Drug Abuse in the Global Village

Hungry

                        Extent of Drug Abuse

Concern about the abuse of tranquilizers, as well as, new trends in abuse of drugs, such as volatile solvents, was reported. Abuse of volatile solvents began in the seventies, reached a peak in the late seventies and early eighties. During the same period, abuse of poppy preparations by injection, oral intake of poppy infusions ("poppy tea") and smoking of cigarettes containing cannabis became evident.  In spite of the concerns above, drug dependence in Hungary is considered low, according to official reports (Szomor-Molnar 1992). In the last two years, opiates, including heroin and hydrocodeine have been reported as the most prevalent drugs abused (Szomor 1994a).

            Polydrug abuse is reported common among abusers (U.N. 1989; Council of Europe 1991).

                       Abuser Characteristics

Abuse of codeine and hydrocodeine is common among young drug abusers. The age of drug abusers tend to be between 20 and 30, but lower for volatile solvents abusers (U.N. 1990). Tranquilizer abusers tend to be middle-aged women, members of single parents families and middle-aged and elderly lonely people (Szomor-Molnar 1992; Council of Europe 1991). According to data from a Youth Outpatient Centre, most abusers were living with their family and abuse was more common among the unemployed (Szomor-Molnar 1992).  Further, alcohol and licit prescription drugs are consumed by both sexes equally, whereas volatile solvents and opiates are abused, primarily, by men (Szomor 1994a).

                         Regional  Variations

Drug abuse tends to be concentrated in larger cities, and particularly, in Budapest (WHO 1992).

                                    Trends

The abuse of opiates is increasing. Some increase in the abuse of pharmaceutical preparation such as codeine and benzodiazepines, was reported in 1989. Data from one drug outpatient center shows that since 1975, there has been a decrease in the abuse of volatile solvents but at the same time an increase in the abuse of illicit and licit drugs (Szomor 1994a).

                             Mode of Intake

Intravenous drug abuse of opiates, benzodiazepines and glutethimide has been increasing according to 1989 reports (U.N. 1989). Recent reports suggest that intravenous heroin abuse has continued to increase. Needle sharing has also increased (Szomor 1994a).

            According to 1993 data from a Youth Drug Center, 44 abusers ever injected drugs (37 males, 7 females) and 24 ever shared needles (21 males and 3 females) (Szomor 1994b).

    COSTS AND CONSEQUENCES OF ABUSE

Between 1973 and 1989, 55 drug related deaths were registered (Council of Europe 1991).

   NATIONAL RESPONSES TO DRUG ABUSE

                           National Strategy

An Interministerial Group for Narcotic Drugs was established in 1991 to develop a national strategy to combat drug abuse. The group chaired by the Ministry of Welfare, coordinates activities between all ministries, agencies and international organizations in the field of drug abuse. It also formulates drug policy and resource allocation proposals.  Nine working groups elaborate guidelines, recommendations and plans (Szomor 1994a).  In its first session, the Committee gave priority to data collection, as a prerequisite to drafting of a National Strategy (Council of Europe 1991).

      Structure of National Drug Control Organs

The Pharmaceutical Department of the Ministry of Social Well‑being  is the competent authority for the issuance of import and export certificates and authorizations.

LEGAL, ADMINISTRATIVE AND OTHER ACTION
TAKEN TO IMPLEMENT THE INTERNATIONAL
             DRUG CONTROL TREATIES**

                           Treaty Adherence

Hungary is party to the 1961 Convention as amended by the 1972 Protocol and the 1971 Convention. Hungary provisionally applies the provisions of the 1988 Convention relating to control of precursors and essential chemicals.

  Measures Taken with Respect to Drug Control

Recently enacted laws and regulations:
An amendment of the Penal Code concerning drug-related crime entered into force in May 1993 which introduces more severe penalties for illicit drug trafficking and organized drug crime. Drug abuse is no longer punished but all circumstances leading to abuse such as cultivation, production, purchase and keeping of a smaller amount are subject to punishment unless the abuser is prepared go undergo treatment in which case the penal procedure is suspended.

