2. NEW PSYCHOACTIVE SUBSTANCES ROMANIA’s Experience Lavinius Sava– sociologist NAA/ Romania’sFocal Point Budapest, 19.04.2016

3. „KNOWLEDGE IS POWER.” (FRANCIS BACON)

4. Romania – country profile

5. NPS – a maximum was registered during 2009-2010, then the trend went down. Slight increases of prevalence are observed in 2014 among users accesing the Emergency Units and Drug Treatment Facilities. among the European countries with the lowest drug consumption rates – below average for the most drugs component of the northern part of the traditional Balkan route - the key route of heroin trafficking.

6. What are the NPS?

7. UNODC -“new psychoactive substances (NPS)” -“substances of abuse, either in a pure form or a preparation, that are not controlled by the 1961 Single Convention on Narcotic Drugs or the 1971 Convention on Psychotropic Substances, but which may pose a public health threat”. (Synthetic cannabinoids, Synthetic cathinones, Ketamine, Phenethylamines, Piperazines, Plant-based substances, other(aminoindanes, phencyclidine-type, tryptamines) ROMANIA – Law no.194/2011 > substitute ROMANIA – Law no.194/2011 > substitute – “any substance or mixture of natural or synthetic substances, in any physical form, or any product, plant, mushroom or fragments, whose use is not regulated by other legal provisions, and are likely to yield psychoactive effects and, which can be use instead of a narcotic substance or preparation with psychoactive effects or instead of a controlled plant or substance for the same purposes, irrespective of content, name, administration route, packaging or label”.

8. brief history of NSP in Romania

9. NPS–why is this a PROBLEM? All studies and indicators show a PROBLEM High prevalence and increasing dynamic, geographically widespreaded Specific pattern of use (injecting drugs) Harmful for IDU’s Public health risk Difficulties in knowledge and low possibilities of specific treatment Insufficient impact of public policies’ controlling measures

10. NPS on the open market The dynamic of the “Dream Shops” in Romania, 2007-2013 450 SPICE SHOPS 2007-2010 => 450 SPICE SHOPS

11. NPS - main features in Romania syntethic cannabinoids(smoking mixtures-SPICE) & amphetamine – like stimulants (cathinones) herbal material, infused with psychogenic substances with the help of isopropylic acid high versatility of the chemical formulas mainly described as bath salts, plant food or potpourri any consistency in the ingredients used, although the packaging and inscription were identical originate from outside Europe, most part from China organised crime groups have started manufacturing them in European countries substances are imported via means of fast track postage, like DHL, TNT, Romanian Post or paid carriers

12. GPS 2010 (national level/15-64 years) – NSP: LTP 1,9%, LYP 1,1%, LMP 0,6% NSP: LTP 1,9%, LYP 1,1%, LMP 0,6% NPS use - popular among the youngster populations Data from studies – target populations

13. NPS patterns of use* age: 11 - 40 years old (significant use at children < 15 years old); high visibility of use; socially integrated youngsters coming from normal families; low adresability to medical/social services. 42,5% - first drug used is NPS /daily basis use use history- varies between 1 and 31 months, with an average of 13 months, most frequent answer recorded is 24 months, or 2 years administration route -smoking, followed by injecting and sniffing. NPS USER’s PROFILE

14. explosive growth of indirect death cases explosive growth of indirect death cases HIV+ OUTBREAK among IDUs from Bucharest!!!

15. CASE STUDY > Operation SmartFox - Typical scenario of NPS distribution MODUS OPERANDI

16. Strategic responses

17. main strategic actions main strategic actions : Monitoring, systematic surveillance and risk assessment Prevention and harm reduction interventions Control – legal responses International cooperation

18. Monitoring, systematic surveillance and risk assessment – main tools

19. PREVENTION Campaigns Training Prevention& Harm reduction 1200 slots available1200 slots available in Bucharest OST 2 mil. syringes /year2 mil. syringes /year since 2012 NSP scaling up the screening for HIV& HVC) HIV/HCV&HVB Testing setting up an informal group of consultation GIRRAD dedicated measures of harm-reduction (syringe vending machines, consumption rooms.) National Antidrug Strategy (2013-2020)

20. Using & updating the anti-narcotic conventional legislation - Law no.134/2000- Using existing laws focused on consumer and health protection or medicine regulation (administrative measures) Innovative legal responses (substances defined by its effects rather then chemical structure) - Law no.194/2011- Control – legal responses:

21. updating the anti-narcotic conventional legislation updating the anti-narcotic conventional legislation Law no. 143/2000 on countering the illicit drug trafficking and use, further amended and supplemented Law no. 339/2005 laying down the rules for the legal status of plants, substances and preparations with narcotic and psychotropic content, further amended and supplemented;

22. Using existing laws focused on consumer and health protection or medicine regulation

23. Law no.194/2011 “substitute” psychoactive effect authorization Innovative legal responses defining substance by its effects rather then chemical structure

24. International cooperation EWS UNODCEMCDDAREITOX

25. MAIN OUTCOMES

26. NO more STREET SPICE/DREAM SHOPS 1.188.184 euro (fines) / 138.340 NPS envelopes confiscated ! 2015 – intense activity for the law enforcement representatives

27. GPS 2013- NPS use is declining The prevalence of NPS use in General Population (15-64 years) LTP(%)LYP(%)LMP(%) GPS 2010 21.10.6 GPS 2013 20.30

28. HIV+ epidemic – steadily decreasing stabilization and slightly decreasing trend for the new diagnosed cases of HIV+ IDUs

29. Drug related emergencies, drug related deaths & treatment admissions Treatment admissions and related emergencies are declining during 2011-2013

30. limits & mutations

32. Conclusions & future developments

33. Delayed and unstructured responding measures at the beginning (2008-2010) then an integrated, coherent and effective control system of the NPS was available. Romania – among European countries innovative responding to the NPS challenge The interventions have notably reduced the NPS related problems in Romania, but also forced up some mutations and readjustments of the markets for these substances (newly emerged on-line markets). NPS phenomenon mutations generate different problems which need to be adressed by new solutions and new specialized resources. Due to these new evolutions the hypothesis of a future return of the NPS in Romania have emerged (as shown by the KI). Conclusions

34. strengthen monitoring & surveillance systems support specialized labs scaling up prevention & harm- reduction interventions constant knowledge & resources development for on-line NPS’ monitoring close international cooperation to set up a new legal framework for NPS control(art.83.E UFT) Future developments

35. https://www.facebook.com/AgentiaNationalaAntidrog/ http://www.ana.gov.ro/ Lavinius SAVA– -National Focal Point on drugs within the NAA, ROMANIA