A needle in the haystack – the dire straits of needle exchange in Hungary

Gyarmathy, V. Anna; Csák, Róbert; Bálint, Katalin; Bene, Eszter; Varga, A.; Varga, Mónika; Csiszér, Nóra; Vingender, István; Rácz, József

doi:10.1186/s12889-016-2842-2

Cited by 15 publications

(7 citation statements)

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“…These suggest the shift of responsibility for drug harms and the focus of harm reduction from the individual alone to social and political institutions which have a role in harm production. In Hungary, there is a noticeable growth of new psychoactive substance use, while availability of harm reduction services is very limited [ 4 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is important to emphasize the impossibility of knowing the quantity, purity, or even the number of different SC compounds in a particular SC product (e.g., [ 59 ]). Another important aspect could emerge: people who use SCs do not (or rarely) access harm reduction services (while intravenous substance users visit these services, for example, needle exchange program, more often [ 4 , 57 ]). People who use SCs rather utilize emergency and toxicology treatments only when they experience very adverse effects.…”

Section: Discussionmentioning

confidence: 99%

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Assessing the experience of using synthetic cannabinoids by means of interpretative phenomenological analysis

et al. 2017

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BackgroundNew psychoactive substances (NPS) have been increasingly consumed by people who use drugs in recent years, which pose a new challenge for treatment services. One of the largest groups of NPS is synthetic cannabinoids (SCs), which are intended as a replacement to cannabis. While there is an increasing body of research on the motivation and the effects associated with SC use, little is known about the subjective interpretation of SC use by the people who use drugs themselves. The aim of this study was to examine the experiences and personal interpretations of SC use of users who were heavily dependent on SC and are in treatment.MethodsA qualitative research method was applied in order to explore unknown and personal aspects of SC use. Semi-structured interviews were conducted with six participants who had problematic SC use and entered treatment. The research was conducted in Hungary in 2015. We analyzed data using interpretative phenomenological analysis (IPA).ResultsParticipants perceived SCs to be unpredictable: their initial positive experiences quickly turned negative. They also reported that SCs took over their lives both interpersonally and intrapersonally: the drug took their old friends away, and while initially it gave them new ones, in the end it not only made them asocial but the drug became their only friend, it hijacked their personalities and made them addicted.ConclusionsParticipants experienced rapid development of effects and they had difficulties interpreting or integrating these experiences. The rapid alteration of effects and experiences may explain the severe psychopathological symptoms, which may be important information for harm reduction and treatment services. Since, these experiences are mostly unknown and unpredictable for people who use SCs, a forum where they could share their experiences could have a harm reducing role. For a harm reduction point of view of SCs, which are underrepresented in literature, it is important to emphasize the impossibility of knowing the quantity, purity, or even the number of different SC compounds in a particular SC product. Our study findings suggest that despite the adverse effects, including a rapid turn of experiences to negative, rapid development of addiction and withdrawal symptoms of SCs, participants continued using the drug because this drug was mostly available and cheap. Therefore, a harm reduction approach would be to make available and legal certain drugs that have less adverse effects and could cause less serious dependence and withdrawal symptoms, with controlled production and distribution (similarly to cannabis legalization in the Netherlands).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessing the experience of using synthetic cannabinoids by means of interpretative phenomenological analysis

et al. 2017

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“…Although community development programs providing access to injecting equipment exist in other countries, including European countries, Australia, and USA, there is a considerable resistance from governments to support integrated NEP of the kind currently implemented in New Zealand (31, 32), with some NEP in Europe having been recently dismantled due to political opposition (33). In many countries, there remains considerable counterproductive, not evidence based, sociopolitical debate over the ethical and financial implications of harm reduction strategies, despite its proven cost effectiveness (3, 34).…”

Section: Discussionmentioning

confidence: 99%

Influence of Peer-Based Needle Exchange Programs on Mental Health Status in People Who Inject Drugs: A Nationwide New Zealand Study

