National Strategies

NATIONAL REPORT

HUNGARY

2001.

PART 1

NATIONAL STRATEGIES:

INSTITUTIONAL & LEGAL FRAMEWORKS

1. Developments in Drug Policy and Responses4.

1.1 Political framework in the drug field4.

1.2 Policy implementation, legal framework and prosecution 8.

1.3 Developments in public attitudes and debates12.

1.4 Budget and funding arrangements13.

PART 2

EPIDEMIOLOGICAL SITUATION

1. Prevalence, Patterns and Developments in Drug Use14.

2.1Main developments and emerging trends14.

2.2Drug use in the population22.

2.3Problem drug use31.

3.Health Consequences34.

3.1Drug treatment demand 34.

3.2Drug-related mortality40.

3.3Drug-related infectious diseases41.

3.4Other drug-related morbidity42.

4.Social and Legal Correlates and Consequences44.

4.1Social problems44.

4.2Drug offences and drug-related crime44.

4.3Social and economic costs of drug consumption49.

5.Drug Markets49.

5.1Availability and supply49.

5.2Seizures 49.

5.3Price, purity49.

6.Trends per Drug

7.Discussion54.

7.1Consistency between indicators 55.

7.2Implications for policy and interventions55.

7.3Methodological limitations and data quality55.

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PART 3

DEMAND REDUCTION INTERVENTIONS56.

1. Strategies in Demand Reduction at National Level56.

8.1 Major strategies and activities56.

8.2Approaches and New Developments60.

1. Intervention Areas63.

9.1 Primary prevention63.

9.1.1 Infancy and Family64.

9.1.2 School programmes64.

9.1.3 Youth programmes outside schools65.

9.1.4 Community programmes65.

9.1.5 Telephone help lines65.

9.1.6 Mass media campaigns67.

9.1.7 Internet67.

.2 Reduction of drug related harm67.

9.2.1 Outreach work69.

9.2.2 Low threshold services70.

9.2.3 Prevention of infectious diseases70.

9.3 Treatment70.

9.3.1Treatments and health care at National level74.

9.3.2 Substitution and maintenance programmes76.

9.4 After-care and re-integration77.

9.5 Interventions in the Criminal Justice System78.

9.6 Specific targets and settings79.

10.Quality Assurance81.

ANNEX

Drug monitoring systems and sources of information84.

Bibliography: books and reviews88.

List of Diagrams91.

List of Tables used in the text95.

Part 1

NATIONAL AND LOCAL POLICIES AND LEGAL FRAMEWORKS

1. Developments in Drug Policy and Responses

1.1.Political framework in the drug field

The adoption of the National Drug Strategy in 2000 was a key event in the management of drug abuse in Hungary.

The Government of the Republic of Hungary approved the draft National Strategy to Combat the Drug Problem on July 11, 2000, and Parliament adopted the document on December 5, 2000 with the backing of six parties, 309 votes in favour, 2 abstentions, no nays, under Parliamentary Resolution 96/2000. This document sets out a drug strategy based on a multidisciplinary approach, and a balanced reduction of supply and demand as the method to tackle the problem. It places the emphasis on preventing drug use, a balanced reduction of both supply and demand, raising public awareness of the need to combat drug use effectively, the recognition of joint responsibility, joint action, and problem management.

The Government approved the first draft of the National Strategy on February 22, 2000, and then submitted it for public consultation. A series of public discussions were held and a total of 1054 public agencies, church organisations, NGOs, and institutions were invited to participate. The outcomes of the discussions were incorporated in what is regarded as the final document. Parliament adopted the document under Parliamentary Resolution 96/2000 on December 5, 2000.

The tasks of the National Strategy include the following:

- to define the fundamental goals and values, and the framework of reference for managing the problem, but also to enumerate the limitations and risks associated with the implementation of the strategy;

- to state the key directions and components of strategy development;

- to provide guidance for the sites and stakeholders concerning the implementation of the strategy;

- to create public consensus, activate the public and social groups, and involve municipal governments, decision-making bodies, NGOs, and local communities, in order to achieve the strategic goals;

- to help meet the requirements of European Union accession and international cooperation concerning the effective management of drug problems.

