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Sadly, drug use in Romania is present, and the whole country is doing the best it can to get rid of it. It is a tough fight, with lots of consequences and life-changing decisions, but there has been a decrease in people using drugs and an increase of unique places for those who want to fight addiction during recent years. Among the most popular drugs used in Romania, this study presents the evolution of drug use by gender and age and details regarding which drugs are more frequently used by men and women. Besides, there is information about the programs used for this battle, Government decisions, explications of these decisions, measures implemented for prevention. Romania has gradually adopted, together with the European Union member states, an ensemble of legislative measures aimed to construct and consolidate the legal framework and national institutional framework to prevent and combat drug trafficking and consumption. Thus, our country is making substantial progress in the fight against the phenomenon and is currently having unitary and coherent national regulations in line with current European and international standards. It wants to adjust in the future implementation of the operational provisions contained in the post-UNGASS result documents As the National Anti-Drug Policy Coordinator, National Anti-Drug Agency has developed and implemented various public policy documents during , alongside other responsible national authorities. The most important one was the implementation of the National Anti-Drug Strategy At the general population level, a lifetime prevalence of the consumption of any type of illicit drug of The prevalence in the last year of this type of consumption is 6. If we exclude over-the-counter drug use from the analysis, the prevalences are In contrast, there is a lifetime prevalence of 6. Depending on the age group, the highest prevalences, regardless of the period analyzed, are recorded in the age groups, confirming the results of other studies, according to which this is the age group with the highest risk of consumption: For the adult population years , there are prevalences over three times lower: 4. Compared to other studies, there are increases in all three types of consumption. It continues to be the most consumed drug in Romania in the school population. Also, cannabis remains the most seized drug at a national level, registering in the highest number of seizures made so far. And in terms of admission to treatment for drug use, cannabis is the primary drug for which services are requested situation registered since , since the entry into force of the Criminal Code. At the general population level, a lifetime prevalence of cannabis use of 6. The majority of cannabis use in the last year is 3. The prevalence of cannabis use until the age of 16 was 9. The majority of cannabis use in the last year was 8. The stimulants are available on the Romanian drug market, such as cocaine, amphetamine and ecstasy. In terms of perceived availability, stimulants are considered difficult to obtain, both in the general population and the school population. The prevalence of ecstasy use in the last 12 months and the last 30 days, observed in GPS, is low, with population surveys capturing only a small number of drug users other than cannabis. Thus, 1. If in terms of experimenting with cocaine-type stimulants, the percentage of male users is double that of female consumers 2. At the general population level, a lifetime prevalence of heroin use of 0. The majority in the last year of heroin use is 0. In heroin use, men have a lifetime use prevalence of 0. There is a significant differentiation of heroin use between the two sexes: 0. Current heroin use has the same value of 0. The lowest declared age of onset was 15 years, and the average age of onset is The quantities of synthetic drugs from significant seizures are increasing compared to for MDMA and amphetamine. Amphetamine — The total amount seized and the number of catches in are increasing compared to MDMA — Compared to the previous year, although registers a decrease in the number of confiscated tablets, the number of seizures increases, confirming the increasing availability of this type of drug on the illicit drug market in the last five years. LSD — recorded a decrease in both the number of catches and the total amount seized. It maintains its availability on the illicit market. Methadone — Also, this year, methadone continues to be on the illicit drug market, even though static data show a slight decrease in the number of seizures but a significant increase in the amount confiscated. Benzodiazepines — In , there was a significant decrease in the number of tablets confiscated compared to However, the number of seizures still highlights the availability of this type of drug on the illicit market. The strategy develops the national policy framework, aiming to address drug, alcohol and tobacco use and drug trafficking. The document was developed following a comprehensive consultation process with all relevant institutional actors at a national level. It closely reflected the objectives and priorities of the European Anti-Drug Strategy At the same time, it proposes an integrated, balanced, scientifically grounded approach to the new problems facing Romanian society from the perspective of the drug phenomenon:. The general directions of action in this field are reflected at a practical level in 5 significant areas of intervention:. At the moment, we are at the third National Anti-Drug Strategy, the strategy in the force being applicable from to and is implemented through two plans of action, each of them lasting four years: and At the national level, two treatment networks provide in the community assistance for the drug users:. The Centers for Prevention, Evaluation and Anti-drug Counseling, within the 34 penitentiary units, four re-education centers, three therapeutic communities and six penitentiary hospitals. In , people received integrated drug assistance, which means maintaining the number of people assisted at the same level as the previous year. Most admissions aimed to provide specific treatment for cannabis use Moreover, this year, it turns out that the trend is given by the number of people requesting treatment as a result of the consumption of cannabis. Thus, the list of drugs for which specialised assistance is requested in Romania maintains its distribution generated by the legislative amendment of Thanks to whom drug users who have committed drug offences are sent to evaluate inclusion in specific assistance programs, most of them being cannabis users. Thus, the stagnation of the number of people who are cannabis users seeking specialised assistance determines the maintenance of the number of admissions due to drug use at a level similar to that recorded previously. Orders for