Hay

Henderson²,

Maltby

et al. 2017

Front. Psychiatry

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Alleviating the personal and social burden associated with substance use disorders requires the implementation of a comprehensive strategy, including outreach, education, community interventions, psychiatric treatment, and access to needle exchange programs (NEP), where peer support may be available. Given that substantial research underscores the potential benefits of peer support in psychiatric interventions, we aimed to conduct a national survey to examine key domains of mental health status in people who inject drugs (PWID) in New Zealand. PWID were recruited from 24 pharmacies and 16 dedicated peer-based needle exchanges (PBNEs) across the country. We focused on two mental health outcomes: (1) affective dysregulation, across the three emotional domains of the Depression Anxiety Stress Scale, due to its role in the maintenance of continued drug use, and (2) positive cognition and effective health- and drug-related information exchange with the provider, using the Satisfaction with Life Scale and an ad hoc questionnaire, respectively, in view of their association with improved mental health outcomes. We hypothesized that access to peer support would be associated with mental health benefits for PWIDs. Remarkably, the results of a multistep regression analysis revealed that irrespective of sex, age, ethnicity, main drug used, length of drug use, and frequency of visits to the NEP, the exclusive or preferential use of PBNEs predicted significantly lower depression and anxiety scores, greater satisfaction with life, and increased health-related information exchange with the service provider. These findings demonstrate for the first time an association between access to peer support at PBNEs and positive indices of mental health, lending strong support to the effective integration of such peer-delivered NEP services into the network of mental health services for PWID worldwide.

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“…In many cities across the globe, such as Amsterdam (Grund et al, 1991), Frankfurt am Main (Duncan et al, 2019;Kamphausen et al, 2015), Lisbon (D anyi, 2018), Manchester (Vitellone, 2017), Paris (Gomart, 2002;Jauffret-Roustide and Cailbault, 2018) and Vancouver (MacNeil and Pauly, 2011;McNeil et al, 2014), harm reduction initiatives are supported by national drug policies, whereas in others they are being actively suppressed. The latter is the case in Budapest, where the needle exchange programme's operation in the 8th district was gradually made impossible during our fieldwork (Gyarmathy et al, 2016;R acz et al, 2016). The third empirical story of our paper narrates the programme's closure and discusses how its eradication fit with the Hungarian Government's drug policy, which is one of the strictest in Europe.…”

Section: Through Thementioning

confidence: 88%

Drug places and spaces of problematisation: the melancholy case of a Hungarian needle exchange programme

Dányi

Csák²

2021

DAT

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Purpose This paper aims to explore multiple problematisation processes through a former needle exchange programme run by Kék Pont (a non-governmental organisation) in the 8th district of Budapest. By presenting a collage of ethnographic stories, this paper attempts to preserve tacit knowledge associated with the programme and thereby keep its office alive as a “drug place”, the operation of which was made impossible in 2014. Design/methodology/approach Drawing on the insights of Foucauldian governmentality studies and actor-network theory, this paper focusses on drug use as a problem in its spatial-material settings. Based on ethnographic fieldwork, the contribution traces multiple problematisation processes and related infrastructures. Findings From the needle exchange programme’s perspective, drug use is not a singular problem but the effect of multiple problematisation processes. Although those processes are often in conflict with each other, the question is not which one is right, but how social workers manage to hold them together. It is a fragile achievement that requires years of training and ongoing negotiation with local actors. By eliminating Kék Pont’s 8th district office, the Hungarian Government did not only hinder harm reduction in the area but it had also rendered tacit knowledge associated with the needle exchange programme as a “drug place” inaccessible. Originality/value The paper is a melancholy intervention – an attempt to preserve tacit knowledge that had accumulated at the needle exchange programme. The retelling of ethnographic stories about this “drug place” is one way of ensuring that other drug policies remain imaginable.

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A needle in the haystack – the dire straits of needle exchange in Hungary

Cited by 15 publications

References 30 publications

Assessing the experience of using synthetic cannabinoids by means of interpretative phenomenological analysis

Assessing the experience of using synthetic cannabinoids by means of interpretative phenomenological analysis

Influence of Peer-Based Needle Exchange Programs on Mental Health Status in People Who Inject Drugs: A Nationwide New Zealand Study

Drug places and spaces of problematisation: the melancholy case of a Hungarian needle exchange programme

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