and skills supporting strengthening and improvement health of oneself and others. One of the
10 chapters proposed includes the chapter “Bad Habits”. This topic includes use of medication, preven-
tion of tobacco and alcohol use, of legal and illicit narcotic drugs.

The Lithuanian Open Society Foundation has been implementing the health education Program for
teachers who provide health education in schools.

“Marytes dienorastis” (“Diary by Mary”) is a prevention program established by the Drug Information
Unit, the Nordic Council of Ministers.

Psychologists of schools have prepared the Social Education for Children and Youth Program. This
program was prepared for teachers, psychologists working in schools and all who take interest in chil-
dren and youth problems and want to help them.

Public Health care institutions of Ministry of Health started to work more actively on the drug prevention
area. Each year organises special campaigns dedicated to the World Day without Tobacco and Drugs,
European Drug prevention Week.

In 1998 the campaign goal was to inform the youth and society about the drug abuse danger. Competi-
tion was organised for the best newspaper article about drug problem and drug prevention program, the
best educational material (a brochure, poster, etc.), also a competition for youth “Do you know?”.

In 1998-1999 the Phare TA to DDR project “Primary Drug prevention of Drug Demand within the lo-
cal community” under subregional Cupertino was very successfully implemented in Klaipeda Commu-
nity. The project in Klaipeda city according to needs assessment was dedicated for drug prevention
among young people The special activities including 8 training’s seminars for community target groups
were arranged for community awareness rising , capacity building and strengthening of interinstitutional
collaboration. The continuity of this project in community is supported by Ministry of Health and
Klaipeda municipality.

The WHO Substance abuse program project “Prevention of substance abuse among young peoples in
CEEC” under implementation. The report Review on substance abuse prevention among young peoples
in Lithuania has been prepared.

The UNDCP programme School project on drug prevention for Baltic States started in 1999.
The Council of Europe Pompidou Group project DRSTP II started in 1999 and is under preparation
for implementation. in Lithuania for drug prevention in community and early intervention.

In Lithuania numerous organisations providing social and psychological help to young people have been
established lately. The telephone psychological help network in established.

Assessment of prevention activities

Currently assessment of the prevention programs, measures implemented in Lithuania is carried out. Ef-
forts to answer the following questions are made: what is compliance of the programs to their goals;
how are these programs valued by schoolchildren, young people; what organisations, institutions per-
form this work, etc.

Currently in Lithuania numerous organisations representing youth interests exist. Interviews with 48
youth organisations show that activities by 20 of them are more or less related to substance abuse pre-
vention. Workshops, discussions, training for youth leaders are organised to deal with drug problems.
Representatives of youth organisations think that the youth organisations had to contribute more to this
field (42%) and even to influence preparation of laws related to substance abuse problems (29%). Ac-
cording to young people aiming at drug prevention more attention should be paid to:

       Leisure organising                               44%
       Psychological education of youth                 36%
       Education by families                            35%
       Psychological and social support to young        30%

Unfortunately, only 25% of young people know that organisations representing interests of youth exist.

The survey carried out in secondary comprehensive schools in Vilnius showed that substance prevention
measures in schools are implemented rarely, they are poor and do not comply with the schoolchildren

Answers by the schoolchildren provided to the question what arrangements/events about drugs are or-
ganised in schools (%):

       Discussed at some lessons                        57
       Lectures delivered                               26,7
       Discussed at class meetings                      17,4
       Discussions organised                            16,3
       Discussed in school paper                        12,9
       Posters, leaflets distributed                    9,4

The majority of the schoolchildren acknowledge that they do not have sufficient information on drugs.
Nearly half of the students (40,5%) pointed out that they lack information on drugs and their harm to
human organism. 47,8% of the 8th grade schoolchildren and 35,3% of the 12 th grade schoolchildren
pointed out lack of such information. It’s interesting to note that even those using drugs recognise that
they lack information on drugs. This was acknowledged by 34,2% of the schoolchildren using drugs.

According to the schoolchildren the best way to provide information about drugs is to organise special
campaigns, concerts with a motto: “No to Drugs”. With age the schoolchildren wanted to participate in
discussions themselves instead of being passive listeners.

53,6% of the respondents provided their proposals how to stop drug abuse among youth. The rest felt
rather pessimistic and their answers provided the opinion it was too late to do something about it, “noth-
ing can be changed”, etc.

