Phare Drug Information Systems Project

1

PHARE DRUG INFORMATION SYSTEMS PROJECT

BRIDGING OVER PERIOD

REPORT

on the Drugs Misuse Situation

1998

Hungary

Prepared by the Phare DIS Team:

Dr. Maria KIS, LCP, head, Health Care Division, Health Informatics Inst. Min.Health

Arpad EÖRDÖGH, NDSRC, chief counsellor, Ministry of Interior

Mark Molnar, research fellow, University of Economy, Dept. of Marketing

Katalin SZOMOR, NDC, FP, Senior Drug Expert, Ministry of Health

Dr. Edit Sandor, drugs expert, Ministry of Health

Dr. Eszter Ujhelyi, NDDRC, head, National AIDS Laboratory

C O N T E N T

PAGE

1. INTRODUCTON1

II.DRUG ABUSE SITUATION6

1. Trends and risks in the field of illegal drug trafficking6
2. Data on drug use, mortality7
3. Outcomes of ESPAD 99’9
4. HIV/AIDS situation in Hungary12
5. Epidemiological research among injecting drug users15
6. Comprehensive analysis of the heroin problem21

III. DEVELOPMENTS IN THE FIELD OF

NATIONAL DRUG CO-ORDINATION AND

STRATEGY DEVELOPMENT30

IV.DRUG DEMAND REDUCTION32

1. Prevention33
2. School drug prevention programs34
3. Early intervention36
4. Treatment, harm Reduction37

ANNEX I.DRUG RELATED LEGISLATION42

ANNEX II.STATISTICAL TABLES53

ANNEX III.CHARTSSee in a separate excel file!

ANNEX IV.LIST OF RESOURCES72

I.

INTRODUCTION

This short report is built on the report submitted in the framework of the Phare DIS project last year, however emphasizes only the changes since that time. It focuses on the heroin problem, as a whole including illicit supply and consumption in an extent data are available or gained during a major research study among intavenous drug users performed by three of the co-authors of this material.

During the past year a lot of important drug political developments took place in Hungary, which contributed to the strenthening of the drug demand reduction side and trying to improve co-ordination. Decisive drug political change was the reintroduction of the penalisation of drug use, and the aggreviated penalisation of drug traffickers including life long sentence.

Major steps were made forward in the field of harmonisation with the IIIrd pillar acquis, as relates the legislation in the field of JHA and the measures for developing EU conform institutional system in the field of the fight against drug abuse and organised crime, international cooperation and the strengthening of border control at the outer borders, and at the entry points of the Balkan route of drugs smuggling.

The drug misuse situation further aggreviated, however significant changes in the former trends could not have been observed. Yet the marihuana and the amphetamine like stimulants are the major drugs among young people and the heroin is the leading drug among problem drug users. The life prevalence of illicit drug use multiplied between the present (1999) and the last ESPAD study in 1995. The injecting drug use has also increased: now nearly 30 % of drug users (reaching the treatment system) declare that they are IDU’s and half of them are heroin users. New trend is the high rate (57%) of IDU among amphetamine (other, than ecstasy) users (coming from a research study among IDU’s), performed by the NDC/FP and NDDRC.

The illicit supply is having a similar structure than the use: large shipments of heroin and marihuana coming from the Balkan route from South, and the steady flow of amphetamine like stimulants from the direction of the Netherlands, back on the same route.

The Hungarian LCP and NDC/FP developed the up-dated Living Document in 1999, and published it in Hungarian and in English at the website.

The Hungarian NDC/FP and the NDRSC collected each legal pieces related to narcotic drugs, psychotropic substances, precursors and money laundering, data collection-, protection, prevention, treatment etc. and placed it to the above website. This website was set up, as a virtual Resource Centre of the Phare DDR project.

In 1998 no changes occurred in the scope of the Information Map.

