COUNTRY REPORT: EPIDEMIOLOGICAL SITUATIONS AND PROJECT ACTIVITIES

Transcription

1 COUNTRY REPORT: EPIDEMIOLOGICAL SITUATIONS AND PROJECT ACTIVITIES BIRUTE SEMENAITE, MEDICAL DIVISION OF PRISON DEPARTMENT AT THE MINISTRY OF JUSTICE OF THE REPUBLIC OF LITHUANIA

2 LITHUANIAN PRISONS. BACKGROUND: 15 PENITENTIARY INSTITUTIONS OF LITHUANIA: - 3 REMAND PRISONS FOR ADULT PRISONERS (including 1 institution combining a remand prison and a closed prison); - 9 CORRECTION HOUSES FOR ADULT SENTENCED MEN (including 1 correction house for patients with active TB); - 1 CORRECTION HOUSE FOR SENTENCED WOMEN; - 1 CORRECTION HOUSE- REMAND PRISON FOR JUVENILES; - 1 CENTRAL PRISON HOSPITAL. PRISON POPULATION 8, 000 (as of ) AVERAGE NUMBER OF PRISONERS 7, 787 (in 2008)

3 NUMBER OF PRISON POPULATION ( )

4 COMPOSITION OF PRISON POPULATION TOTAL NUMBER OF PRISONERS of them: SENTENCED of them: women adult prisoners sentenced whom the court process has not been concluded REMAND PRISONERS of them: women adult prisoners WOMEN TOTAL ADULT PRISONERS TOTAL

5 LEGISLATIVE BASIS FOR DRUG USE CONTROL (1) NATIONAL PROGRAM OF DRUG CONTROL AND DRUG USE PREVENTION FOR LITHUANIAN STATE PROGRAM OF HIV/AIDS PREVENTION AND CONTROL FOR STATE PROGRAM OF PREVENTION AND CONTROL OF SEXUALLY TRANSMITTED DISEASES FOR

6 LEGISLATIVE BASIS FOR DRUG USE CONTROL (2) REGULATIONS FOR ASSESSMENT OF INEBRIETY OR INTOXICATION OF DRUNK - DRIVING AND OTHER PERSONS APPROVED BY RESOLUTION OF THE GOVERNMENT OF THE REPUBLIC OF LITHUANIA No. 452 DATED

7 LEGISLATIVE BASIS FOR DRUG USE CONTROL (3) METHODOLOGY OF MEDICAL EXAMINATION PERFORMANCE FOR ASSESSMENT OF INEBRIETY OR INTOXICATION BY PSYCHOTROPIC SUBSTANCES APPROVED BY THE WRITTEN ORDER OF MINISTER OF HEALTH CARE No. V-505 DATED

8 LEGISLATIVE BASIS FOR DRUG USE CONTROL (4) PROCEDURE OF DETERMINATION OF INEBRIETY OR INTOXICATION WITH PSYCHOTROPIC SUBSTANCES OF PERSONS HELD AS INMATES AT CUSTODIAL INSTITUTIONS APPROVED BY THE WRITTEN ORDER OF DIRECTOR GENERAL OF THE PRISON DEPARTMENT AT THE MINISTRY OF JUSTICE OF THE REPUBLIC OF LITHUANIA No. V-20 (issued on 28 January 2008)

9 HIV/AIDS EPIDEMIOLOGICAL SITUATION IN PRISON SYSTEM OF LITHUANIA

10 DETECTION OF HIV IN PRISON SYSTEM OF LITHUANIA BY YEAR 400 Total Known cases New cases detected in pre-trial New cases detected in Correction House

11 INCIDENCE OF ACUTE VIRAL HEPATITIS IN PRISON SYSTEM OF LITHUANIA

12 NUMBER OF ACUTE VIRAL HEPATITIS IN PRISONS OF LITHUANIA Total HVB HVC

13 DRUG USE IN PRISON SYSTEM OF LITHUANIA

14 NUMBER OF DRUG USERS IN PRISONS OF LITHUANIA (abs. No.)

15 25,00% 20,00% 15,00% 10,00% 5,00% 0,00% DRUG USE DRUG USE IN PRISONS OF LITHUANIA (%) 18,1% 18,4% 17.7% 15,6% 14,4% 13,3% 11,3% 6,6% 7,5% 8,8% 19.3 %