Licensing system for manufacture, trade and distribution:
There is a government-controlled licensing system. Codeine, concentrate of poppy straw, dihydrocodeine, ethylmorphine, morphine, pholcodine and thebaine (all narcotic drugs) and gluthemide and phenobarbital (psychotropic substances) were reported having been manufactured in 1992.

Control system:
(i) Prescription requirement: There is a prescription requirement for supply or dispensation of preparations containing narcotic drugs and psychotropic substances.
(ii) Warnings on packages: The law requires warnings on packages or accompanying leaflet information to safeguard the users of preparations containing narcotic drugs and psychotropic substances.
(iii) Control of non-treaty substances, if any: None reported.
(iv) Other administrative measures: None reported.

                            Social Measures

Penal sanctions related to social measures: In 1992, courts applied measures of treatment, education, after-care, rehabilitation or social reintegration for a drug-related offence in addition to conviction or punishment.

Other social measures: None reported.

        DEMAND REDUCTION ACTIVITIES

                          Primary Prevention

A National Prevention Planning Work Group was established in 1992 with a mandate to prepare a national drug prevention plan (Szomor-Molnar 1992). In the first phase, an assessment of the drug problem was undertaken, drug prevention activities were listed and evaluated for effectiveness. At a later phase, drug prevention committees consisting of local officials, multisectorial experts, NGOs and teachers, were formed in Budapest and in 17 counties,  to implement drug prevention activities, taking into consideration local needs and cultures (Szomor 1994b).

            Media campaigns consist of distribution of posters, leaflets and street marches (Szomor 1994a).

            Drug prevention activities have been carried out in primary, secondary and higher education centres, according to U.N. reports (U.N. 1992). A pilot study on health education, which includes drug prevention was carried out in 1991 (Council of Europe 1991). Educational authorities have been considering drug prevention education as part of the curriculum, according to a 1992 report. A decision in this regard has not been reported (Szomor-Molnar 1992).

            In a model programme, in a Youth Drug Centre, training was provided to doctors, social workers and teachers. Special attention is given to the training of local school teachers. Training is also given to law and medical students. Peer groups are also given special training in drug prevention (Szomor 1994a).

            Budapest organized the first big drug campaign in 1992, involving thousands of youth, among other groups. The first national 24 hours drug hot line, operates in Budapest, since August 1992. A drug abuse prevention bus, operating since March 1994, provides drug information and counselling. The Police is also active in drug prevention (Szomor 1994b).

            AIDS prevention activities were organized by the State in 1985 (Szomor-Molnar 1992). Trained medical students inform youth on drug related risks. Needle and syringes are sold in pharmacies, at low cost and without prescriptions (Council of Europe 1991). However, pharmacists sometimes resist selling these articles to drug abusers (Szomor-Molnar 1992). There are no needle exchange programmes and intravenous drug abusers are not vaccinated against Hepatitis B (Szomor 1994b).

                 Treatment and Rehabilitation

Treatment and care of drug abusers is the responsibility of the public health care system, according to the Hungarian Health Act. Compulsory treatment may be ordered by health authorities (Szomor-Molnar 1992). In May 1993, new drug abuse related measures were introduced in the Hungarian Penal Code, to divert drug dependent abusers into treatment and to minimize criminalization. Drug abuse offenders may opt for voluntary treatment, as an alternative to penal procedures (Szomor 1994a).

            Family Help Centers, operating in major towns, conduct early identification activities among populations at risk to provide social support and counselling (Szomor 1994b).