The co-operation with the eesvMSDP, with the twinning institutes and among the Phare countries, the not always easy learning process in the framework of the Phare DIS project assisted the team in developing the collection and analisation of the Hungarian drug related data, and in closing up to the EU REITOX system during the past 6 years. An added value is the well operating co-ordination among the Phare fight against drug abuse program Hungarian project coordinators (NDC, NDDRC, DIS LCP, NDDRSC, precursors LCP and contact points). Most hopefully this impetus will not be lost in the forthcoming phase of institutionalisation of the REITOX Focal Point.

II.

DRUG ABUSE SITUATION

II./1. TRENDS AND RISKS IN THE FIELD OF ILLEGAL TRAFFICKING

Still steady is the flow of heroin on the Balkan route. Slight changes occur, new forks appear in the Balkan route. New methods of concealment are used. Increasing seizure figures (See table 1. in Annex I.). Due to good profiling the seizures by the Customs went up to 90% of the total seizures per year. Big shipments of marijuana (2 tons seizures at a time) appeared on the traditional heroin route. Opening new routes from Russia and Ukraine are expected. Due to increasing transport costs, new approach is the setting up of heroin refineries (deriving mainly from the Golden half moon area and new cultivation areas) in Russia. Rumours can be heard about Italian- Russian mafia co-operation in drugs smuggling.

Nigerian cocaine and heroin smuggling rings provide “full service” (though small quantities) via Hungary including organising Central-European couriers to South America, wire-transfer of dirty drugs money, means and ways of concealment. Hungarian drug distributor rings, formed by professional criminals are importing enormous quantities of synthetic drugs from the Netherlands and Germany. Supply and demand for synthetic drugs therefore is on the increase.

The illicit demand for certain precursors, which are not produced traditionally in Hungary is on the increase. Free-lance buyers on behalf of the owners of usually Dutch illicit laboratories are trying to establish steady contact with small Hungarian enterprises for acquiring BKK or PMK. Since the co-operation between the industry, the Licensing Division of the Ministry of Economy, the police and the customs is excellent, all suspicious attempts ends in controlled delivery operations.

II/2. ANALYSIS OF THE DATA FROM THE NATIONAL TREATMENT, MORBIDITY AND MORTALITY STATISTICS OF DRUG USERS

The problem of illegal drugs consumption has been started in the early nineties in Hungary, parallel with the opening of the borders, the political, economic and social transition. The middle of the nineties has brought changes in the structure of drugs consumption, mainly in the form of shift from softer to harder forms of drugs, mainly opiates (e.g. from hydrocodein to heroin), and towards more serious forms of consumption (injecting instead of per os use). The same time the recreational drug use has been started (ecstasy, rave parties) and reached a big size, with organised crime behind the scene - opening hundreds of rave discos, with a staff involved in distribution. The liberal media was against the official drugs policy and supported the drug using lifestyle. To turn this trends the present Government advertised a more repressive drugs policy, as ever before, and reintroduced penalisation of drugs consumption and promised to organise large scale anti drug activities among young people.

The recreational drugs use of amphetamine like stimulants causes serious problem among large layers of the young people interconnected with the dance culture, yet aware of the risks.

The drugs consumption starts mainly in the 15-18 years cohort, and the cases under 13 tend to increase in the treatment statistics in the last 2 years. The gateway drug is in most cases the ecstasy, and/or the marihuana.

The misuse of sedative type of drugs is yet high, but its rate comparing to the illegal drugs rapidly dicreases.

The rate of volatile solvent abuse decreased significantly in the statistics, however special educational homes for children have more problems with VSA abuse, as before. The homeless people are also sniffing VSA as this is the cheapest way of toxicomania.

In the treatment statistics of 1998 (n=8957) the 4 main drugs are 34.7% opiates, 26.0 % sedative type and multiple drug abuse, which is mainly the combination of sedetive type drus, 15.2 % for amphetamines, and 15.1 for cannabis. The rest 9 % includes the other drugs.

