Although the drug strategy adopted by the Hungarian government in 2013 aimed to make the country drug-free by 2020, the (not so) new synthetic drugs still rule the country. After the municipal elections, there is some hope that harm reduction can return to Budapest.
Illicit drug markets have been behaving strangely in Hungary for the last ten years. The decline of Ecstasy and the boom of new synthetic drugs was happening all across Europe after 2009 – but what made this small Central European country peculiar was the almost total collapse of the heroin and amphetamine markets, replaced by new stimulants. A similar trend could only be observed in Romania (where it seems heroin is now back, unlike in Hungary). Despite (or partly due to?) all efforts of law makers to ban new substances as soon as possible, the market for designer drugs has been stabilising.
There are two types of these drugs: synthetic cannabinoid agonists, which are dubbed as “herbal” or “bio” by Hungarian users, and cathinones, dubbed as “crystal” on the street. Almost every year a new substance comes to dominate the designer market. This year the dominant stimulant was ethyl-hexedrone (replacing pentedrone) and the dominant synthetic cannabinoid agonist was 5F-MDMB-PINACA (replacing ADB-FUBINACA). God knows what comes next year but we can be almost sure the designers will throw something new into the market.
There are some signs (police seizures for example) that the designer market boom peaked around 2014, and that its rise is now somewhat slower, or even stagnating. But there is no chance that they will be gone any time soon. According to the latest epidemiological study among the adult population, the use of “herbal” is the most prevalent among illicit substances. That is if we trust the results – it is very hard to make accurate estimations of illicit drug use trends in Hungary due to the restrictive and stigmatising political environment.
Researchers are now trying to use new methods, such as the Random Response Model (RRM) to make sure people give an honest answer to questions about their drug use. They found a surprisingly big gap between the regular survey findings (9% life prevalence of illicit drug use) and those measured with RRM (23%). A lesson learnt for other countries: it seems the political-cultural environment has more effect on the accuracy of our epidemiological findings on drug use than we previously thought.
There is evidence for the growing use of some classical drugs in the past four years, for example amphetamine, ecstasy, and cocaine. The size and potency of ecstasy pills is increasing, as well as the purity of cocaine, in line with trends reported from other European countries. It seems the market for party drugs is well-connected to Western Europe again, even if the cocaine prices are still very high (75 Euros/gram), which prevents the less wealthy from using the substance. Heroin use is still sporadic; most people inject designer drugs.
While party-going middle class people now tend to use classical drugs again, the use of new synthetic drugs is still spreading among the poor, the socially excluded, and marginalised groups of society. This is due to the easy accessibility and low price of these drugs. Slummy micro-ghettos in big cities and segregated Roma settlements in rural areas are the epicentres of designer drug use. People live here in the devastating grip of deep poverty, social exclusion, and criminalisation, without access to even the very basic social and health care programs. It is staggering but not surprising to see that while most injectors use stimulants, the majority of those entering drug treatment are still heroin users. When most programs struggle for survival, capacities and resources are missing for innovation and outreach.
Injecting drug use itself, mostly prevalent in urban centres, is now in decline – people inject less frequently and prefer to use stimulants by sniffing/foiling, mixing them with “herbal” smoking sessions. Some people in the capital, Budapest, claim this decline in injections is due to the closure of needle and syringe programs (NSPs). But if this was true how would we explain that professionals also report declining injecting use outside of Budapest, where the NSPs have not been closed? The increasingly restrictive climate has affected the lives of drug users of course: it forced them into hiding. Now they are less visible for services and they can access services less easily. Fear of arrest and stigma plays a crucial role. Sometimes the fear is well-founded – the police are under political pressure to arrest as many drug users as possible. A year ago policemen even invaded and searched a mobile outreach program in Budapest.
8,146 drug-related criminal offences were reported last year, 82% of them for simple drug use/possession. Only 17% of the offences are related to dealing/trafficking, one third of those involving a small quantity. Our criminal justice system still focuses on punishing the users, mostly the poor users. New psychoactive substance use is an administrative and not a criminal offence – which may seem a less punitive option. But it is not. While criminal offenders can go to a 6 month consultation program as an alternative form of punishment, administrative offenders cannot. This is the ultimate absurdity of the drug war in Hungary: we coerce middle class kids who smoke cannabis occasionally into unnecessary treatment, but we don’t even offer help to the marginalised drug users. According to the statistics, most people who enter treatment in Hungary are coerced and the number of those who go voluntarily is declining.
Meanwhile, the hepatitis C epidemic is still spreading among drug users, at least according to the estimations of epidemiologists, who say the incidence rate among new, young users is high. It is very hard to even monitor the epidemic now because there are so few services that can reach the most affected communities to test them, not to mention to help them to enter treatment. The government supports abstinence-only treatment centres and police-led school prevention programs. After the closure of the two largest harm reduction programs, the remaining services are poorly funded, often work with unstable opening hours, with underpaid staff, in a hostile political climate. EU funds are not available for harm reduction programs, and Hungary is always left out of the scope of grant calls from other international donors. So now we, as an EU member state, have a less developed harm reduction system than in some of the former Soviet countries that receive Global Fund support.
There is a slight chance that things can at least change for good in Budapest and in some bigger cities, where opposition mayors were elected at the October municipal elections. New mayors have limited powers and money due to centralisation efforts by the government, but they can still have some impact on the local level. We launched an advocacy campaign to reform urban drug policies this year, and even invited the Vienna drug coordination team to show how the system works there. On behalf of civil society organisations we prepared a minimum program on drug policy and asked candidates to support it. The program called for a new urban drug coordination system, inclusion of civil society, and a new urban drug strategy with budget allocated to its implementation. Several new mayors are among those who supported it, including Gergely Karácsony, the new chief mayor of Budapest. Now we negotiate with them to make sure the program will not stay on paper.