            Detoxification is carried out in hospitals, in detoxication wards, in Budapest and in major cities, or in internal medicine or psychiatric departments. In 1991, there were 7 out-patient clinics in Hungary (Szomor-Molnar 1992).  Children and young drug abusers are referred to out-patient clinics. In 1990, 104 drug abusers were treated, about 56 were treated for the first time. About 55 were admitted due to volatile solvents abuse, including 10 girls. Adult drug abusers are usually referred to psychiatric hospitals. A special drug abuse ward has been opened in the National Institute of Neurology and Mental Hygiene (20 beds). In 1990, 1,343 patients were treated in psychiatric out-patient clinics for psychotropic substances dependence and or psychosis caused by medical drugs (790 women and 553 men) (Council of Europe 1991). In 1991, there were 36 cases of volatile substance abuse under 19 years of age in juvenile psychiatric units, compared to 80 cases, in 1988 and 51 cases in 1986. In 1992, drug outpatient clinics treated 249 opiates abusers, 97 volatile solvents abusers, 25 cannabis abusers and 1 cocaine abuser. Licit drug related psychoses cases, treated in psychiatric units, ranged between 161 and 164, from 1980 to 1991, but increased 203 cases in 1992. According to 1993 data from a Youth Drug Centre, there were 81 first time in treatment patients 18 years of age or older, 14 between 14 and 18 years of age and 67 below 14 years of age (Szomor 1994b).

            Long-term drug related rehabilitation programmes are offered by religious organizations. Some of the services include medical and/or psychotherapeutic services,  as well as, treatment in therapeutic communities (Szomor 1994b).

            There are no detoxification and no drug maintenance programmes in the medical department of prisons. However, the Central Hospital of Prison Administration and the Neuro-Psychiatric Department of the Forensic Institute for Observation and Treatment of Mental Patient, provide detoxification and drug maintenance programmes (Szomor 1994b).

          SUPPLY REDUCTION ACTIVITIES

     Arrests, Convictions and Types of Offenses

In 1993 penal procedures were taken against 54 foreigners and 46 Hungarian citizens (Szomor 1994a). In 1989, a total of 54 drug related convictions were reported (including one for trafficking). Of those convicted, most (37) were in the 20 to 29 age group and only three were between 15 and 19 of age. Thirty two convictions were related to opiates and 21 to cannabis. Thirty five of those convicted were males and 18 females (U.N. 1989).

            There are approximately 10,000 to 14,000 cases of forged medical prescriptions per year in Hungary.  Between 1989 and 1991, 444 drug related crimes were committed (Council of Europe 1991).

                                   Seizures

In 1992, about 15 kg of cannabis plants, 3.7 kg of cannabis resin, 7.5 kg of cocaine, 76.4 kg of heroin, 3.3 kg of morphine, 54 kg of hallucinogens, 163 units of LSD and 0.15 kg of stimulants were seized (U.N. 1992).

                      Supply Source of Drugs

Heroin seized originates from the Middle East, through the Balkan Route, and cocaine from Latin America (Council of Europe 1991; Szomor-Molnar 1992). Some of the trafficking and seizures were attributed to the opening of the borders with Bulgaria and Romania and to the war in Yugoslavia (Council of Europe 1991).

                       References and Notes

U.N. 1989, 1990, 1992.   Responses to the UNDCP's  annual reports questionnaires for the years 1989, 1990 and 1992.

Council of Europe (1991),  "National Report of Hungary" presented at the First Pan-European Ministerial Conference on Co-operation on Illicit Drug Abuse Problems, Oslo 9-10 May 1991.

Szomor-Molnar, K. (Ed.) (1992),  Drug Abuse Situation and Demand Reduction Policies in Hungary. Budapest, Interministerial Drug Committee of Hungary.

Szomor, K. (Ed.) (1994a),  Summary on the Implementation of the Recommendations of the Oslo Declaration in Hungary, Budapest,  Interministerial Drug Committee of Hungary.

Szomor, K. (1994b).  "National Report of Hungary to be submitted to Regional Discussion", paper presented at 1992 Regional Phare Programme on Drugs, Barcelona 12-15 July, 1994.

WHO (1992),   European Summary of Drug Abuse (ESDA) First Report (1985-1990), Copenhagen, WHO.

Notes:
** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section was prepared by the Secretariat of the Commission on Narcotic Drugs based on annual reports questionnaires for the years 1988-92, and the Statement made at 37th session by the distinguished delegate for Hungary, Commission on Narcotic Drugs.