In the ESPAD school survey the 3 most frequently used drugs waer marihuana, sedatives and volatile solvents. Ecstasy, or other amphetamines prevalence was much lower, than expected, only each 25th students tried it. An increase of life prevalence of each illegal drugs can be observed, however the values are yet much lower, than in the majority of the EU member countries. The data of the ESPAD survey in 1999 see in chapter II/3.

If we compare the type of drugs used by males, or females in the treatment statistics: the number of male drug users is 2.4 times more, than female. A deviation from this rate is the cannabis use (6.3 times more males, than females), the opiates (3.3 times more males, than females. Relatively the women use more sedative type stimulants, than the males.

The number of opiate related death cases rapidly increased in 1996 (from the 4 cases in 1995 to 51 in 1996. Yet the majority is represented by sedative type (5-6 times more, than the opiates), between 200-300 in the last 2-3 years.

I/3. DRUG USE AMONG SECONDARY GRAMMAR SCHOOL STUDENTS

Dept. of Sociology of the Budapest University of Economy, Zs. Elekes, B. Paksi

Second time was performed the European School survey on alcohol and drug use of the 16 years old secondary grammar school students in Hungary. The first one was supported in 1995 by the Ministry of Health, the size of the sample was 17.055 students, in 1999 the National Scientific Research Fund supported the study and the Ministry of Youth and Sports also contributed.

The size of the sample was 100 % = 6421 (3306 boys and 3115 girls) in 1999, and the study had a national representation for the age group born in 1983, to each type of secondary grammar school and to each type of settlements. Since in 1995 only 3.9 %, than in 1999 6.9% of the schools invited to participate, rejected, having referred to the new penal legislation regarding drug use.

The study serves valuable and comparable data on the drug using habits of the young generation, including smoking and drinking habits as well as the abuse of licit and illicit drugs.

Shocking is the extremely low rate of abstinence (5.7 %) among those who are 16 at present. This indicates serious societal and health risks and forecasts a lot of problem for the future, if prevention and education will not be effective enough.

Comparison of substance using habits of the Hungarian secondary grammar school students born in 1983

Source: ESPAD 2nd, 1999 (Zs.Elekes, B.Paksi)

SMOKING

71.7% of the Hungarian secondary grammar school students born in 1983 smoked a cigeratte at least once in their life.

ALCOHOL

90.8% tried the alcohol

ILLICIT DRUGS

12.5% consumed at least onece an illicit drug.

Significant changes occured between the 1995 and 1999 ESPAD sudy in Hungary regarding the spread of drug consumption. The life pravelance values for illicit drugs multiplied in an average by 4-6. Except the use of volatile solvents, or alcohol with medicine, the use of each licit and illicit drugs was on the increase.

The data indicate, that the marihuana is the most widespread drug among secondary grammar school students in Hungary, and the sniffing of volatile solvents, which was a traditional type of abuse, and the consumption of sedatives and the medicines with alcohol was on the increase,

At the same time it is remarkable, that the significant increase in the life preavelance of illicit drugs was not going together with a decrease in the use of licit substances, and yet, the consumption of sedatives increased in the last 4 years, either ordered by the physician, or not.

The most well known drugs

Students indicated that they know most about the following 4 drugs: heroin, cocaine, ecstasy and marihuana.

Rate of abstinence

The rate of abstinence, that is the rate of those, who never used any of the substances was only 5,7% in the sample. The difference between girls and boys is not significant, the rate of abstinence among girls is 5,6%, among boys 5,8% .

Prevalence of drug taking during the last year

8.3 % of the young people used marihuana and hashis during the previous 12 months. 4.8 % is the prevalence among girls, and 2 and a half times more is among the boys, that is 11.9 %. Majority of them used marihuana, or hashish only 1, or 2 times. The rate of those, who consumed 3 times, or more, than 3 imes was 5.5% among boys, and 2.5% among girls.

