Country overview: Hungary
- Drug use among the general population and young people
- Problem drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-related deaths
- Treatment responses
- Harm reduction responses
- Drug markets and drug-law offences
- National drug laws
- National drug strategy
- Coordination mechanism in the field of drugs
- Public expenditure
- Drug-related research
|Year||Hungary||EU (27 countries)||Source|
|Population||2012||9 957 731 p ||503 663 601 b p||Eurostat|
|Population by age classes||15–24||2012||12.1 % p||11.7 % b p||Eurostat|
|25–49||36.1 % p||35.4 % b p|
|50–64||20.4 % p||19.5 % b p|
|GDP per capita in PPS (Purchasing Power Standards) 1||2011||66||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2010||23.1 %||29.4 % p||Eurostat|
|Unemployment rate 3||2012||10.9 %||10.5 %||Eurostat|
|Unemployment rate of population aged under 25 years||2012||28.1 %||22.8 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2011||174.4||:||Council of Europe, SPACE I-2011|
|At risk of poverty rate 5||2011||13.8 %||16.9 % e||SILC |
p Eurostat provisional value.
b Break in series.
1 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
2 Expenditure on social protection contains: benefits, which consist of transfers, in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.
3 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.
4 Situation of penal institutions on 1 September, 2011.
5 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold, which is set at 60 % of the national median equivalised disposable income (after social transfers).
The most recent general population survey on drug use in Hungary was conducted in 2007. It found that lifetime prevalence was 8.5 % for cannabis, 2.4 % for ecstasy, 1.8 % for amphetamines, 1.1 % for hallucinogens and under 1 % for other illicit substances. In 2003, lifetime prevalence was 9.8 % for cannabis, 3.1 % for ecstasy, 2.5 % for amphetamines and under 2 % for other substances, except for sedatives and/or tranquillizers (22.2 %).
Available data for young adults aged 18–34 found that lifetime prevalence was 19.1 % for cannabis, 5.1 % for ecstasy and 4.0 % for amphetamines. Lifetime prevalence for this age group was lower for all other illicit substances. Last year prevalence of cannabis use was reported by 5.7 % of the sample and last month prevalence by 2.7 %.
Hungary also participated in the international study on Health Behaviour in School-aged Children (HBSC) among young people aged 15–16 and 17. The most recent survey was carried out in 2010 and indicates 14 % lifetime prevalence rates for cannabis use among 15- to 16-year-old students. Experimentation or use of the substance once or twice in the past 12 months were the most commonly reported patterns of use.
Nationwide data on drug use among 16-year-old students are based on the European School Survey Project on Alcohol and Other Drugs (ESPAD) surveys, which have been conducted regularly since 1995. The most recent ESPAD results, from 2011, showed that 19 % had ever tried marijuana or hashish (13 % in 2007; 16 % in 2003). In 2011 lifetime prevalence for inhalants was reported by 10 % of the students. Lifetime prevalence was 6 % for amphetamines, 4 % for ecstasy, 3 % for LSD, 2 % for cocaine and 2 % for heroin. Last year prevalence was 15 % for cannabis (10 % in 2007; 11 % in 2003), and last month prevalence for cannabis was 8 % (5 % in 2007; 6 % in 2003). In terms of gender differences, the reported lifetime prevalence of cannabis use was 21 % among males and 18 % among females.
The results of both studies indicate that drug use, in particular cannabis and amphetamines, has become more prevalent among school-aged adolescents in the last four years.
Universal prevention activities are mainly implemented in educational settings. Detailed information on school-based drug prevention programmes is available here. Programmes can be searched based on various criteria. In 2011 projects on strengthening families and improving parenting skills, and providing alternative leisure activities at a community level, were supported within the scope of grants from the Ministry of National Resources. In 2010 short-term re-training sessions were organised for school drug coordinators to enhance implementation of school-based prevention activities, while in 2011 a number of teachers were trained on basic mental hygiene issues.
