Country overview: Hungary
- Situation summary
- Drug use among the general population and young people
- High-risk drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-induced death and mortality among drug users
- 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 (28 countries)||Source|
|Population||2013||9 908 798 ||505 665 739 ||Eurostat|
|Population by age classes||15–24||2013||12.1 %||11.5 % ||Eurostat|
|25–49||35.5 %||35.0 % |
|50–64||20.8 %||19.7 %|
|GDP per capita in PPS (Purchasing Power Standards) 1||2012||67||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2011||23.0 %||29.0 % p||Eurostat|
|Unemployment rate 3||2013||10.2 %||10.8 %||Eurostat|
|Unemployment rate of population aged under 25 years||2013||27.2 %||23.4 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2012||177.1||:||Council of Europe, SPACE I-2012|
|At risk of poverty rate 5||2012||14.0 %||17.0 % e||SILC |
p Eurostat provisional value.
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, 2012.
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).
Three nationwide studies on drug use among the general population have been conducted in Hungary. The most recent general population survey on drug use was conducted in 2007 among 18- to 64-year-olds. 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.
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 in 2007. Last year prevalence of cannabis use was 5.7 % and last month prevalence was 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 indicated a lifetime prevalence rate of 14 % 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 15- to 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 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.
Universal prevention activities are mainly implemented in educational settings within a framework of comprehensive health promotion programmes, and they are funded by the Government through a tender procedure.
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, fizzy drinks and some food, 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 encouraging them to take up sporting activities, and also provide education and information. Prevention activities are also carried out among army conscripts. Hungary participated 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 provided as an alternative to the criminal procedure. In 2012 more than 2 600 clients were enrolled in the programme.
In 2012 a number of nationwide campaigns were supported that aimed to increase awareness of the dangers of new psychoactive substances among various audiences (www.designerdrog.hu and www.dizajnerdrog.hu).
View ‘Prevention profile’ for additional information.
Up to 2012 the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) defined problem drug use as injecting drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis were not included in this category. However, in 2012 a new definition of ‘high-risk drug use’ was adopted. The new definition includes ‘problem drug use’, but is broader (mainly in its inclusion of high-risk use of more substances). Details are available here.
Data from a 2010–11 capture–recapture study suggests suggest that there were between 2 910 and 3 577 problem opioid users, with a central rate of 0.5 for 1 000 inhabitants aged 15–64. In 2007–08, 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.
With regard to high-risk cannabis use, an estimated 0.3 % of the Hungarian population aged 15–64 used cannabis daily or almost daily in 2007.
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. Some qualitative studies in 2010–11 indicated an increase in injecting of new psychoactive substances, and in particular a shift from injecting ‘traditional’ substances (heroin, amphetamines) to new psychoactive substances. Studies in this area could not identify any patterns by age or injecting career.
In 2012 the data collection system for treatment demand was provided by 81 treatment centre. A total of 3 885 clients entered treatment, 2 574 of whom were new clients entering treatment for the first time. Three-quarters of all clients entered treatment in outpatient settings. The majority of clients enter treatment as an alternative to criminal procedure, and only about one-third enter treatment voluntarily.
In 2012 cannabis remained the primary substance of abuse among all treatment clients at 66 %, followed by 12 % for amphetamines and 6 % for opioids. Among new treatment clients, cannabis was reported as the primary substance of use by 75 %, followed by 11 % for amphetamines, 3 % for other stimulants and 2 % for opioids. Other substances accounted for 5 % and 4 % of all and new treatment demands respectively. Cannabis users accounted for around 80 % of all clients who entered treatment as an alternative to criminal procedure.
Clients injecting their primary substance as their main route of administration accounted for 9 % of all and 4 % of new treatment clients. More than a half of new treatment demands and two-thirds of all treatment demands using opioids, reported injecting. While amphetamines were injected less frequently, it was the most often injected substance among new treatment clients.
In 2012 some 48 % of all clients entering treatment were under the age of 25. This figure was even higher (56 %) among clients entering treatment for the first time. In terms of gender distribution, among all clients entering treatment in 2012 the majority (86 %) were male and 14 % were female. A similar gender distribution was recorded among new treatment clients: 87 % were male and 13 % 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 human immunodeficiency virus (HI)/acquired immune deficiency syndrome (AIDS) and hepatitis surveillance database. In 2011 the National Centre for Epidemiology implemented the fifth nationwide prevalence survey on infectious diseases among people who inject drugs (PWID). 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 PWID, in eight cities.