Altogether 2,2% was sniffing volatile solvents in the previous year. The rate was 3.2% among boys, 1.3% among girls.

Prevalence of drug taking in the last month

Smoking

montly prevalence 36.4%.

Girls: 35,3%, boys 37.5%.

Prevalence of drug misuse in the last month

Marihuana 3.8 % (three times increase), (5,1%, among boys, and 2.4% among girls).

The first use

The first age of the illicit drug use is 15 years among boys and girls as well. Only the marihuana, the sedatives and the use of medicine and alcohol toether and the VSA among boys starts at the age around 14.

The drug used first time was the marihuána, or hashis (7.6 % of the sample).

The first occasion of use was mainly, that somebody shared drug with them in the company (6.0% of boys, 3.2% of girls mentioned). The second source of acquiring was an older friend (3.4% of boys, 2.4% of girls). The peers were also important source of getting drugs (3.4% of boys, 1.3% of girls mentioned it).

The most frequent reason for trying drugs first time was the curiousity (11.9% of boys, 6.3% of girls). The second reason at boys was that they wanted to feel comfortable (5.8%). The girls mentioned other reasons (3,6 %).

Most dangerous forms of consumption

0.7 % indicated, that they use drugs by injecting.

Awareness about the place of drugs distribution

About half of the students in the total sample knew a place, where marihuana can be acquired. Majority of them (35.5% of the total sample) mentioned the disco, or a bar. They mentioned dealers (11.4%), or any other place (9.7%), the less frequently the public area, or school was mentioned (7.7%, or 6,9% resp.).

Last month prevalence of smoking and alcohol

The spread of the smoking and alcohol consumption has not been changed significantly since 1995 (ESPAD 1st).. However, the last month prevalence increased slightly among boys, and more significantly among girls.

Characteristics of the consumption habits

A significant change occured in the consumption of illicit drugs. The rate of prevalence or each drug multiplied by 4-6 times since the 1995 ESPAD study. Although in 1995 the marihuana was the most widespread illicit drug among Hungarian secondary grammar school students, the life prevalence value was slightly higher, than the prevalence of opiates or volatile solvents. In 1999 the marihuana became the most widespread among illicit drugs in case of students. However the life prevalence value of marihuana is not so much higher, than those of the other illicit drugs. However not only its life prevalence, but its prevalence in the last month increased significantly. The increase of the consumption of marihuana and the other illicit drugs was not accompanied by the decrease of licit drugs, yet, the use of sedatives (either for the order of the doctor, or without medical prescription) was also increased in the last four years.

The spread of drug use is accompanied by the slightly increasing smoking habits, and the formerly widespread, and not decreasing alcohol use.

HIV/AIDS SITUATION IN HUNGARY

As a new HIV/AIDS risk group has appeared in Hungary, the injecting drug users, the National AIDS Committee (N.A.C.) set out a new objective in 1996: to pay more attention to the drugs problem, and the Interministerial Drug Committee (I.M.D.C.) started to place more emphasis on the HIV/AIDS co-morbidity risks among drug users. The N.A.C. financed 2 times, in 1997 and in 1998 a nationwide HIV/AIDS and hepatitis B and C surveillance among drug users. 1 % of its yearly budget was spent to this tasks. The co-operation was improved between the two area also on institutional and on NGO’s level.

HIV/AIDS prevention activities and registration of cases started in Hungary in 1996. A comprehensives statistics is available between 1985-1999 (up to now). The main indicators are the following.

Registered (verified) HIV/AIDS cases between 1985–1998 in Hungary

659 persons = 581 males + 78 females

Registered (verified) new HIV cases in the year of 1998

75 persons = 59 males +16 females

Average increase in the number of HIV positive persons/year:1985-1998

7.1 % (7.1 % for males and 7 % for females)

Increase in the number of HIV positive persons in 1998 comparing to the period of 1985-998