In Romania, an alarming increase in the notification of human immunodeficiency virus (HIV) infections among PWID was reported between 2011 and 2013; however, in 2014-15, the number of new HIV notifications among PWID decreased. Data based on HIV testing results among drug users seeking treatment or attending harm reduction services also indicated an increase in HIV prevalence between 2010 and 2013, but more recent data suggest some decrease in the prevalence rates among these groups.
Hepatitis C virus (HCV) infection is the most common drug-related infectious disease among Romanian drug users. An increasing trend in HCV prevalence among drug users admitted to treatment over the period 2008-12 was reported, while in the period 2013-15, HCV prevalence among this population fell slightly. Furthermore, data from those seeking drug treatment indicated a constant upwards trend in hepatitis B virus (HBV) infection prevalence rates between 2009 and 2013. HIV and HCV and/or HBV coinfections are frequent among Romanian PWID.
In the last decade, there has been a change in patterns of drug use and a high-risk group of NPS users has emerged in Romania, which could explain the changes in the prevalence of drug-related infectious diseases among PWID. The limited availability of adequate prevention measures might have contributed to the trend, while intensified testing of PWID might have led to higher detection rates in the most recent years.
In Romania, drug-related emergencies have been monitored nationwide since 2010. In 2015, a total of 4 060 emergencies caused by illicit psychoactive substances were reported, which is an increase compared with 2014. The majority of the cases were linked to the use of NPS, followed by cannabis and opioids; however, the prevalence of the latter is on the decline. In about one fifth of the reported emergencies, more than one illicit substance or alcohol was involved. Young males are the most common group likely to seek emergency help as a result of illicit substance use.
Newly diagnosed HIV cases attributed to injecting drug use
NB Year of data 2015, or latest available year. Source: ECDC.
Prevalence of HIV and HCV antibodies among people who inject drugs in Romania
NBYear of data 2015.
Characteristics of and trends in drug-induced deaths in Romania
NB Year of data 2015.
Drug-induced deaths are deaths directly attributable to the use of illicit drugs (i.e. poisonings or overdose). In 2015, as in previous years, reported drug-induced deaths were mainly based on examined deaths in Bucharest, and, as such, were likely to be underestimated for the country as a whole (four drug-induced deaths were reported in the rest of Romania). The analysis indicates that victims had a long-term drug use history and that they had mainly used illicit drugs by injection.
According to the toxicological results, opioids — mainly methadone — were most frequently the principal drugs involved in drug-induced deaths, and the proportion of druginduced deaths that involved opioids was higher than in 2014. NPS were detected in two deaths and cocaine in one death in 2015. Two or more psychoactive substances were present in half of deaths. With regard to distribution by gender and age in 2015, the majority of victims were male and the mean age of victims was around 32 years.
The drug-induced mortality rate among adults (aged 15-64 years) was reportedly 1.6 deaths per million in 2015. This is much lower than the latest European average of 20.3 deaths per million, although this is most likely underestimated.
No studies on mortality among drug users have been conducted in Romania in recent years.
Drug-induced mortality rates among adults (15-64)
NB Year of data 2015, or latest available year.