According to the National Centre for Epidemiology, of the 38 acute cases of HCV registered in Hungary in 2012 (20 cases with a known transmission route), 17 were due to injecting drug use. The number of registered acute HCV cases infected by drug injecting increased significantly between 2006–11. For HBV, 53 acute cases were registered in 2012; however, the transmission route was only reported for 13 cases, of which six were linked to injecting drug use.
In 2012 there were 219 newly diagnosed HIV-positive cases in the general population. The incidence rate was 22 cases per million inhabitants. No HIV infections among PWID were identified among all cases with a known risk factor, while the overwhelming majority of newly registered cases were linked to homosexual transmission.
On the basis of the national seroprevalence survey carried out in 2011 among 666 PWID, no HIV positive case was found, while 24.1 % had antibodies to HCV and 0.5 % were positive for HBV (HBsAg). No HIV cases were detected among 375 voluntarily tested clients of service programmes in 2012. While the voluntarily testing among 354 service clients in eight cities revealed HCV prevalence of 23.2 % and HBV (HBsAg) prevalence of 0.8 % among 378 PWID tested. There is a concern that injecting of new psychoactive substances may increase the risk of drug-related infectious due to more frequent injecting patterns.
Since 2009 the data on drug-related direct and indirect deaths have been derived from the mortality module of the National Centre for Addiction (OAC) reporting system, which contains detailed information on each case, including toxicology results.
In 2012 a total of 24 drug-induced deaths were reported, an increase on the previous two years (14 in 2011; 17 in 2010; 31 in 2009; 27 in 2008; 25 in both 2007 and 2006). Toxicology was known for all cases, and in the majority (13) opiates were involved. With regard to distribution by age and sex, 18 were males and the mean age at the time of death was 32 years. The presence of new psychoactive substances alone or in combination with other drugs was reported as one of the emerging trends for drug-related deaths in Hungary, whereas the number of opioid-related deaths started to decrease in 2009. This is consistent with seizure and treatment data showing that the level of heroin injection has been decreasing.
The drug-induced mortality rate among adults (aged 15–64) was 3.5 deaths per million in 2012, which is below the European average of 17.1 deaths per million.
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. Treatment services at the regional level are primarily 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 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 established, in the 1980s. In 2012 some 91 service providers were entitled to deliver outpatient treatment services: 23 outpatient drug treatment centres, 53 outpatient addiction care units and 15 outpatient psychiatric care units. Treatment services include specialised addiction treatment or psychiatric treatment in general. A further 55 organizations, mostly non-governmental organisations (NGOs) provided quasi-compulsory treatment as an alternative to criminal procedure. This intervention, however, is classed as an indicated prevention measure and does not fall under the healthcare definition. Inpatient care is offered by psychiatric departments, departments of addiction, crisis intervention departments and NGOs running therapeutic communities. Drug treatment institutes operating in Hungary have contracts with the National Health Insurance Fund; however, the amount allocated through the Fund in 2012 was lower than in 2011, which affected the availability of services. 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 2012 was 637, of whom 494 were on methadone (data from eight treatment centres out of 12). Buprenorphine/naloxone combination treatment was introduced in 2007 and accounted for 143 clients in 2012.
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 PWID 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. Delays in the tendering process affected the availability of injecting equipment and resulted in reduced operating hours and temporary closure of programmes. 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 28 fixed needle and syringe exchange programmes, a mobile unit (Budapest) and 20 street outreach programmes. In four cities, clean needles and syringes are also available from vending machines.
In addition to sterile needles and syringes and counselling on safer injecting, most programmes also provide alcohol pads, condoms, acidifiers and vitamins. Half of them provide sterile filters, while less than a third distribute sterile mixing containers. Since 2010 some needle and syringe programmes offer voluntary testing for HIV, HCV and HBV in the framework of the diagnostic programme coordinated by the National Centre for Epidemiology.
In 2012 about 421 000 syringes were distributed, which represents a reduction of 35 % compared to the previous year. While client numbers remained stable, this reduction coincided with a reduction in the budget available for community-based and low-threshold treatment of drug users.
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, the United Kingdom, Italy and France). However, in 2011–12 a ‘heroin shortage’ pattern was observed in Hungary and very few heroin seizures were reported, with 3 kg seized in each, 2011 and 2012.
Nigerian- and Albanian-led criminal groups play a central role in the import, smuggling and distribution of cocaine in Hungary. In recent years the cocaine seized in Hungary has travelled through Spain, Romania or Greece, thus emphasising the increasing importance of the south–north trafficking route. 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 decreasing over the next two years. It then increased again in 2008 and 2009 (23 kg and 20 kg respectively) and declined in 2011–12 (13 kg in each reporting year).