this type of consumption remain high in the picture drugs for which specialised assistance is requested in Romania. These represent about a quarter Regarding admissions to treatment due to problems caused by the consumption of new psychoactive substances, after several years in which there were slight variations in the number of requests, in , there is a downward trend To implement the national anti-drug policies, in , were approved by the Government decisions, two programs in the field of drug demand reduction: The Program of national prevention and medical, psychological and social assistance for consumers of drugs for the period — approved by Government Decision no. National Program for prevention and medical, psychological and social assistance for drug users for the period — is implemented exclusively by the National Anti-Drug Agency and the Program of National Interest for Prevention and Assistance medical, psychological and social development of drug users — will be implemented by non-governmental organisations specialised in drug demand reduction, which will receive funding from the National Anti-Drug Agency, based on a selection procedure of projects submitted by them. Within the National Program for prevention and medical, psychological and social assistance for drug users for the period —, two were structured subprogrammes specific to integrated assistance, as follows: By Decision no. Sub-program IV aims, on the one hand, to strengthen the services of exchange — type programs syringes in the community and deprivation of liberty systems, to reduce risks and the negative consequences associated with drug use and, on the other hand, the increase the level of information, education and awareness of drug users, as well as developing appropriate interventions to prevent deaths or infectious diseases associated with drug use. Subprogramme V aims to adapt the services within the integrated assistance circuit to individual consumer needs and consumption patterns, with a focus on polyconsumption, combined substance use, over-the-counter medication, consumption of non-opioid substances, as well as consumption of new psychoactive substances, but also developing integrated inter-institutional services for drug users who have committed criminal acts with low social danger to include them in the circuit integrated support. This Program aims to pilot and promote good models practices in the field of drug demand reduction, according to European standards and international measures in the area, the measures provided for it to increase the availability, accessibility and coverage of services within the integrated circuit of assistance consumers and drug addicts, through development and implementation of appropriate and necessary policies. By completing the network of risk reduction services and the negative consequences associated with drug use adapted to the needs of consumers of drugs that have not accessed the benefits of the care system, it is desired both to identify, attracting, motivating and sending them to services with a high level of specialisation, as well as addressing basic social and medical needs, correlated with existing resources in integrated circuit assistance. By developing shelter services for consumers, social centre services for homeless children, outreach services in the community, sheltered housing, and by promoting these services, it is pursued empowering the integrated care system for drug users so that, through implicit development of methodologies and operating rules to ensure consistency with medical and social systems, thus achieving a maximum community impact at the level of policies in the field. Compared to the two programs mentioned above, the Ministry of Health runs the Program of National Mental Health Center, which provides for the following activities:. They provide substitution treatment with opiate agonists and antagonists for individuals with drug addiction and testing drug metabolites in urine to introduce treatment and monitor treatment. Of these, only the National Anti-Drug Agency centers provide national coverage, being developed in the 41 county residences and the six sectors of Bucharest. The National Anti-Drug Agency centers and those developed by the Ministry of Health offer free services for drug users. These services are provided in the 34 penitentiary units and the four re-education centers. Also, starting with , the specialists from the Prevention Centers, Drug Evaluation and Counseling provides medical, psychological and social assistance services to drug users in police custody. Other aspects of the provision and use of treatment for addiction outpatient drugs. The requests addressed to the outpatient assistance services know a decrease of 6. This was determined particularly by the evolution of the demand for treatment due to opioid consumption Unlike the previous year, when a preponderance of requests for assistance in the outpatient system compared to those registered in the inpatient network, in the reference year, the share of outpatient requests in the total admissions to treatment is This brings us back to the situation observed in when stabilisation of the relationship between applications was observed addressed in the outpatient system and those registered in the hospitalisation network Concerning age and sex, the characteristics of the beneficiaries in the treatment system are similar to those observed in previous years, as follows:. The primary drug for which assistance was mainly requested in in the system outpatient treatment is cannabis — Compared to the previous year, although it maintains approximately the same share of people to receive integrated care problems caused by cannabis use in — In Romania, the outpatient care system for drug users consists mainly of specialised care centers, which have multidisciplinary teams consisting of: doctors, psychologists and social workers, with specific training in providing treatment for drug users in their psycho-social reintegration. These teams offer, first of all, psycho-social treatment and implement case management for drug users. Identification services are provided to a lesser extent and attracting drug users to specialised treatment programs. The residential treatment network in Romania provides specialised services medical, psychological and social to the psycho-social reintegration of drug users. Of these, the most important are detox programs and psychiatric medical services. They can continue the therapeutic process in psychiatric wards, therapeutic communities or private centers, where they benefit from psycho-social counselling and management services. Methadone maintenance treatment is a recognised therapeutic approach at the national and international level as an effective method of treating opiate addiction, contributing to reducing individual and social damage. The development of a