Strategic Principles

- Priority of facts: the National Strategy relies upon the findings of scientific research, rather than assumptions. It focuses on field-proven methods of intervention.

- Partnership, joint action: the National Strategy relies for the most part on the general public and government institutions and agencies to join forces, and also on the proactive cooperation of local communities. It recognises that concerted actions multiply the impact and effectiveness. It takes the needs of families, schools, and local communities into account. It requires and promotes cooperation at local, regional, national, and international levels.

- Comprehensive approach: the management of the drug problem requires a multi-dimensional, balanced, and clearly articulated approach – with important contributions expected in the fields of prevention, education, treatment, research, programs at the workplace, law enforcement, and a number of other areas. Tackling the drugs problem calls for joint and concerted actions in different professions and fields. No professional community may vindicate or undertake the resolution of the matter on its own.

- Accountability: the National Strategy specifies the effectiveness indicators to help gauge the extent to which each aim is achieved. This makes the implementation process transparent and the outlays accountable. The National Strategy will be reviewed at predefined intervals.

- Long-term planning: experiences in other countries suggest that drug problems may only be tackled in the long run. Short-term solutions cannot produce results when our responsibility is not only to manage the current threats but also to reshape the attitude of the next generation to drugs.

Strategic Tools

A broad public consensus must be achieved in the course of combating the drug problem in terms of the importance of the issue and the key stations of the journey to the solution. Certain aspects of the drugs problem affect large social groups, the solution, therefore, calls for concerted efforts on the part of the public.

The Co-ordination Committee on Drug Affairs facilitates political level discussions between the diverse Ministries, and ensures that Hungary lives up to its commitments under international conventions. The experts must develop the professional methods for tackling the drugs problem or extend the scope of the existing programs. The working groups under the Co-ordination Committee on Drug Affairs also help make sure that this aim is achieved.

General Aims

At the beginning of the third millennium, we are guided by the vision of creating a free, self-reliant, and productive society. This society attaches great importance to human dignity and physical, mental, and social welfare, as well as creativity. In order to foster and develop these qualities, the public is able to manage the health-related, social, and criminal harm associated with the use and distribution of drugs.

Drug abuse affects us all and calls for joint action. The state and public institutions play a major role in this joint effort.

The Structure of the National Strategy

Long-term aims: all of the actions required to achieve the stated aims by 2009.

Medium-term aims include the actions defined for 2002.

Short-term aims comprise our immediate tasks that are conducive to the medium-term aims.

1. Community, cooperation – the public should be sensitised to the effective management of drug issues, and local communities should enhance their problem resolution capability in tackling the drugs problem.

Local communities represent the key success factor for the effectiveness of the National Strategy. Cooperation and concerted action at the local settlement level can impact decisively on combating the problem. All effective prevention starts in the family. Whether or not parents and families have a value system and serve as role models impacts on the development or prevention of the problem in a profound way. It is necessary to reinforce all actions and cooperation concerning the basic building blocks of human communities – i.e. the family, neighbourhood, local community, etc. We, therefore, rely on the cooperation of families, relatives, educators, local experts, helpers, pastors and congregations, and municipal leaders. No major breakthrough can be made in tackling the problem without improving the moral consciousness of youth.

The engine driving the drug policy in local communities is the Drug Consultation Forum, which coordinates local actions and initiatives, and serves as a forum for the local institutions along the lines of the national aims. The Forum represents the key link to ensure that strategic ideas become reality.