Some children who provided their proposals supported punishment, bans, stricter regulation. They pro-
posed to impose stricter punishment on drug dealers, to strengthen border control, laws, etc. Not a
small part of the children said that education about drugs, should be introduced to young people at ear-
lier stage, different forms should be used. It was proposed to promote healthy lifestyle more actively, to
encourage leisure activities of young people. In their answers the schoolchildren underlined that “all
should consolidate aiming at solving this problem”, i.e. young people, teachers, police, etc., because
“only all together may change something”. The schoolchildren expressed many reproaches: “Finally you
addressed us”; “Youth should be continuously taken care of and not only when something happens”;
“Maybe it’s good drugs exist, otherwise you would forget us completely.

Having reviewed the prevention programs and measures being implemented in schools and the survey
among schoolchildren the following conclusions have been drawn by the investigators:
 No uniform drug prevention policy and strategy exists in Lithuania;
   Substance prevention programs implemented in schools are rather rare, poor and do not meet inter-
    ests by schoolchildren;
   The majority of programs are teenager orientated;
   No education on substance abuse prevention among parents;
   Foreign prevention programs are not always adjusted for Lithuania;
   Shortage of methodology materials, visual aids.

The investigators provided the main requirements for prevention programs and measures to be imple-
mented in schools.

Participation in substance abuse prevention by institutions.

In 1998 interviews in Klaipeda city were carried out with institutions participating in the substance abuse
prevention (Phare TA to DDR project). The interviews aimed at two goals: to obtain general informa-
tion about the institutions; to identify participation of the institutions in the substance abuse prevention
(primary prevention among youth, risk groups, drug addicts); to investigate inter-co-operation of the
institutions and to learn the opinion of respondents about the youth generation in the city. 76 different
institutions including 65 public institutions and 8 non-governmental institutions, 5 private ones partici-
pated in the survey.

The survey showed that about 82% interviewed institutions are engaged in substance prevention work
among young people. Each organisation devotes about 32% (the range is from 2% to 100%) of its time
to prevention work among young people. It is obvious that activities of youth education institutions and
NGO’s are orientated towards this work. The health care sector, municipal structures, police, mass
media and some other institutions include units within their structures that organise in substance preven-
tion work among young people. The names of these units are different varying case by case, for exam-
ple, in schools these are usually councils, commissions.

About 64% of the respondents said that their institutions work with young people who try to use sub-
stance. The institutions devote about 26% of their time to this work – individual meetings with school-
children, their parents are organised, psychological telephone help is provided on the “youth line”, the
teenagers’ club and the youth club exist, etc. 13 (17%) of the institutions who participated in the survey
had units to work with risk groups. The survey data showed that mainly the health sector, NGO’s and
mass-media are involved in work with drug addicts. 14 (18%) of the respondents said that their work
was directly related to drug addicts.

A conclusion was drawn that co-operation among various institutions engaged in the substance preven-
tion was not sufficient. The most efficient substance prevention methods in Klaipeda were as follows:
 training of staff engaged the substance prevention, co-ordination of activities;
 organising of leisure time activities for youth;
 resolution of employment problems for school graduates;
 control of illicit drug trafficking;
 treatment and rehabilitation of drug addicts.

Youth organisations contribute their efforts to counteract the drug abuse phenomenon and implement
various programs including the social ones against alcohol and drug abuse, thousands of young people
participate in the youth temperance movement, work as volunteers at the telephone hot lines.

In Lithuania numerous organisations providing social and psychological help to young people have been
established lately. The telephone psychological help network in established.

Treatment and rehabilitation

The capacities of the national institutions for treatment of drug addicts till now was limited. Specialised
dependence disorders treatment centres operated only in Vilnius and Klaipeda – the Vilnius Narcologi-
cal Centre and the Klaipeda Centre for Dependence Disorders. In Kaunas drug addicts undergo treat-
ment in the Narcological Department of the Kaunas Psychiatric Clinics, in other towns and regions
treatment of drug addicts are provided in psychiatric and outpatient institutions – in primary health care
establishments, i.e. mental health centres and special narcological units. For implementation of the Law
on Narcological Care staff of the primary health care establishments also take part in treatment of drug
addicts. Detoxification services are provided in special narcological units in Vilnius, Kaunas, Klaipeda,
also in the Toxicology Department of Vilnius University and Toxicology department in Children clinics.