methadone maintenance treatment program has a chance of success if it is accessible. The inclusion in the assistance is made as soon as possible, and retention in treatment is not conditioned for a certain period of time. Factors that may influence the participation of beneficiaries in such a program are:. Following the legislation in force in the field of reference, the substitute treatment of opioid addiction is available in health facilities and treatment centers for drug users. This treatment is implemented, both outpatient and residential, being also available in the penitentiary system. The substitution treatment programs developed by the National Anti-Drug Agency were available in only in Bucharest. By , the services of Substitute treatment was also available in the county seat municipalities of Oradea and Iasi. Starting in , the National Anti-Drug Agency specialists granted methadone substitution treatment services in the Romanian Police detention sections. Within the Mental Health Program, substitution treatment with agonists are provided and opiate antagonists for people with drug addiction nationwide. Nine hospitals run the program in the network of the Ministry of Health. People deprived of their liberty benefit from substitution treatment with agonists and opiate antagonists for people with drug addiction. This program is included in The mental health program implemented by the Ministry of Health and is running in 11 penitentiary units, namely: Bucharest Rahova Penitentiary-Hospital, Penitentiary. Of these, three are private, and NGOs develop one. Common drugs in our country 2. Cannabis It continues to be the most consumed drug in Romania in the school population. Stimulants The stimulants are available on the Romanian drug market, such as cocaine, amphetamine and ecstasy. Heroin At the general population level, a lifetime prevalence of heroin use of 0. Heroin — The year registers a significant increase. Strategies of Fighting against Drugs 4. At the same time, it proposes an integrated, balanced, scientifically grounded approach to the new problems facing Romanian society from the perspective of the drug phenomenon: multi-drug use, including drug and alcohol combinations; rapid expansion of consumption of new substances with psychoactive properties; the dynamics of the drug market, generated including the use of the Internet as a means of drug distribution; drug abuse; diversion of drug precursors; the quality of demand reduction services; the incidence of Hepatitis C among injecting drug users and the risk of an HIV epidemic and other associated diseases. The general directions of action in this field are reflected at a practical level in 5 significant areas of intervention: — Reducing the demand for drugs, by strengthening the integrated national system of prevention and assistance, following scientific evidence, which includes all universal, selective and indicated prevention programs, projects and interventions implemented in school, family and community, as well as identification interventions, attracting and motivating drug users to provide specialized assistance services. Also, at the level of the penitentiary system, assistance services have been developed, granted by the specialists of the National Administration of Penitentiaries, but also by the staff of The Centers for Prevention, Evaluation and Anti-drug Counseling, within the 34 penitentiary units, four re-education centers, three therapeutic communities and six penitentiary hospitals. Integrated support level I — a network of reduction services the risks and consequences associated with drug use subprogramme V. Integrated assistance level II and III — network development and consolidation of integrated support services for drug users. Compared to the two programs mentioned above, the Ministry of Health runs the Program of National Mental Health Center, which provides for the following activities: They provide substitution treatment with opiate agonists and antagonists for individuals with drug addiction and testing drug metabolites in urine to introduce treatment and monitor treatment. Number of beneficiaries The requests addressed to the outpatient assistance services know a decrease of 6. Gender and age of beneficiaries Concerning age and sex, the characteristics of the beneficiaries in the treatment system are similar to those observed in previous years, as follows: The average age of those who used the services of outpatient care is The primary drug of consumption and the route of administration The primary drug for which assistance was mainly requested in in the system outpatient treatment is cannabis — Residential treatment services The residential treatment network in Romania provides specialised services medical, psychological and social to the psycho-social reintegration of drug users. The primary providers of opiate addiction treatment OST Methadone maintenance treatment is a recognised therapeutic approach at the national and international level as an effective method of treating opiate addiction, contributing to reducing individual and social damage. Factors that may influence the participation of beneficiaries in such a program are: -the number or location of the centers providing such services, the work schedule of -the centre, the evaluation procedures, and the degree of training of the specialists in the field of medical, psychological and social view. The primary providers of opiate addiction replacement treatment are: -National Anti-Drug Agency. Of these, three are private, and NGOs develop one 6. Prevention Prevention in school: — Increasing the level of information, education and awareness of the school population in the view of non — initiation of drug use in school, extracurricular and school programs spending free time; — Increasing the level of information, sensitization and awareness of the school population in order to avoid the transformation of experimental and occasional consumption into regular consumption, in within the school, extracurricular and leisure programs. Prevention in the community: — Reducing the influence of risk factors and developing the influence of protective factors within vulnerable groups, correlated with their needs and particularities; — Reducing the influence of risk factors and developing the influence of protection factors at occupational categories that are prone to drug use, correlated with the level of social responsibility and their particularities; — Adopt a healthy lifestyle at the general population level as an alternative to drug use in leisure programs. Drug demand reduction campaigns: — Increasing the level of information and awareness of the general population and the population at risk on the effects, risks and negative consequences of drug use in the view of not starting or delaying the onset of drug use.

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