Support The Romanian Harm Reduction Network needs your help to end a senseless and preventable epidemic whose victims are some of the most stigmatized and vulnerable members of society: intravenous drug users. This epidemic can be stopped through cheap and simple measures. All that is needed is political willingness. On September 30, 2011, The National Committee to Fight HIV published a report about the HIV situation in Romania. When talking about the tendencies concerning HIV contamination in Romania, it was noted for the first time a significant increase in the numbers of intravenous drug users (IDU): 62 cases of HIV patients compared to 14 cases in 2010. Between 2011 and 2014 there was a total of 692 cases. It’s worth mentioning that between 2007 and 2010 only 28 IDU were diagnosed with HIV. Of the total 692 HIV infected users, 231 are in prison. Even though in the past there were syringes exchange programs in prisons, currently there aren’t any because there is no demand from the prisoners. This happens because the lack of privacy which leads to searches in the rooms of those who asked for syringes.
THE EPIDEMIC FORMULA
(New drugs + increased number of injections) - syringes = HIV NSPP = new substances with psychoactive proprieties/ethnobotanicals/ new drugs/”legal” drugs
THE CAUSES OF H IV EPIDEMIC AMONG IDU
New drugs: they came on the market between 2007 and 2008 and they could be sold without restrictions due to the legislative void. In 2012 the shops were closed and the new drugs entered the black market. The new drugs are synthetic products similar to normal drugs, but much more toxic. In Romania there were available mostly synthetic cannabinoids (JWH, HU, CP) and synthetic stimulants (piperazine, cathinone). Heroin users from Bucharest started to inject synthetic stimulants. Most of the users, no matter the substances they used, were misled by the fact that these were legal and they thought that they are safer than normal drugs.
LEGAL RISKS
According to the Romanian legislation, heroin is a high risk drug. After the issue of the new Code of Criminal Procedure, heroin possession is punished by a prison sentence of six months to 3 years or a fine, and heroin trafficking by a sentence of 7 to 15 years. Until March 2014, the sentence was 2 to 5 years in prison and for trafficking was 10 to 20 years. From the legal point of view, a user who buys heroin for other users is considered a trafficker, even if there’s no financial gain. Apart from the fact that the synthetic stimulants were more intense, they were also legal and their possession was not punished by law. Therefore, the users didn’t risk having problems with the police.
BEHAVIORAL CHANGES
Heroin is a depressant, which means it has a calming effect; the average consumption rate is three injections per day (upon awaking, in the middle of the day, and before going to sleep), the goal being the withdrawal management rather than a recreational one. The synthetic stimulants cause hyperactivity, panic, insomnia, hypertension and hyperventilation, lost of appetite and dehydration. The addiction is psychological and it consists of compulsive consumption until the depletion of the supply or of the user: there are documented cases of 48-72 hours consumption or of persons who had walked without stopping for dozens of kilometers. The number of injections increased from 3 times a day to 10-30 a day. The control over the environment and over the utensils was gone. (Grafic: distributed syringes- NSPP hospitalizations-new cases of IDU with HIV)
seringi distribuite
SNPP internări
cazuri noi CDI HIV+
The transition to the new drugs determined an increase in the sharing of syringes. The hygiene conditions in which the injections took place were gone. Starting 2010, because of the lack of the international funding, the syringe exchange programs decreased from the point of view of the quantity of syringes and the areas covered by the programs. The programs used to work well, but they were not sustainable because there was no permanent funding. The NGOs think that if the programs were supported by public funding, the problem would be solved. The authorities say that there is no money for these programs. The necessary budget for a national syringe exchange program is estimated to 3 to 5 million euros.
REGIONAL CONTEXT
According to World Health Organization (WHO), more than 80% from the total of new cases of HIV patients from the east-European countries are intravenous drug users. In Russia, the percentage is 93%. The increase in the number of HIV patients was also confirmed in Greece, Bulgaria and Lithuania. While in other regions of the world the HIV infestation rate is declining, the epidemic has the biggest rate of infestation in the former Soviet states and Central Asia. The propagation of HIV in Romania is carefully scrutinized by the United Nations* and the European Disease Control Center**.
SOLUTIONS FOR STOPPING THE EPIDEMIC
The development of the syringe exchange programs: all the countries that had implemented syringe exchange programs have managed to keep HIV under control. In the countries that maintain a repressive policy, the epidemic continues to grow. Ensuring that the programs are sustainable: HARM REDUCTION WORKS. FUND IT! There are hundreds of reports that show the efficiency of harm reduction programs. Nevertheless, in conservative communities the approach is considered a way of encouraging the drug consumption. This kind of mentality interferes with emergency interventions and aggravates the public health crisis.
LEGISLATIVE CHANGES
The bigger the problem, the more necessary are the legislative changes, such as: the exculpation of drug possession for private use – this way, the users are no longer in the police jurisdiction, but that of the doctors and social workers; the change of the legislation concerning the funding of the NGOs so that they could access public funds with total transparency. According to RHRN, the syringe exchange costs 500 euros/client/year, while the treatment of HIV costs at least 6000 euro/patient/year. For each 500 euro invested in supplying disposable syringes for a drug user, the state would save 5500 euros. The authorities unanimously agree that “it’s easier to prevent than to cure.” However, the budget for HIV treatments raised from 37 million euros in 2008 to approximately 53 million euros in 2012, while the prevention of HIV infestation is still unfunded. HOW TO GET INVOLVED IN THE ROMANIAN HARM REDUCTION NETWORK CAMPAIGN
LEARN MORE
U.N. Report huffingtonpost.co.uk/michel-kazatchkine/bucharest-hiv-aids_b_4095619.html E.D.C.C Report emcdda.europa.eu/news/2012/HIV-outbreaks EURONEWS youtube.com/watch?v=wcC7IR5vgUE DRUG REPORTER drogriporter.hu/en/romania COUNT THE COSTS countthecosts.org BREAKING THE TABOO breakingthetaboo.info SUPORT DON’T PUNISH supportdontpunish.org
ROMANIA HARM REDUCTION NETWORK RHRN.RO/EN/HOME-EN/ OFFICE.RHRN@GMAIL.COM
December 2016
RHRN.RO/EN/CATEGORY/BLOG-EN/ 0733 987 506
1. Tell us why is important to act – write an email for support. 2. Get a photo of yourself with the message. 3. Post the message on Facebook or other social media platforms and send it to us by email at office.rhrn@gmail.com 4. All the photos that we collect will be added to the petitions we will send to the local authorities. Each person counts. Be a part of the campaign!
Illustrations: Sorina Vazelina Translator: Oana Zamfirache
Special thanks to: Ștefan Iancu, Dan Popescu, Grigore, the ARAS team (syringe exchange program), the people from Arena and Carusel, two substitution treatment centers.