16 DRUG USE AMONG PRISONERS (%) Opiates (F11) 81 79,9 75,6 66,7 57,1 42,0 36,0 Cannabis (F12) 0,9 0,7 1,0 0,8 1,6 2,6 4,4 Tranquilizers (F13) 3,3 1,8 3,2 6,2 3,9 1,5 1,5 Cocaine (F14) 0,2 0,2 0,1 0,1 0,2 0,2 0,3 Stimulants (F15) 2,8 3,4 2,6 4,5 9,7 11,9 8,7 Haliucinogenes (F16) - 0,1 0,1 0 0,1 0,2 0,5 Inhalators (F18) 1,5 2,1 3,0 3,6 2,4 2,0 1,5 Several drugs (F19) 10,2 11,4 14,4 18,1 25,0 39,6 47, ,2 3,4 1,1 0,1 8,1 0,2 1,2 41,7

17 DRUG USE IN LITHUANIAN PRISONS ACCORDING TO THE WAY OF DRUG USE % 7.3% 1.4% 86.3% Injection Inhalation Per os Snuff

18 WAYS OF DRUG SMUGGLING INTO PRISONS As of 1 January 2007, parcels and packages were cancelled. Currently, the main ways of smuggling drugs into prison are: throwing them over the prison wall; family members trying to smuggle drugs during family meetings.

19 SERVICES RENDERED TO DRUG USERS (1) Psychological counselling and psychological programmes: work with inmates having dependence on narcotic substances is aimed their social and psychological rehabilitation.

20 SERVICES RENDERED TO DRUG USERS (2) In 4 penitentiary institutions there are rehabilitations centres functioning. They accommodate inmates participating in various rehabilitation programmes. Day Centre functioning in one of the penitentiary institutions serves the same purpose.

21 SERVICES RENDERED TO DRUG USERS (3) Groups of Alcoholics Anonymous and Drug Users Anonymous are functioning in 7 penitentiary institutions. The activities of these groups are based on 12 Step Minnesota Programme. Individual work is also being carried out with inmates having dependence on narcotic substances. The programme applied there is called Behaviour-Conversation-Change (BCC). Individual psychological counselling is done in all (15) penitentiary institutions.

22 SERVICES RENDERED TO DRUG USERS (4) Detoxication is also available in all (15) penitentiary institutions.

23 AVTIVITIES CARRIED OUT BY THE LITHUANIAN WORK GROUP ON HIV Prevention in Prison Settings WITHIN THE FRAMEWORK OF UNODC PROJECT HIV/AIDS Prevention and Care Among Injecting Drug Users and in Prison Settings in Estonia, Latvia and Lithuania

24 On 3 April 2007 a technical work group which should take part in planning and implementation of the Project activities, coordinate and ensure cooperation with other national and international programs and projects was set up by the order of the Prison Department under the Ministry of Justice. The officers and specialists of the prison Department and its subordinate institutions as well as representatives of non-government organizations were involved in the activities of the work group. The work group alongside with officers and specialists of the penitentiary system were active participants at the conference on Planning of UNODC Project Activities in Lithuania 2008 and submitted its proposals to the Project Plan 2008 and Activity Plan 2009.

25 In 2007 the review of legal basis and policy was scheduled. The objective of the above mentioned activity was to draft and submit proposals for improvement of legislation and policy documentation, arrange a round table discussions with experts and policy makers. The activities proceeded in On 4 September 2007 the legislation experts and international expert who have won the tender met with the representatives of the administration of the Prison Department and TWG coordinators to harmonize future activity plans. Having evaluated the legislation the experts prepared a report and made a conclusion that there were no legal obstacles to implement programs on harm reduction in penitentiary institutions.

26 In 2007/2008 the ongoing study on the drug use situation in the prison settings was carried out. The study was carried out by using two methods: in one of the correction houses a rapid assessment and response (RAR) method was applied, the rest 8 correction houses performed anonymous interviews (326 prisoners were interviewed). RAR results were presented at the workshop on 13 March The research revealed the high percentage of prisoners being drug users, the common way of drug use being by injecting. The generalized data of anonymous interview will be introduced on at the conference held for the anniversary of the Prison Department. The interview revealed that prisoners have got good knowledge of HIV/AIDS and other diseases transferred through sexual intercourse or through blood and risk of getting infected thereof but they do not abstain from risk behavior. The underlying analysis of the situation enables to better evaluate the drug use problems and adopt optimal decisions.

27 In 2008 the anonymous interview of officers and specialists on drug use, prevention of HIV/AIDS and other diseases transferred through sexual intercourse or through blood was carried out. Approx. 800 officers and staff members were interviewed. The questionnaires are not yet summed up. The level of knowledge of officers and staff members will be evaluated after revising the questionnaires. Thereby the topics for training will be easier to choose to ensure the higher level of knowledge which will improve the quality of work with drug users and drug abused inmates.