Drug policy is based on epidemiological research and national information providers: the data help understand the existing drugs situation, project the impact of proposed measures, and define the key actions to take. An audit of the institutions in charge of drug prevention and problem management may promote the effectiveness of community prevention efforts by identifying the institutions’ efficiency, strengths and weaknesses, capacity, as well as local development directions and cost-benefit ratios. A review of the legislative background is also necessary in the interest of establishing facilities for drug-free entertainment, for instance. This is coupled with the extension of local drug prevention services and the systemisation of training for narcotics experts. With a view to international commitments and recommendations, the very first thing to do is to set up the Focal Point, i.e. the National Information Centre on Drugs, in line with the EU standards. This Centre also serves as the main vehicle for data collection, summary, and provision – primarily for decision-makers, public administration agencies, and politicians in general.

2. Giving youth a chance to lead a productive lifestyle and reject drugs (prevention)

The outreach of health promotion and prevention programmes (prevention at schools, communities and through the mass media) must be extended. This requires support for school prevention programmes, informative publications, and media events reaching the predefined target groups. Prevention must be pervasive in places frequented by the young and those who help them. The actions of relatives, helpers, community leaders, even decision makers and policy makers must be rooted in a prevention-based mentality. „Train the trainers” type programmes have been approved by the profession and have become a preferred choice for the training of experts (educators, health educators and other experts at schools). The prevention efforts in local communities are of outstanding importance, with a special emphasis on recreation and sports programmes. The organisational framework of prevention must be developed (i.e. within the Drug Co-ordination Fora at the local level, and the Co-ordination Committee on Drug Affairs working groups at the national level). When examining the prevention methods and their effectiveness, international recommendations, and especially EU recommendations, must be taken thoroughly into account. A separate institution must be established with a role to adapt prevention methods in Hungary and to coordinate training. In the long run, the effectiveness of actions can be measured by epidemiological surveys among young people.

3. Helping the individuals and families that use or are affected by drugs (social work, treatment, rehabilitation)

Every link in the narcotics treatment chain in Hungary (ranging from first contact through detoxification, therapy and after-care to rehabilitation and harm reduction) is underdeveloped and grappling with severe capacity bottlenecks. Each link, therefore, needs to be developed, but the most urgent task is, perhaps, to improve outreach and the organisations that promote admission in the institutional system. This requires the development of those institutions and professional methods which have had small penetration levels to date in Hungary. After-care and rehabilitation also suffer from capacity and funding problems. The linkages between special drug therapies and other medical disciplines and the social care delivery system need to be developed. The missing professional protocols and qualification methods of care delivery institutions must be developed with the involvement of the appropriate professional organisations and in view of the international recommendations. This is especially urgent in those domains of special intervention where Hungary has no track record (or hardly any). Examples of that include paediatric addictology care, treatment for special patients with dual diagnosis, programmes in correctional institutions, and harm reduction.

The Drug Co-ordination Fora and working groups under the Co-ordination Committee on Drug Affairs broaden the organisational foundations for the local and national coordination of treatment and cooperation with other disciplines.

4. Restricting access to drugs (supply reduction)

The drug-related provisions of the legislation to combat organised crime must be enforced in order to restrict access to narcotics and precursors. The institutional system in charge of supply reduction (the Police, Customs and Excise, the Border Guard) must be reinforced, and the efforts of medical experts and probation officers must be made more effective. The latter is faced with new challenges following the amendment to the Criminal Code, which the current organisation is not prepared to live up to. The above-mentioned development includes organisational changes, headcount increases, training, technical background enhancements, and the extension of existing and well-functioning international relations. The impact of amendments to the Criminal Code must be studied in a broader timeframe. The special aspects of drug-related crime must be applied during the process of upgrading the system of Unified Police and Prosecution Crime Statistics, in order to define the phenomenon and design the required interventions more precisely. Narcotics must become a stand-alone discipline in the training curricula of law enforcement officers. The Drug Co-ordination Fora and working groups under the Co-ordination Committee on Drug Affairs broaden the organisational foundations for local and national coordination of supply reduction and cooperation with other disciplines. The legislation to combat organised crime is to be supplemented with additional statutes in the course of 2000.

