Examining the role of Drug Consumption Rooms in Romanian HIV Prevention
Drug consumption rooms (DCRs), defined by the Eurpean Monitoring Centre for Drugs and Drug Addiction (EMCDDA) as "professionally supervised healthcare facilities where drug users can use drugs in safer and more hygienic conditions," could play a vital role in helping to tackle rising rates of HIV infections among Romania's drug users.
The country is currently facing a dramatic increase in the number of newly registered HIV cases among intravenous drug users. For example, in 2008 there were just three newly confirmed cases, while in 2012 there were 237 such cases, according to the National Institute of Infectious Diseases. A separate study carried out in September 2012 by the Romanian Angel Appeal Foundation* among injecting drug users in Bucharest and the surrounding country of Ilfov highlights the severity of the situation further; out of 417 participants tested, 52.5 percent were HIV positive, 85 percent had Hepatitis C, and 20 percent had the Hepatitis B virus (National Anti-Drug Agency, Report for 2013).
One of the primary explanations for the high prevalence of disease in these communities are the conditions in which people must use. For one, injecting drugs in public areas increases the risk of infections through contracting bacteria. Another major risk that people face when they are using drugs in public places is the lack of sterile injecting equipment. Drug users injecting in non-sanitary mediums are also exposed to risks such as blood clots, pulmonary embolism and bacterial endocarditis, due to the lack of medical help on hand.
Drug consumption rooms could, therefore, play an important role in lowering, and even preventing the aforementioned risks associated with intravenous drug use. DCRs offer clean, monitored environments where people are able to safely use with sterile equipment and outside of the view of a potentially condemning public.
In 2013, the author carried out a study among injecting drug users in the capital Bucharest. Ninety-four percent of those surveyed responded that it would be helpful to have a place specially arranged for drug use with sterile materials available, and that if such an option was more widely available, they would make efforts to access these facilities. In addition, the respondents stated that to ensure the DCRs appealed to drug users, they should include, among other things:
- Water, light and heat
- A closed space so they cannot be seen by children
- A discreet booth similar to those used in elections
- No police or people who would harrass them
- Medical specialists and guards
In Romania there are illegal drug consumption rooms - such as apartments - where drug users gather to inject themselves. These drug-user houses, however, are typically not sanitary due to the lower socio-economic conditions many of these people live in. The walls and floors are dirty, the place can be bug-ridden, and some rooms don't have windows. What's more due to the common conflicts that arise in these places, a good part of the apartment, furniture and goods are damaged or destroyed.
Providing monitored DCRs is not simply about giving people a space to inject, it's about mitigating the health risks associated with intravenous drug use. Furthermore, if DCRs can become a fixture, they have the potential to act as a bridge between drug users and health services, and could thus help people tackle their addiciton safely.
* The study was carried out in collaboration with the National Anti-drug Agency and the Carusel Association.
Schatz, E., Nougier, M. (2012). Drug Consumption Rooms Evidence and Practice, s.l., s.n
Social Work Review no 1 (2014): The Role of Drug Consumption Rooms in HIV prevention” - Din Crina Teodora, Bucharest