Hungarian Civil Liberties Union organized its annual legal training and conference for drug treatment providers and researchers between 13 and 14 November, 2004.
Legal training for workers of drug treatment facilities
On November 13 HCLU organized a one-day legal training seminar for NGOs working in the field of drug addiction treatment and harm reduction services. Almost 60 people attended the session held at the European Youth Centre to participate in the training seminar. Among the atendees were representatives of leading drug ambulance services, NGOs, street outreach workers, lawyers, medical doctors and psychiatrists. The training seminar consisted of lectures, presentations and interactive discussions. The head of the Legal Aid Service of HCLU, Andrea Pelle summarized the deficiencies of Hungary’s present drug legislation and law enforcement practices, including the controversy surrounding identification of ”drug addiction” and ”drug addicts” (there are reduced sanctions against ‘drug addicts’ according to the penal code).
Eszter Csernus, head of the Patients Rights Program, pointed out in her presentation that there is a strong and urgent need for HIV/AIDS and Hepatitis B & C screening at drug treatment facilities, as only a very small proportion of clients are presently tested for blood born diseases. Erik Látrányi, an attorney with HCLU’s Drug Policy Project gave a presentation on the concept and regulation of ”diversion into therapy” in Hungarian drug law (the modified penal code allows people who possess small amount of illicit drugs to choose a six-month therapy or prevention program instead of incarceration). After each presentation the audience asked questions and consulted with our lawyers regarding special cases. All the participants concluded that the training was very successful and that there was a need for further sessions because of present confusion surrounding Hungary’s drug laws.
”HIV, Hepatitis C and Drug Use: Reducing the Risks” (Conference, 14 November, 2004)
On November 14 HCLU organized a conference on the prevention and control of HIV/AIDS and Hepatitis C epidemics among intravenous drug users in Hungary. This was an occasion for presenting the new volume of our ”Drug Policy Booklet” series entitled ”Intravenous Drug Use and Public Health,” which evaluates Hungary’s HIV and Hepatitis C screening and monitoring programs, as well as treatment for IDUs and special risk drug users, including individuals currently held in prisons.
We invited speakers from various countries with the intention of addressing all of the issues HCLU considers to be fundamental questions of Hungarian drug policy. Morag MacDonald (Centre for Criminal Justice Policy and Research at University of Central England, Birmingham) spoke about problematic drug use and harm reduction in correctional settings, presenting the findings of her research carried out in several Central-Eastern European countries last year. She concluded that though prison administrations are looking at the issue of problematic drug use in prisons, harm reduction is still not receiving serious attention in Hungary. There is no substitution therapy, needle exchange or HIV prevention programs in prisons and the existing HIV and Hepatitis screening systems are not satisfactory.
Laetitita Hennebal (ENDSP / Cranstoun Drug Services, London) presented another study that focused on examining the policy in place for the provision of substitution treatment in prison, as well as practical experiences in different countries. The conclusion of the presentation was that substitution therapy is generally an effective and feasible way of reducing harm and preventing HIV in correctional settings but that it is provided in a heterogeneous way across Europe. Prison administrations have to overcome prejudices and develop substitution programs according to the local needs and special target groups in order for harm reduction initiatives to be successful.
Konstantin Lezhentsev (IHRD, Budapest) pointed out several of the most destructive myths about treating HIV and Hepatitis C positive IDUs, including the myth that IDUs fail to meet the basic conditions required to access life-saving HAART and Interferon treatment because of their lifestyles and attitudes. This myth continues to exist in spite of several studies from various regions that prove the effectiveness of HAART and Interferon treatments for IDUs living with HIV/AIDS and/or Hepatitis C. Lezhentsev also addressed the crucial role that Methadone maintenance programs can play in motivating and maintaining IDUs in treatment and the unfortunate lack of political will to offer equal access to treatment for IDUs in most CEE countries.
Hans T. Verbraeck (Addiction Research Centre, Utrecht) presented a study on Roma IDUs in CEE countries (the co-author of which were Jean-Paul Grund and Paul J. Öfner). Currently, Roma IDUs have problems with access to health care and harm reduction services because of racist prejudices, poverty and social exclusion. There are several regions, towns and districts where the IDU population consists mainly of members of the Roma minority. One such place is the 9th district of Budapest, where hundreds of Roma intravenous amphetamine users live under sub-standard hygienic and social conditions. General HIV/AIDS and Hepatitis prevention and harm reduction programs fail to reach many members of the Roma IDU population because of their special needs. Government must act to develop special strategies and projects aimed at better protecting the Roma IDU population.
Eszter Ujhelyi (Szent László Hospital, Budapest) is one of the few researchers in Hungary that has carried out sentinel surveillance among IDUs to assess the extent of the HIV/AIDS and Hepatitis C epidemic in Hungary and its associated harms. Although the surveillance covered only a small sample of IDUs, it shows that blood born infections are spreading among the Hungarian IDU population: HIV/AIDS infections are occurring with greater frequency and the seroprevalence of Hepatitis C has doubled between 1997 and 2003 among IDUs (from 16% to 31%). Dr. Ujhelyi emphasized that there is a lack of government funding for HIV/AIDS and Hepatitis C screening programs in Hungarian treatment facilities. She suggested that greater involvement of the NGO in providing counseling and screening services would be a meaningful step towards providing better services and protections for Hungary’s vulnerable IDU population.
Several representatives from both the governmental and non-governmental sectors participated in a discussion session following the presentations. Participants included representatives of Prison Administration, The Ministry of Health, needle exchange and methadone treatment providers, and HIV activists. The discussants generally agreed that there is a need for urgent action from both governmental and non-governmental organizations to prevent the further spread of blood born diseases among IDUs.