With regard to selective prevention, activities are targeted at recreational settings and vulnerable young people. Preventive activities at leisure events such as festivals and clubs focus on provision of information, distribution of water, vitamins and fizzy drinks, and capacity building of staff working in those settings, with an overall aim to ensure clubbing and nightlife become safer.
Programmes targeting disadvantaged young people who spend a lot of time hanging around on the street are implemented in various locations across Hungary. These projects offer young people alternative ways to spend their spare time by getting them involved in sport activities, and also provide education and information. Prevention activities are also carried out with army conscripts. Hungary is participating in EU-wide and international prevention projects such as the Healthy Nightlife Toolbox Project and ReDNet.
The main targets of indicated prevention activities are criminal offenders enrolled in preventive–consulting services, a type of quasi-compulsory treatment as an alternative to the criminal procedure. In 2011 some 4 148 clients were enrolled in the programme.
View ‘Prevention profile’ for additional information.
The first estimate of the prevalence of hidden problem drug use in Hungary was conducted in 2003. In 2005 the rate for problem drug use was 3.48 per 1 000 inhabitants aged 15–64, corresponding to 24 204 problem drug users (in a range between 19 333 and 29 075). In 2008–09 the number of injecting drug users (IDUs) was estimated to be 5 699, with a central rate of 0.8 for 1 000 inhabitants aged 15–64. This estimation was based on the records of infectious diseases screening programmes.
Capture–recapture data suggests that the population size of problem opiate users in 2007–08 was between 2 780 and 3 480, with a central rate of 0.5 for 1 000 inhabitants aged 15–64, while some qualitative studies showed a significant decrease in the number of heroin users since 2010 and a general shift towards injection of new psychoactive substances. The estimated population size of amphetamine users was 27 323 (95% CI: 18 138–36 508), while the estimated number of cocaine users was about 5 600.
Up to 2012 the EMCDDA defined problem drug use as injecting drug use or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis were not included in this category. Details are available here.
In 2011 the data collection system for treatment demand was provided by 85 treatment centres. A total of 4 783 clients entered treatment, 3 222 of whom were new treatment clients. The majority of all treatment clients enter treatment as an alternative to criminal procedure, and only about one-third enter treatment voluntarily.
In 2011 cannabis remained the primary substance of abuse among all treatment clients at 69.4 %, followed by 11.9 % for amphetamines and 6.8 % for opioids. Similarly, among new treatment clients, cannabis was reported as the primary substance of use by 77.3 %, followed by 11.0 % for amphetamines and 2.3 % for opioids. Cannabis users accounted for around 80 % of all clients who entered treatment as an alternative to criminal procedure.
In 2011 some 50 % of all clients entering treatment were under the age of 25. This figure was slightly higher among clients entering treatment for the first time, with 57 % under the age of 25. In terms of gender distribution among all clients entering treatment, in 2011 the majority (86.6 %) were male; 13.4 % were female. A similar gender distribution was recorded among new treatment clients: 87.7 % were male and 12.3 % were female.
There are two primary sources of information on drug-related infectious diseases in Hungary — the National Registry of Infected Patients, run by the Department for Epidemiology of the National Centre for Epidemiology, and the special HIV/AIDS and hepatitis surveillance database. In 2011 the National Centre for Epidemiology implemented the fifth nationwide prevalence survey on infectious diseases among injecting drug users. In addition, a voluntary diagnostic testing programme was offered by needle and syringe programmes and specialised outpatient treatment centres to detect HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalence rates, and also risk behaviours among IDUs, in five cities.
According to the National Centre for Epidemiology, of the 43 acute cases of HCV registered in Hungary in 2011 (22 cases with a know transmission route), 16 were due to injecting drug use. The number of registered acute HCV cases infected by drug injecting increased significantly between 2006–11. For HBV, 66 acute cases were registered in 2011; however, the transmission route was only reported for 18 cases, of which six were linked to injecting drug use.
In 2011 there were 162 newly diagnosed HIV-positive cases in the general population. The incidence rate was 16 cases per million inhabitants. No HIV infections originating in the IDU risk group were identified among all cases with a known risk factor.