International Cooperation

Given its geographic and political situation, Hungary is working with international organisations to tighten control over and crack down on the drug routes and smuggling networks that stretch across the country.

The solution for meeting the drug-related European Union accession requirements in light of the approaching accession lies in integrating with the network of national information collection and dissemination centres known as the „European Monitoring Centre for Drugs and Drug Addiction”, and in setting up a National Centre (Focal Point). The existing information exchange process must continue with the INTERPOL, EUROPOL, and the institutions of the Council of Europe. Hungary pursues its drug-related programmes under the PHARE Programme.

The opportunities in regional and European cooperation must be exploited in the reduction of both supply and demand. The Central European Initiative under the Prague Memorandum (1995) must be a priority. This programme aims to support tactical and strategic cross-border cooperation by developing national drug control strategies in the interest of integration in a concerted sub-regional strategy.

Hungary takes part in the efforts and programmes of the special UN anti-drug agencies, including the United Nations Commission on Narcotic Drugs (CND), the International Narcotics Control Board (INCB), and the United Nations International Drug Control Programme (UNSDCP). Hungary will establish a National Opium Committee, the resolution for which is included in the Single Convention on Narcotic Drugs (New York, 1961).

Since drugs move without borders and boundaries, cooperation as recommended by the international organisations is paramount in the framework of bilateral treaties on the fight against terrorism, organised crime, and drug-related crime. Our bilateral treaties on organised crime must be reviewed by 2002 in order to integrate the tasks related to EU accession.

In the field of supply reduction, Hungary’s Customs and Excise Authority cooperates with the World Customs Organisation’s (WCO) Regional Liaison Office in Warsaw.

1.2.Policy Implementation, legal framework and prosecution

Monitoring the National Strategy

The Co-ordination Committee on Drug Affairs is responsible for controlling the implementation of the National Strategy, coordinating the operations of individual Ministries and public institutions, and for approximating the views of the sectors. The Committee is to present an annual report to the Government on the Hungarian drug situation and to assess the implementation of the National Strategy.

The local Drug Co-ordination Fora play an important role as an implementation tool. The annual reports of the Forums are summarised by the Coordination Secretariat reporting to the Co-ordination Committee on Drug Affairs.

The Committee evaluates the implementation of the National Strategy annually, and commissions an audit and efficiency inquest into the Strategy and care delivery institutions every three years. It then proceeds to prepare a report for the Government and Parliament. The Committee is responsible for keeping the public up-to-date on the implementation of the Strategy and the results achieved.

Item 2. c) of Parliamentary Resolution 96/2000 (XII.11.) on the adoption of the National Strategy to Combat the Drug Problem states that the Government is to report to Parliament every two years – the first occasion being the Parliamentary Sessions in autumn 2001 – on the implementation of the Programme and the audit and efficiency inquest into the care delivery institutions.

Legislative Environment

International Conventions

Hungary has joined all the narcotics conventions. The 1961 Single Convention on Narcotic Drugs, the 1972 Amendment Protocol, and the 1971 Convention on Psychotropic Substances were adopted by our former legislation, while Hungarian Parliament ratified the 1988 UN Convention in 1996. The latter international norm has eventually been implemented in practice over the past two years through the amendment of national and criminal laws.

The joint Health Ministry – Interior Ministry Decree 4/1980 (VI.24.) provides for the production, processing, distribution, importation, exportation, storage, and use of psychotropic substances. The Exhibits to this Decree list the psychotropic substances subject to special control.

Drug policing statutes

The fundamental source of legislation for drug policing is Act XXXIV of 1994 on the Police Force. This Act already takes reality after the political changes into account, and delegates policing tasks (rights and obligations) finally where they can be performed. The Act states that the police – as part of their duty to enforce the law – are to control the production, distribution, and use of substances that represent a hazard to the public – including narcotics, etc.