Cannabis is the only illicit drug that is produced domestically, and there are signs of a gradual decrease in production after 2011. Cannabis is also increasingly smuggled into Hungary by Vietnamese-led criminal group from the Czech Republic and Slovakia, and recently from the Western Balkan countries. In 2012 herbal cannabis remained the most widely seized drug (2 092 seizures), followed by amphetamines (454) and cannabis plants (193). In 2012 the quantity of cannabis resin, cannabis plants and methamphetamine seized was less than in 2011. In 2012 a record amount of 1 777 kg of herbal cannabis was seized. Following the seizure of a record number of ecstasy tablets in 2005 (234 582), the number seized decreased significantly in the following years, while in 2012 some 12 437 tablets were seized, the highest figure since 2009.
The share of new psychoactive substances among all seizure has increased steadily since 2010, and these substances have been involved in about 40 % of all seizures. In 2012 herbal substances treated with synthetic cannabinoids and cathinone derivates were the most frequently seized substances, with 1 298 and 874 seizures respectively.
Several laboratories producing poppy extract, two illicit amphetamine laboratories and a laboratory producing new psychoactive substances were seized in Hungary during 2012.
In 2012 some 5 219 criminal proceedings concerning the misuse of illicit drugs were registered, a reduction compared with 5 989 cases in 2011 and 5 789 in 2010; in 2009 a lower number of 4 828 cases were registered. As in the previous years, most of the criminal offences were use-related (4 584 cases) and involved cannabis (3 925 cases, including 3 903 demand- and supply-related offences and ‘other type of offence’, such as initiating substance abuse, preparations, supply for production and financing).
The new Criminal Code entered into force on 1 July 2013.
The drug control sections have been organised to cover trafficking, possession, incitement of minors to use drugs or similar substances, assisting production, precursors, new psychoactive substances (NPS) and performance enhancement (doping).
Consumption has been re-introduced as a criminal offence punishable by up to two years in prison (it had been deleted from the 2003 Code). Possession is still punishable by up to two years if involving a small amount, but other penalties are now 1–5 years as a basic offence, increasing to 2–8 years if committed under certain circumstances, and 5–10 and 5–15 years if involving larger quantities. Supply is still punishable by up to two years if involving a small amount (now 1–5 years if committed under certain circumstances), and 2–8 years as a basic offence, rising to 5–10 and now 5–20 years or life if involving certain circumstances or large quantities respectively. Various lower maximum penalties for offences committed by addicts, introduced in 2003, were repealed, and the option to suspend prosecution in the case of treatment is now only available to addicted or dependent offenders committing drug law offences, and cannot be repeated within two years of a previous suspension.
In 2012 a Government Decree set up a formalised rapid assessment that could place a new psychoactive substance under temporary control in a new schedule C of the Act on Medicinal Products. Accordingly, a new section of the 2013 Criminal Code provided for punishment of up to three years for manufacture and (since January 2014) 1–5 years for supply and up to 3 years for possession of more than a small amount (10 g) of new psychoactive substances (up to 1 year for less than that). The section penalising incitement of minors to use ‘a substance or agent that has a narcotic effect but is not classified as a drug’ is retained, though the maximum penalty falls from 3 to 2 years.
View the European Legal Database on Drugs (ELDD) for additional information.
Hungary’s current National Anti-Drug Strategy 2013–20, ‘Clear consciousness, sobriety and fight against drug crime’, was adopted on 16 October 2013 (Parliament Resolution No. 80/2013).
The National Anti-Drug Strategy states five basic values: right to life, human dignity and health; personal and community responsibility; community activity; cooperation; and scientific basis. It establishes objectives and development directions at three intervention areas:
- health development, drug prevention;
- treatment, care, recovery;
- supply reduction.
The Strategy also includes implementation criteria for human and social resources such as training, cooperation between institutions, financing, research and international relations in order to monitor and evaluate the achievement of the tasks. The most important indicators required for monitoring the National Anti-Drug Strategy are briefly outlined, and organisations responsible for information collection are identified in the document.
View ‘National drug strategies’ for additional information.
The Coordination Interministerial Committee on Drug Affairs (CICDA) and the Council on Drug Affairs (CDA) advises the government and reports to it on a yearly basis. Chaired by the Secretary of State for Sport and Youth Affairs, the CICDA includes representatives from all relevant ministries and national institutions and (since 2013) the CDA represents NGOs acting in the field. In 2010 the Committee on Controlled Substances was set up under the CICDA 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 CICDA and the CDA.
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 Ministries approve an overall budget that takes into account the main goals of the strategy. However, this budget 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 total drug-related expenditure 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). This total 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) Hajnal, G. (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 expenditures.
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.