On the basis of the national seroprevalence survey carried out in 2011 among 666 IDUs, no HIV positive case was found. However, 157 of 652 IDUs tested (24.1 %) were HCV (antibodies) positive and three of 664 IDUs tested (0.5 %) were HBV (HBsAg) positive.
Since 2009 the data on drug-related direct and indirect deaths have been derived from the mortality module of the National Centre for Addiction reporting system, which contains detailed information on each case, including toxicology results.
In 2011 some 14 drug-related death cases were reported (compared to 17 in 2010; 31 in 2009; 27 in 2008; 25 in both 2007 and 2006), the lowest number in the past 15 years. Opiates were involved in 71.4 % of reported death cases. With regards to distribution by age and sex, all but one case were males and the mean age at the time of death was 32.1 years.
The State Secretariat for Health Care is responsible for all aspects related to drug users’ healthcare, while the State Secretariat for Social and Family Affairs is in charge of issues related to social care. Both secretariats are located at the Ministry of Human Resources. Most treatment services at the regional level are provided by public bodies, and to a lesser extent by non-governmental drug service providers. Drug treatment services are differentiated on the basis of type of services, namely medical, health or social services. Some treatment units provide only health or social services, while others provide mixed services. A clear separation exists between the financing, definition, regulation and inspection of social and health services. Medical types of drug treatment services are financed by the National Health Insurance Fund, with the exception of about 10 % of inpatient and outpatient institutions financed by the church or other organisations. The majority of social services for drug users are financed using a fixed financing model that may be supplemented with additional resources allocated via tendering.
Treatment for drug users is offered at various outpatient and inpatient facilities throughout Hungary. Facilities include rehabilitation and therapy centres, psychiatric departments, therapeutic communities and crisis intervention departments. The need to develop outpatient institutions specialising in treatment for drug addicts was identified, and the first services were established, in the 1980s. In 2007 there were 22 specialised outpatient treatment centres operating in 15 counties. Inpatient care is offered by psychiatric departments, departments of addiction, crisis intervention departments and by non-government organisations (NGOs) running therapeutic communities. Drug treatment institutes operating in Hungary had a contract with the National Health Insurance Fund for 269 beds in 2009. Long-term rehabilitation is mainly provided by NGOs. The services they deliver are only partially medical or healthcare-related, and are dominated by social and welfare elements such as work therapy and social reintegration. In 2010 the first four-week online self-help programme was launched for problem cannabis users. Although the programme is available to the whole country, face-to-face consultations, if needed, are offered at the Blue Point’s outpatient treatment centres in Budapest.
In 1994 the first methadone maintenance treatment programme was launched in Hungary. By 2010 it was available in ten institutions in eight towns. The total number of clients in opiate substitution treatment in 2011 was 639, of whom 510 were on methadone (data from nine treatment centres). Buprenorphine/naloxone combination treatment was introduced in 2007 and accounted for 129 clients in 2011.
View ‘Treatment profile’ for additional information.
A harm reduction approach has been promoted in Hungary for many years. The National Office for Rehabilitation and Social Affairs funds the low-threshold services for IDUs through a three-year contract with service providers selected through a tendering procedure. To be eligible for the funding, the applicant should deliver at least two of the following basic services: psychosocial interventions, information and prevention services, street outreach, or drop-in. Needle and syringe exchange is defined as a complementary service to be eligible for the funds. The complementary funding for low-threshold activities may come from local governments and other tendering procedures of ministries.
A number of low-threshold services provide counselling, referral to long-term treatment, social support and legal assistance. Needles and syringes are available across the country through 22 fixed needle and syringe exchange programmes (five in Budapest and 17 in other cities), two mobile units (one in Budapest, one in another city), and 13 street outreach programmes (six in Budapest and seven in other cities). Clean needles and syringes were also available from five vending machines (one in Budapest and four in other cities); however, the vending machine in Budapest was discontinued in mid-2011 due to financial problems. A total of 24 organisations are involved in needle and syringe exchange programmes in Hungary. In 2011 more than 648 000 syringes were distributed, highlighting an increasing trend in the number of syringes distributed, when compared to the 2010 data. As well as sterile needles and syringes, most of the programmes also provide alcohol pads, condoms, filters, sterile mixing containers and ascorbic acid. Some programmes also offer vitamins and special vein protection creams. Since 2010 some programmes have offered their clients voluntary testing for HIV, HCV and HBV in the framework of the diagnostic programme coordinated by the National Centre for Epidemiology.