First Aid Hospital, which is addressed by many drug addicts due to emergency medical indications. In
other towns drug addicts are provided help due to overdose in reanimation wards. After detoxification
patients should undergo rehabilitation but this component is not developed yet.

In the country (Vilnius) there are only 20 places for rehabilitation. Rehabilitation institutions were estab-
lished in the Vilnius Narcological Centre and the Lithuanian AIDS.

In different towns and regions mental health centres are established. Detoxification and rehabilitation
institutions that will observe drug addicts and engage in treatment and rehabilitation activities are planed
following the Law on Mental Health Care, the Law on Narcological care and in accordance to the Na-
tional Drug Control and Drug prevention programme 1999-2003. Funds will be provided for improve-
ment of treatment facility for drug addicts, establishment of new one.

The development of specialised health care institutions for drug addicts is declared by Law on Health
care system The new nomenclature in this law on dependence disorders budgetary centres introduced in

Establishment of 5 District Dependence Disorders Centres in country is under preparation. The docu-
ments for Governmental decision are co-ordinated.

Based on the Decree by the Ministry of Health (October 19, 1998) Vilnius Narcological Center and
Klaipedos Dependence Disorders Center are under process of transformation to the District Centres.
Such District Dependence Disorders Centres will be established in Kaunas, Klaipeda and Siauliai - next
biggest three districts of Lithuania from January 2000.

Klaipeda Municipality accepted Resolution on establishment of Rehabilitation centre in Klaipeda. The
premises for centre are appointed. Rehabilitation places are planed also to establish in other cities ac-
cording to plan of National Drug Control and Drug Addiction Prevention programme .It support the
Ministry of Health and Ministry of Social Affairs and Labour, local authorities.

Chapter III. Established and changing responses to drug misuse
Substitution treatment


Methadone maintenance program after very careful preparation period was allowed by the order of
Health Ministry in 1995 and started in major cities in Lithuania as pilot programmes, i.e. Vilnius, Kau-
nas, Klaipeda, in their specialised institutions.

The criteria to the admitting to the program were elaborated in accordance to the Swedish model. The
professionals before starting were trained in Stockholm, Karolinska Institute. The training materials for
Lithuanian professionals has been prepared.

According to legislation admission criteria were: regular opiate use for 5 years, several unsuccessful at-
tempts of drug free treatment, minimum age of 20 years, incurable disease and other individual reasons
in accordance to decision of special commission on Methadone program, investigation of mental, physi-
cal and social status was recommended before starting and during programme, detoxification before the
starting of programme was recommended, control on abuse of other drugs was required, psychological
and social assistance were recommended. The special regulations for methadone control by drug con-
trol has been prepared. The starting dose -minimal effective., for patient was not allowed to use other
drugs parallel. Termination of the programme was foreseen in accordance to health status improvement,
in case of rough disturber of the regulations, using of other drugs. Involvement of GP was not allowed,
take home doses or prescription of drugs was not allowed, detoxification after termination of treatment
not regulated.

The interest of the drug addicts at beginning of the program was very high. One of the reasons that drug
free treatment facilities - detoxification and rehabilitation were very limited also the special action of ad-
vertising on very positive treatment results of methadone took place in the Lithuanian daily news Later
Law on control of Narcotic Drugs and Psychotropic substances adopted in 1998 prohibition advertis-
ing. Some specialists were very interest to start this programme because Methadone programme was
supported by Lindesmith Centre, other specialists were careful and supported development of drug free
treatment facilities for drug addicts. The period of discussions took time. Policy on starting of metha-
done supported mothers, who have children drug addict and were very tired from such life style in fam-
ily this factor was important.

The evaluation was carried out May 1996 by Swedish experts Karolinska Institute. Department of
Neuroscience section of Psychiatry, St. Goran Clinic of Dependence Disorders.

According to the data of Vilnius narcological centre after two years analysis of methadone programme
showed, that out of the 170 patients, treated in two years 2/3 remained on the methadone program. 100
patients from all were evaluated to their health and social status. The average duration in MMT for the
evaluated patients was 16,1 month.

40 % of the patients demonstrated a considerable improvement in general health status and social con-
ditions, stopped to use illegal drugs, some got job, two women were pregnant and delivered babies. 32
% showed average improvement, 28% showed minimum improvement and continued to inject drugs
demonstrating Chaotic behaviour patterns. The latter category was problematic difficult to manage. The
amendments for the regulations were few time adopted.

