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

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

The two largest needle exchange programs (NEPs) in Hungary were forced to close down in the second half of 2014 due to extreme political attacks and related lack of government funding. The closures occurred against a background of rapid expansion in Hungary of injectable new psychoactive substances,...

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Bibliographic Details
Published in:BMC public health Vol. 16; no. 160; pp. 157 - 7
Main Authors: Gyarmathy, V Anna, Csák, Róbert, Bálint, Katalin, Bene, Eszter, Varga, András Ernő, Varga, Mónika, Csiszér, Nóra, Vingender, István, Rácz, József
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 16-02-2016
BioMed Central
BMC
Subjects:
Clients
Closures
Communicable Disease Control - methods
Data collection
Disease Outbreaks
Disease transmission
Drug policy
Drug use
Exchanging
Greece
Harm Reduction
HIV
HIV Infections - epidemiology
HIV Infections - etiology
HIV Infections - prevention & control
HIV Infections - transmission
Human immunodeficiency virus
Humans
Hungary
Hungary - epidemiology
Hypodermic needles
Low income groups
Medical research
Medicine, Experimental
Needle exchange
Needle exchange programs
Needle Sharing
Needles
People who inject drugs
Politics
Psychotropic Drugs
Public health
Romania
Substance Abuse, Intravenous - complications
Syringes
Hungary
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Summary:The two largest needle exchange programs (NEPs) in Hungary were forced to close down in the second half of 2014 due to extreme political attacks and related lack of government funding. The closures occurred against a background of rapid expansion in Hungary of injectable new psychoactive substances, which are associated with very frequent injecting episodes and syringe sharing. The aim of our analysis was to predict how the overall Hungarian NEP syringe supply was affected by the closures. We analyzed all registry data from all NEPs in Hungary for all years of standardized NEP data collection protocols currently in use (2008-2014) concerning 22 949 client enrollments, 9,211 new clients, 228,167 client contacts, 3,160,560 distributed syringes, and 2,077,676 collected syringes. We found that while the combined share of the two now closed NEPs decreased over time, even in their partial year 2014 they still distributed and collected about half of all syringes, and attended to over half of all clients and client contacts in Hungary. The number of distributed syringes per PWID (WHO minimum target = 100) was 81 in 2014 in Hungary, but 39 without the two now closed NEPs. There is a high probability that the combination of decreased NEP coverage and the increased injection risk of new psychoactive substances may lead in Hungary to a public health disaster similar to the HIV outbreaks in Romania and Greece. This can be avoided only by an immediate change in the attitude of the Hungarian government towards harm reduction.
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ISSN:1471-2458
1471-2458
DOI:10.1186/s12889-016-2842-2