Hungary has traditionally been a transit country for heroin trafficked across the Middle East via the Balkan route to western Europe (Belgium, Germany, the Netherlands, United Kingdom, Italy and France). However, in 2011 no seizures indicating heroin transit were reported. Nigerian citizens play a central role in the import, smuggling and distribution of cocaine in Hungary. Hungarian nationals are mostly recruited as couriers in these networks. An increasing number of Hungarian groups that had previously distributed synthetic drugs are switching to the distribution of cocaine due to its growing demand. Hungarian perpetrators characteristically transport drugs from the Netherlands, Belgium and Spain. Cannabis is the only drug that is increasingly produced domestically, usually by Vietnamese-led criminal groups. Cannabis is also increasingly smuggled into Hungary from the Czech Republic, and recently from the Western Balkan countries, usually by the same criminal groups that are responsible for domestic production. The smuggling of substances from the Netherlands has remained prevalent.
Data on seizures are provided by the Hungarian police. In 2011 herbal cannabis remained the most widely seized drug (2 073 seizures), followed by amphetamines (483), cannabis plants (192) and cocaine (108). Among the new psychoactive substances, cathinone derivates and herbal substances treated with synthetic cannabinoids were the most frequently seized substances, with 595 and 465 seizures respectively.
In 2011 the quantities seized were smaller than in 2010 for all substances except cannabis resin. The amount of cannabis resin seized doubled when compared to 2010 (9 kg in 2010; 18 kg in 2011). There has been a declining trend in the quantity of heroin seized since 2005, and in 2011 the smallest amount ever seized in Hungary (3 kg) was reported. The trend in the quantity of cocaine seized follows an increase–decrease–increase pattern. The first data on cocaine seizures was available in 2000, and the quantity seized increased in the following years, peaking at 94 kg in 2004 and falling over the next two years. It then increased again in 2008 and 2009 (23 kg and 20 kg respectively) and declined in 2010 and 2011 (14 kg and 13 kg respectively). Following the seizure of a record amount of ecstasy tablets in 2005 (234 582), the number seized decreased significantly in the following years.
Two illicit amphetamine laboratories were seized in Hungary during 2011.
In 2011 some 5 989 criminal proceedings concerning the misuse of illicit drugs were registered and the figure has substantially increased when compared to the 5 789 cases reported in 2010 and 4 828 in 2009. Most of the criminal offences involved cannabis (4 741 cases) and were use-related offences (5 231 cases).
The drug control sections of the Hungarian Criminal Code (HCC) were considerably amended in 2003. This amendment was based on the principle that both demand and supply must be reduced, and that there is a need to differentiate approaches towards drug consumers, where prevention, treatment and criminal law must all be taken into account. The HCC was reorganised into sections covering possession, trafficking, minors, addicts, exemptions from punishment and drug precursors. The amendment introduced more detailed provisions (lower maximum sentences if the offender is an addict, detailed and differentiated regulations on drug-related crimes if people under the age of 18 are involved), and made the treatment option available both for users and addicts. It also removed ‘consumption’ as a specific offence — although in an indirect way consumption remains punishable, as possessing and acquiring drugs remain offences.
As of 2011, for several substances (psilocybin, psilocin, mCPP, BZP), upper limits defining small amounts were redefined based on the pure active substance content in a base form, while for other substances ‘small amounts’ are still regarded as equivalent to the physiological effects of a maximum of 0.9 grams of morphine base. For THC, since 2012 the upper limit of ‘small amount’ is regarded as 6 grams of the pure and acid THC content together. The new government regulation adopted in 2012 set the rules for the classification of new psychoactive substances and determined the roles and responsibilities of various bodies involved in the process of registration and turnover of these substances. From 1 March 2012, following the amendment of the HCC, trafficking of new psychoactive substances was punishable by imprisonment of up to three years.