After two years the regulations of Methadone programme and admission criteria to Methadone substitu-
tion therapy for drug addicts were revised and Order of the Ministry of Health No. 702 with aim for
liberalisation of substitution therapy was promulgated December 22, 1997. The discussions on the out-
comes after application of the Order No. 702 were very active including the Health Committee of the
Parliament and the validity of the Order No. 702 was stop before coming its in to force, the special
Resolution of Health Committee of Parliament on control of substitution program was adopted.

The new one Order of Ministry of Health No. 68 was promulgated in beginning of 1998. The regula-
tions allowed to use methadone substitution therapy in Primary health care Institutions, Mental Health
care centres. Admission criteria were reduced: regular opiate injection for 2 years, several unsuccessful
attempts of drug free treatment, detoxification before the admitting not required but recommended, dos-
age of methadone not regulated, urine screens recommended, psychological and social assistance rec-
ommended, take home doses for stable clients or in extraordinary situations allowed, involvement of GP
in the co-operation with MMTP, short detoxification 2-8 weeks was allowed, criteria of the termination
of treatment - clinical indications, decided by methadone programme commission,. the age not men-

In 1998 the substitution therapy programme started in Druskininkai - resort (small group) and in three
primary health care institutions of Vilnius city in collaboration with Vilnius narcological centre. One of the
GP program was adopted in the Rome settlement in Vilnius, where drug abuse was very wide.

In 1998 According to report on Methadone substitution therapy 493 persons participated in programs:
77% man, and 23% women. According to age: 20-30 years age - 33%, 31-40 years - 50%, over 40 -
17%. Termination of treatment in 1998 except 66% who remained on treatment were: 7% stop to use
methadone because improvement of health, 4% sentenced, 2% died, 21% fell out because started to
use other drugs. The part of patients the programme influenced positive. The other part beside Metha-
done use other drugs. Control capacity are very limited because lack of equipment The personal very
swamped with work. The social and psychological measures are limited. The social integration of the
drug addicts are limited because unemployment increase constantly, the financing of substitution therapy
are not solved.

Vilnius narcological centre made lot of efforts for implementation of substitution therapy; published me-
thodical recommendations, translated published books, product special video on drug related health
problem with support of Lindesmith Centre.

The needs for revision of regulations of methadone programme and admission criteria to methadone
substitution therapy arose and is on agenda of the Ministry of Health. Decentralisation of the programme
from specialised centre to Primary health care institutions is planed because different reasons: reorgani-
sation of specialised health care, establishment of District Dependence Disorders centres and one of
them application of inhabitants living in around of Vilnius narcological centre on dangerous situation as
result of substitution therapy.

Risk behaviours patterns (e.g. injecting, sharing)

95% of all drug addicts use intravenous injections. Few Syringe exchange programs have been started
in different places of country. At the same time information is provided regarding safe use of syringes.
The risk is related not only to the infection of HIV but also hepatitis.

In pharmacies disposable syringes are available but the infection risk arises due to the fact that the drug
addicts mainly use home made drugs taking it from one container and have special culture of using drugs
-to share one needle. The AIDS risk also arises from in the neighbouring regions - the Kaliningrad re-
gion, Byelorussia.

Women, children and drugs.

According to the data of the state Mental Health centre from all drug addicts registered in the medical
care institutions 18,9 % are women. They use the same drugs as men, most are IDU.
The drug addicts women have social difficulties because unemployment and ordinary earn money on
street walking. The special consultation room was established in 1998 in Vilnius City near the Railway
station managed by the AIDS Center social workers for teaching of streetwalkers women on safe sex
and safe drug use. Possibilities to take shower, to change needles here were created.

According to data of Vilnius narcological centre in 1998 493 patients received methadone substitution
therapy 23% from them women. Two were pregnant and gave birth for two babies.

According to data of AIDS centre in the end of 1998, 135 HIV /AIDS cases were disclosed, 123 man
and 12 women. Women form 9,75% from all cases.

The street walking among young women is increasing and it’s very connected to drug abuse. The cases
occurred when pregnant women being dependent on drugs and infants with drug syndrome were born.

