József Rácz1, Róbert Csák2, Krisztina Tímea Tóth3, Eszter Tóth3, Klaudia Rozmán3, V Anna Gyarmathy4. 1. Eötvös Loránd University, Institute of Psychology, Budapest, Hungary; Semmelweis University, Faculty of Health Sciences, Budapest, Hungary; Blue Point Drug Counselling and Outpatient Centre, Budapest, Hungary. 2. Semmelweis University, Faculty of Health Sciences, Budapest, Hungary; Blue Point Drug Counselling and Outpatient Centre, Budapest, Hungary. 3. Eötvös Loránd University, Institute of Psychology, Budapest, Hungary. 4. Semmelweis University, Faculty of Health Sciences, Budapest, Hungary; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: vgyarmat@jhsph.edu.
Abstract
BACKGROUND: There has been an almost exponential growth in the number of new psychoactive substances (NPS) on the drug markets in Europe during the past decade. While most users of NPS use them by routes other than injecting, percutaneous use of NPS is associated with very frequent injecting episodes and paraphernalia sharing. METHODS: We assessed to what extent new clients between 2006 and 2014 (N=3680) at Blue Point, Hungary's largest needle exchange program, exhibited a shift during these years in the drugs they primarily injected. RESULTS: Until 2010, 99% of clients injected either heroin or amphetamines. After 2010, however, there was a "replacement chain" of new substances, with one appearing and disappearing after the other: between 2010 and 2014, NPS under five names appeared and gained dominant prevalence (from 0% to 80%), and gradually replaced first the two "traditional" drugs amphetamine and heroin (which diminished to 17% together in 2014) and later each other. We also saw an increase in the proportion of female and older clients. CONCLUSIONS: While our findings are restricted to injected NPS, they suggest that NPS affect the vast majority of the population of people who inject drugs not only in terms of drug use patterns, but maybe also in terms of demographics. Given that over 80% of people who inject drugs use NPS and injecting NPS is associated with increased injecting risks, harm reduction services should be made more available to avoid an epidemic of blood-borne infections.
BACKGROUND: There has been an almost exponential growth in the number of new psychoactive substances (NPS) on the drug markets in Europe during the past decade. While most users of NPS use them by routes other than injecting, percutaneous use of NPS is associated with very frequent injecting episodes and paraphernalia sharing. METHODS: We assessed to what extent new clients between 2006 and 2014 (N=3680) at Blue Point, Hungary's largest needle exchange program, exhibited a shift during these years in the drugs they primarily injected. RESULTS: Until 2010, 99% of clients injected either heroin or amphetamines. After 2010, however, there was a "replacement chain" of new substances, with one appearing and disappearing after the other: between 2010 and 2014, NPS under five names appeared and gained dominant prevalence (from 0% to 80%), and gradually replaced first the two "traditional" drugs amphetamine and heroin (which diminished to 17% together in 2014) and later each other. We also saw an increase in the proportion of female and older clients. CONCLUSIONS: While our findings are restricted to injected NPS, they suggest that NPS affect the vast majority of the population of people who inject drugs not only in terms of drug use patterns, but maybe also in terms of demographics. Given that over 80% of people who inject drugs use NPS and injecting NPS is associated with increased injecting risks, harm reduction services should be made more available to avoid an epidemic of blood-borne infections.
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