View ‘Legal profile’ for additional information.
Hungary’s first national drug strategy, covering 2000–09, was evaluated in 2009 and a new National Strategy for Tackling the Drugs Problem 2010–18 was adopted in December 2009. A year later, in December 2010, the new strategy was repealed following the elections in March 2010 and subsequent change of government. The drafting and adoption of a new national strategic document for tackling the drug problems in Hungary is currently underway.
View ‘National drug strategies’ for additional information.
The Coordination Committee on Drug Affairs (CCDA) advises the government and reports to it on a yearly basis. Chaired by the Secretary of State for Sport and Youth Affairs, the committee includes representatives from all relevant ministries and national institutions and (since 2007) from four NGOs. In 2010 the Committee on Controlled Substances was set up under the CCDA to respond quickly and initiate assessments and proposals for appropriate control measures on emerging new psychoactive substances.
The National Drug Prevention Coordination Unit, part of the State Secretariat for Sport and Youth Affairs, handles the day-to-day coordination of the drug strategy. It is also tasked with policy development, coordination and implementation, and with overseeing the operation of the CCDA.
The National Drug Prevention Office, part of the National Institute for Family and Social Affairs, supports the activities of the Coordination Forums on Drug Affairs (KEFs). It assists the Coordination Forums with programmes in the area of prevention and facilitates drug-related research and information dissemination.
KEFs coordinate activities at the local level. They are committees of 8–10 members (representatives of NGOs, health/law enforcement state services, local government, churches) that collect information, determine the most important risk groups, and define the targets of community-based interventions, as well as possibilities for treatment. KEFs must ensure that information about local services is available. There are 85 of them operating at the local, county and regional level.
In Hungary there is no specific budget attached to the drug strategy, but every year the ministries approve an overall budget that takes into account the main goals of the strategy. This budget, however, is estimated by authorities to represent no more than 4–6 % of the total drug-related expenditure.
One study, (1) following a well-defined methodology, estimated these total drug-related expenditures for four years (2000, 2003, 2005 and 2007). In 2007 the total drug-related public expenditure (2) represented 0.04 % of gross domestic product (GDP). The total expenditure was divided into four main areas: law enforcement (75.3 %), prevention and research (10.5 %), treatment (10.4 %) and harm reduction (3.8 %). Trend analysis shows that between 2000 and 2007 total drug-related expenditure remained stable as a percentage of GDP (between 0.04 % and 0.05 %). Law enforcement absorbed at least 66 % of these funds, while treatment and harm reduction together did not exceed 15 % of the total.
(1) Gy Hajnal (2009), ‘A kábítószerrel kapcsolatos költségvetési kiadások alakulása 2000 és 2007 között’, in Felvinczi, K., Nyírády, A, Drogpolitika számokban, L’Harmattan, Budapest, pp. 375–409.
(2) Some of the funds allocated by governments for expenditure on tasks related to drugs are identified as such in the budget (‘labelled’). Often, however, the bulk of drug-related expenditure is not identified (‘unlabelled’) and must be estimated by modelling approaches. The total budget is the sum of labelled and unlabelled drug-related expenditure.
View ‘Public expenditure profile’ for additional information.
The coordinating body for drug issues in Hungary, the Ministry of Human Resources, also coordinates drug-related research through an open tendering mechanism. The national focal point, which also conducts and initiates research, collects all research reports available in Hungary and disseminates their results via its website and newsletter. Information on the different research institutions and organisations is available here. Research results are usually available from public institutions, sponsors and researchers’ websites. Recent drug-related studies mentioned in the 2012 Hungarian National report focused primarily on interventions and prevalence of drug use, although studies on the consequences of drug use and supply and markets were also mentioned.
View ‘Drug-related research’ for additional information.