In the pregnancy period specific attention is paid to prevention of harmful habits, mothers participate in
special training courses Motherhood School preparing for delivery, they are provided detailed informa-
tion about harmful and negative impact of drugs, alcohol and smoking. Publications are provided to
them, they are taught to refuse alcohol, reduce smoking, refrain from unnecessary medication. Much
initiative in this field is demonstrated by the Family Planing Center, similar programs are being imple-
mented by public organisations in co-operation with preventive organisations of foreign countries.

The situation on children and drugs every year is worsening. In 1998 In medical institutions 28 children
drug addicts registered it form 1% from all drug addicts, and 288 cases were registered from 15-19
years, it form 10%. Drug addiction among children constantly increase. In 1997 till 14 years were regis-
tered only 0,2% and from 14 -to 19 2,6 times less than in 1998.

In kindergartens no special drug prevention programs are applied, children are provided information
about risk in connection with consumption of any medication. Medication packing includes the mark
Keep away from children. Currently in Pedagogical University discussion about the possible intervention
at this age stage is going on.

For families with little children, if parents abuse alcohol or drugs and provide poor care to their children
social service units are informed of that and the social staff attends these families, sometimes parents are
deprived their rights in compliance with the laws, and the children are put into institutions.



Main achievements

Lithuanian society is concerned about drug abuse situation because drug abuse prevention is one of a
national prioritised area:
 Lithuania is a party of all three UN conventions 1961, 1971, 1988 On Narcotic Drugs, Psychotro-
    pic Substances control and On fight against illicit trafficking of narcotic drugs and psychotropic sub-
 Lithuania has ratified the Convention of European Council on prevention of money laundering;
 Lithuania has ratified the UN Convention on Protection of Children Rights;
    and adopted the Law On Protection of Children Rights;
 The Program by the Government of the Republic of Lithuania 1997–2000 prioritised the drug abuse
    prevention in the public health sector;
 The National Health Program 1998–2010 was adopted including alcohol, drug and tobacco abuse
    prevention measures;
 The National Drug Control and Drug Abuse Prevention Program 1999–2003 adopted;
 The laws on Narcotic Drugs and psychotropic substances control was adopted
 The Law on Precursors control has adopted;
 The Law on Money Laundering was adopted in 1997 and special Units in The Ministry of Finances
    and Ministry of Interior for prevention of Money laundering were established;
 The State Alcohol Control Program 1999-2011 was adopted;
    (Law on Alcohol control act);
 The State Tobacco control program 1998-2010 adopted;
    (Law on Tobacco control Act);
 The State Mental Health program for 1999-2010 adopted;
    (Law on Mental Health care act);
 The State AIDS Prevention Program for 1999-2001 adopted;
 Each year the epidemiological survey regarding substance abuse is carried out among schoolchildren
 Annual reports on drug situation are prepared;
 The Ministry of Education and Science approved the Health Education Program including drug
    abuse prevention. Prior to 2004 drug prevention issues will be included in the education contents in
    the pre-school establishments and schools;
 International co-operation regarding drug control has been elaborated. Various international organi-
    sations support Lithuania to establish drug demand reduction programs such as:
EU PHARE Program Fights against Drugs
EC Pompidou group Drug Demand Reduction Program, Drug Supply Reduction program;
UN program Substance Abuse Prevention in Schools, Curriculum (started)
WHO Program Substance Abuse Prevention among Young People in CEEC, and other programs;
 Initiative by youth organisations in drug prevention area has been increasing, more NGO’s are in-
    volved, collaboration with governmental organisations has been improved;
 For the Vilnius University students who study psychology a course on psychological aspects of de-
    pendence (32 hours) has been delivered since 1995;
 The Under graduation Training Department in University organises training for general practitioners
    on dependence aspects;
 The Tobacco and Alcohol Control Agency have been established;
   Co-operation between different institutions has improved,
   In 1995 the Governmental Drug Control Commission was established;
   Agencies for licit drug control circulation and illicit drug trafficking control have been established;
   Reorganisation of public health care is taking place, the prevention network is strengthened;
   More specialists acquire higher skill and competence level due to the experience exchange on sub-
    stance abuse prevention with other European countries;
   Agencies for protection of children rights have been established at different levels;
   The network of psychological assistance providing advisory services to young people operate in the
    country at a large scope;
   Crisis centres for women have been established;
   Other social programs are implemented;
   In the counties Centres for dependence diseases involved in drug demand reduction are under es-
   Public Health Centres involved in prevention of dependence diseases are under establishment;
   The State Mental Health Centre has been established;
   The State Mental Health Commission is under establishment;
   The Resolution on fight against drugs was adopted by the Baltic Assembly.
   Amendments to Penal code on illicit trafficking of Psychotropic substances and Precursors have
    been adopted 1998,1999.
   The development of health care institutions for drug addicts started;
   Drug Information system in country has been created.