28 In 2007/2008 in the course of implementation of the Project elaboration and publishing of training programs and tools was organized. In 2007 a work group (involving penitentiary specialists and specialists working in the field of public health and programs on HIV and drug use prevention and harm reduction) was set up for revision of the manual Risk Reduction Among Imprisoned Drug Users. The manual was translated into Lithuanian and currently the program for its adaptation is being elaborated for use of the manual in penitentiary institutions for educational purposes. The manual is dedicated to social rehabilitation officers of penitentiary institutions and representatives of NGOs working in the above mentioned institutions.

29 In 2007/2008 the training sessions (qualification upgrading by organizing (or participating in) national conferences, workshops for penitentiary officers and staff members, non-government organizations) were carried out : * On 30 October 2007 a national conference on Treatment of Drug and Psychotropic Substances Addiction and HIV Prevention in Penal Facilities was organized. 70 members participated at the conference: penitentiary officers and staff members; representatives of NGOs. The speakers were representatives from WHO, MoH, PD and leading experts in addiction treatment.

30 * On November 2007 representatives of the Prison Department and its subordinate institutions participated in the training session on Harm Reduction Advocacy. * On September 2008 and September 2008 specialists from Health Care divisions participated in the training sessions on Medical Treatment and Health Care of Opioid-Dependent Persons. * On 19 November 2008 and 26 November 2008 a oneday training on Psychoactive Substance, Dependence and Treatment of Dependence was organized for guard and security officers of penitentiary institutions.

31 On 1-2 December 2008 the representatives of the penitentiary system were active participants at the national conference on Enhancement of HIV Prevention Among Injecting Drug Users and in Penitentiary Institutions: Towards a Versatile Approach. One panel discussion was dedicated to cooperation of penitentiary institutions and NGOs for handling current drug use related problems.

32 On June 2007 a study visit with the purpose of experience exchange on HIV/AIDS prevention and observation in prison settings of Germany was organized. The representatives from MoJ, PD and its subordinate institutions as well as from NGOs working within prison settings visited penitentiary institutions (harm reduction programs) and scientific research institutes (epidemiology and prevention of infectious diseases). The representatives were presented the positive experience of HIV control and prevention in prison settings of Germany.

33 In 2007/2008 the improvement of HIV prevention in prison settings was followed up through the grants (1) In projects to provide support to inmates received financial support: - NGO,,Positive Life - Support to People Living with HIV/AIDS and Ex-Inmates Released from Penitentiary Institutions. - NGO,,Halfway - Mutual Assistance Groups for Injecting Drug Users. - SCF,,KRIS- in the North West of Lithuania - Social-Psychological Assistance to Released Ex- Inmates

34 In 2007/2008 the improvement of HIV prevention in prison settings was followed up through the grants (2) In 2008 the following projects were approved (to be launched in 2009): - SCF,,Lighthouse of Hope - Psychological-Social Work with Inmates. - NGO,,Halfway - Enhancement of HIV/AIDS Prevention. The ongoing project. - SCF,,KRIS- in the North West of Lithuania will continue its activities in implementation of the project Increase in the Use of Social Services for HIV/AIDS Prevention and Harm Reduction Among Inmates. - PI Social Risk Prevention Centre will implement the project Quality of Life of HIV Infected Inmates in Prison Settings in penitentiary institutions.

35 In the course of implementation of the Project penitentiary officers and staff members were invited to participate at international meetings, conferences and specialist training sessions: On February 2007 at the 2nd meeting of the Expert Group of the project on Prison Health of the Northern Dimension Partnership in Public Health and Social Wellbeing held in Oslo (Norway). On May 2007 at the 18th international conference on Problems of Reduction of Drug Related Harm held in Warsaw (Poland) On September 2007 at the 2nd international conference on Prison Health held in Varna (Bulgaria). On September 2007 at the international conference Substitution Treatment for Opioid Dependancy held in Riga (Latvia). On 26 February 2008 at the workshop Prevention, Treatment and Care of HIV Infection in Prison Setting held in Moscow (Russia). On November 2008 at the annual conference of the WHO project Prison Health held in Kiev (Ukraine).

36 IMPORTANT ACTIONS FOR FUTURE Establishment of drug rehabilitation and prevention centers in all correction houses Cooperation with state institutions and NGOs Availability of education for prison staff and inmates Individual counseling of inmates

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