CONTACTS MINISTRY OF ADMINISTRATION AND INTERIOR NATIONAL ANTI-DRUG AGENCY Romanian Monitoring Center for Drugs and Drug Addiction 37 Unirii Boulevard, Bloc A4, District 3 BUCHAREST, ROMANIA Phone/Fax: (00 40) (21) 316.47.87; 323.30.30/ ext. 21706 or 21731 Team • ANGELA PANTEA, PhD, pharmacist Director of the Romanian Monitoring Center for Drugs and Drug Addiction E-mail: [email protected] [email protected] [email protected] • MONICA AGAPIE, chemical engineer E-mail: [email protected] • RUXANDA ILIESCU, biomedical engineer E-mail: [email protected] • MADI-ELENA SURUGIU, MD E-mail: [email protected] • LUCIAN SUDITU, MD, epidemiologist E-mail: [email protected] • PAULA ŞTEFANIA FRUSINOIU, philologist E-mail: [email protected] • ANDREI BOTESCU, psycho-sociologist E-mail:[email protected] 2 Acknowledgment This report represents the result of the collaboration between RMCDDA team and Romanian specialists from Drug Demand Reduction respectively Drug Supply Reduction fields, to whom we wish to address our special thanks: o Gabriela ALEXANDRESCU, executive manager “Salvati Copiii” NGO o Dr. Cristian BELLU BENGESCU – Mental Health Laboratory – District IV, Bucharest o Alina BOCAI – UNDP Project Manager, UNAIDS o Dr. Gheorghe BUDILEANU – Director of the Mental Health Laboratory – District IV, Bucharest o Prof. Ioan BURAGA, Ph.D. – Director, the Directorate for Medical Assistance within the Ministry of Health o Specialist Cătălina CHENDEA – the General Directorate for Pre-University Learning System – the Ministry of Education and Research o Dr. Teodora CIOLOMPEA – Directorate for Medical Assistance within the Ministry of Health o Dr. Mihnea COSTESCU – National Legal Medicine Institute “Mina Minovici”, Bucharest o Dr. Cristian CURCĂ – National Legal Medicine Institute “Mina Minovici”, Bucharest o Professor Dan DERMENGIU, Ph.D. – Director of the National Legal Medicine Institute “Mina Minovici”, Bucharest o Economist Maria DUMBRĂVEANU – specialist within the Sanitary Statistics and Medical Documentation Center, the Ministry of Health o Dr. Silvia FLORESCU – Director, Research Department, the National Institute of Research and Development in Health o Dr. Cristina HUDIŢĂ – Director, Students Evaluation and Treatment Center, “Sf. Stelian” Hospital, Bucharest o Sociologist Raluca IONESCU, probation counselor – the Office for Victims Protection and Social Reintegration of Offenders o Dr. Radu Alexandru MACOVEI – Director of the Clinical Toxicology Ward, the Emergency Hospital, Bucharest o Mariana MUREŞAN, specialist within the National Institute for Statistics o National Drug Analyses Laboratory team, G.I.R.P. – M.A.I. o Chief Superintendent Sorin OPREA – Director, the General Directorate of Countering Organized Crime and Anti-drug, G.I.R.P. 3 o Economist Ioana PERŢACHE – Director, Sanitary Statistics and Medical Documentation Center, the Ministry of Health o Eduard PETRESCU – UNAIDS National Program Officer o Romanian Harm Reduction Network team, coordinated by Maria GEORGESCU, M.D. o Manuela STANCIU, specialist officer within the Anti-drug Directorate, GDCOCA/G.I.R.P. o MD Adrian STREINU-CERCEL – The President of the National Commission for Fight against AIDS o Dr. Coriolan ULMEANU, Ph.D. – Director, Pediatric Hospital “Grigore Alexandrescu”, Bucharest o Dr. Lucian VASILESCU – Director of the XVI Psychiatric Department, “Al. Obregia” Clinical Hospital, Bucharest Our special thanks go to the Spanish Pre-Accessory Adviser, Miss Carmen PAVON de PAULA, her assistant, Miss Dana NISTOR and the Spanish and French Experts involved in the Twinning Project. Last, but not least, we address thanks to our colleagues within the following directorates of N.A.A.: o Drug Use Prevention Directorate o Evaluation-Coordination Directorate o International Relations Directorate 4 Table of Contents Introduction ..................................................................................................................... 8 Summary........................................................................................................................ 10 Trends and changes/data analysis and interpretation........................................... 10 PART A. NEW DEVELOPMENTS AND TRENDS ......................................................... 12 Chapter 1- National policies and context.................................................................... 12 1.1 Legal framework .................................................................................................. 12 o Laws, regulations, directives or guidelines in the field of drug issues (demand and supply).....................................................................................................................................12 o Laws implementation..........................................................................................................13 1.2 Institutional framework, strategies and policies............................................... 14 o Coordination arrangements...........................................................................................14 o National plan and/or strategies .....................................................................................15 o Implementation of policies and strategies.....................................................................16 o Impact of policies and strategies...................................................................................17 1.3 Budget and public expenditure .......................................................................... 17 o In law enforcement, social and health care, research, international actions, coordination, national strategies..............................................................................................17 o Funding arrangements ..................................................................................................19 1.4 Social and cultural context ................................................................................. 20 o Public opinion of drug issues ........................................................................................20 o Initiatives in parliament and civil society .......................................................................20 o Media representations...................................................................................................21 Chapter 2 – Drug Use in the Population ..................................................................... 24 2.1. Drug use in the general population................................................................... 24 2.2 – Drug use in the school and youth population................................................ 27 2.3 Drug use among specific groups....................................................................... 31 Chapter 3 – Prevention................................................................................................. 33 3.1 Universal prevention ........................................................................................... 33 o School-based universal prevention...............................................................................34 o Family based drug use prevention................................................................................35 o Community-based prevention .......................................................................................36 3.2 Selective/indicated prevention ........................................................................... 36 o In Recreational Settings ................................................................................................36 o At risk groups ................................................................................................................37 5 Chapter 4 – Problem Drug Use .................................................................................... 38 Chapter 5 – Drug-Related Treatment........................................................................... 39 5.1 Treatment system ................................................................................................ 39 5.2 Drug free treatment.............................................................................................. 40 o In-patient and outpatient ...............................................................................................40 5.3 Medically assisted treatment.............................................................................. 42 Chapter 6 - Health Correlates and Consequences..................................................... 44 6.1. Drug related deaths and mortality amongst drug users ................................. 44 6.2. Drug related infectious diseases....................................................................... 48 o HIV/AIDS, viral hepatitis, STD, tuberculosis, other infectious morbidity.......................48 o HIV/AIDS and injecting drug use...................................................................................49 6.3 Psychiatric Comorbidity (dual diagnostic)........................................................ 52 6.4 Other drug related health correlates and consequences ................................ 53 o Non-fatal drug emergencies..........................................................................................53 o Driving under the drug influence / accidents.................................................................54 Chapter 7 – Responses to Health Correlates and Consequences ........................... 56