                  Alcoholic psychosis, alcohol and drug addiction dynamics of
                   morbidity for 100 000 inhabitants in Lithuania 1991-1998

2500                                                                                                                                              80
                                                1983                                                                                              70
                                                                                                              53,60                               60
                                1576,3                 1980,4   1871,6                                                      53.6           55,8
       1404,1          1376,2                                                                                                     45,6            50
1500                                     1603

                                                                                             32                                                   40
                                                                                      25,2                            34
                                                                              21,1                          26,1
500                                                                                           18,2
                                                                               15,3   15,3                                                        10

  0                                                                                                                                               0
        1991    1992     1993    1994    1995   1996      1997    1998         1991   1992   1993     1994         1995    1996     1997     1998

                                                                                                    Alcoholic psychosis
                        Alcohol addiction
                                                                                                    Drug addiction

              Register Drug Addicts according to main Drug Usage in Lithuania

         Hallucinogens        10        (0,3%)
                                                                                 in 1998 - 2862 drug addicts
              Cannabis         35         (0,9%)

            Stimulants             82         (2,9%)

              Solvents                  148      (5,2%)

Hypnotics and sedatives             129             (4,5%)

              Polydrug                                    477   (16,7%)

               Opiates                                                                            1989   (69,5%)

                          0                            500                1000    1500          2000               2500

              Registered drug users by age groups in
                          Lithuania 1998
                            till 14 year
                            1,0% (28)
 35 year and over
   26,0% (742)
                                                      25-34 year
                                                     42,0% (1199)

 15-19 year
10,0% (288)
                              20-24 year
                             21,0% (606)
                                               All: 2862

                              Drug addicts in Lithuania 1998

          According to residence                                  According to sex


Urban 94,2 %                       Rural
                                                 Males   81,1 %
Rural 5,8 %                                      Females 18,9 %


                              52,4% (22 cases)

Somatic disease
                                                             4,8% (2 cases)
16,7% (7 cases)

          Infective disease                        Accident
           7,1% (3 cases)                        19% (8 cases)

                               OF KLAIPĖDA 1998
                                                                                                                    European level

                                                                                                                    Country level
100                     96,3
                                                                                                                    Data of 9 forms
80                                          74,1
                                                                                                                    Data of 11 forms
60                                  57

20                                                                                                                      15 13,6               16
                                                                       12       13,3                                                               12,5
                                                                                                                    8             10,9   9
                                                                                                        6,5                                              5,3
                                                                                                4   2
      Alcohol use during Drunken during last Smoking during last        Marihuana,            Other illegal drugs       Sedatives            Inhalants
        last 12 month        12 month            30 days                 Hashish

                       DRUG RELATED CRIMES

              NUMBER OF                                                                   630     629


200     157     144

      1987    1988    1989    1990   1991    1992       1993    1994    1995    1996    1997    1998


         (THOUSANDS)                                                                      101,589


   60                                                                   50,312

   40                                                                                                        35,006

   20     14,8
                  8,845                                6,879    6,879
                           3,345             1,879

        1987     1988     1989     1990   1991        1992     1993     1994     1995     1996   1997        1998

       KILOGRAMS                                                                                1525
                                                1405                                    1391

                                                         963             977


 600                             463

 200     60,3     84

       1987     1988   1989    1990    1991    1992    1993    1994    1995    1996    1997    1998

   1200                                        1061


   600                            496                                          511

   400                                                                290


           1992       1993     1994         1995      1996         1997     1998


      KILOGRAMS                                                                                       30,356

30                                                               27,312





 5                                             3,022
             2,159    1,727                                                1,437    0,825
        0                      0,431      0
     1987   1988     1989     1990     1991   1992     1993     1994      1995     1996     1997      1998







 2                                                   1,056
            0           0          0

     1992        1993       1994        1995       1996      1997      1998


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