Romanian Roulette: Shooting up in Bucharest

Last autumn, a 13-year old from Iași, in Eastern Romania, was found dead in the back of a supermarket after having used legale, the nickname for “legal highs” in Romania.

Legale – usually amphetamine-like substances or smokable synthetic cannabinoids – are not actually legal any more.

In 2011, the shops selling “legal highs” were shut down and, slowly, the drugs were made illegal. At first, the authorities prohibited the substances one by one but, like elsewhere, the producers got creative and invented similar, but chemically different and therefore legal, narcotics. After a few years, authorities implemented a sweeping ban.

The ban resulted from the societal shock around the increasingly numerous cases of hospitalisations and even death directly related to “legal highs” being sold so freely in “spice shops”.

The old heroin users thought switching to legale was a better option.

When spice shops first appeared, they attracted both traditional and new users. The old heroin users, for example, who maybe wanted to kick the habit, thought switching to legale was a better option. Others, especially kids, were less afraid to experiment with a legal product from shops than the better known drugs from the street corner.

Stefan I., formerly addicted to ketamine and a legale user, depicted his experience with legale in a series of articles published by Vice Romania. He wrote about ‘Extra Charge’, a brand name for a type of mephedrone, how exciting and addictive it was and how it gradually put him in a psychotic state. At some point, around 2011-2012, Stefan stopped experimenting with newer legale on the market because their psychotic episodes were too rough and occasionally lead him to him getting arrested or committed to psychiatric wards.

It’s followed by a terrible low, and sometimes psychotic and schizophrenic episodes.

“This was very dangerous stuff,” Stefan told Political Critique. “It gives you a very strong high, as strong as methamphetamine, but then it’s followed by a terrible low, and sometimes psychotic and schizophrenic episodes.”

Since 2013, when authorities introduced the ban,it has become more difficult and expensive to purchase legale, so some of the users – those who could – dropped it.

But they are still relatively easy to find, either by ordering them on the internet (after a bit of searching) and having them delivered, or by getting introduced to a dealer, or – for the very brave or desperate – by approaching a notorious street dealing gang in Bucharest. To stay high for a day on legale can cost between 8 and 25 euros.

And many – especially the young – take the opportunity. According to officers from the Romanian Anti-Drug agency quoted by a Digi24 news report , one in 100 kids have tried legale at least once before the age of 13.

Extra Dangers of Legale

According to Alina Dumitriu, who works with drug users at one of Bucharest’s major infectious diseases wards and also on an ambulance for the NGO ARAS (the Romanian Anti-AIDS Society) distributing clean syringes to drug users, the switch from heroin to legale among injecting drug users, which took place around 2010, has been a turning point in Romania.

Unlike heroin, whose effect is longer lasting, legale make users shoot up as much as three to ten times per day, as the high disappears and is replaced by a destructive low.

Few people – including many of the users themselves – know precisely what’s inside the newest legale. The Romanian police occasionally busts ‘labs’ where producers intentionally add substances to the mix to increase its addictiveness.

They “miss” the times when heroin was the preferred injectable drug because at least they knew how to react to it.

Even doctors in emergency rooms are stumped, saying they “miss” the times when heroin was the preferred injectable drug because at least they knew how to react to it.

In Romania, Dumitriu explains, the switch to legale coincided with international financing for harm reduction programmes drying out, as the country joined the European Union and was deemed competent to solve its own issues.

Romanian authorities never really stepped in to fill the gap. In an infamous example of state institutions ineptitude, syringes purchased for the harm reduction programmes were of so low quality that they broke in people’s veins.

Dumitriu fears that a similar hike in HIV or hepatitis rates could take place again now, as her organisation (ARAS) ran out of funds for syringe replacement programmes at the end of last year. ARAS is not the only organisation conducting such programmes, but they all struggle to find resources.  “After 2010, the prevalence of HIV among injecting drug users exploded, from around 1 percent to about 60 percent. Since 2007, Romania does not have a national strategy for prevention and treatment of HIV, despite us repeatedly telling authorities about the serious situations on the ground.”

She’s adamant that the authorities need to come up with a strategy and protect the users from diseases, otherwise not only many will get sick, but they will infect others in the general population.

The Most Vulnerable

Alina Dumitriu tells a story of a six-year old child who, left alone to play with friends, started pretending to injecting drugs. That’s what he had seen at home, so that’s what he imitated. ‘Everyone in the house does it: the mother, the father, the cousin, the aunt, the grandfather,’ says Dumitriu. ‘Of course the kid will do the same.’

The prevalence of drug use among some of the marginalised communities Dumitriu works with – like the Ferentari neighbourhood in Bucharest- is widespread. Heroin or legale are increasingly popular here because they’re the cheapest.

Poverty also does not help with addiction recovery.

The poorest drug users are also the most vulnerable. For example, poor Roma drug users from Bucharest might not even have health insurance so they can’t get help for serious health problems associated with drug use: gangrenous toes or tuberculosis or hepatitis C. Dumitriu says she often finds herself looking for doctors willing to see these patients pro bono.  The governing Social-Democratic Party (!)  just increased almost threefold the monthly health contribution , making is inaccessible to the poor. Dumitriu says this measure ‘condemns to death’ many of the people she works with, as the uninsured have to pay six months at once in order to get care; a small fortune by Romanian standards.

Poverty also does not help with addiction recovery, say both Dumitriu and Stefan.

For one, even if the person kicks off drugs in a rehabilitation center, they return home to the same pressing problems that may have contributed to their drug use in the first place. For another, poverty translates into a lack of basic things needed for a successful recovery – such as more and better food while detoxing in a state hospital where the canteen’s offer is pitiful.

Stefan I. explains that, while detoxification (getting over the withdrawal stage) is offered for free in state psychiatric hospitals, it is often in conditions of detention and not followed up by rehabilitation (long-term recovery based on psychotherapy, group therapy and ergotherapy), which he considers key to recovery.

In Romania, according to Stefan, rehabilitation is offered by only a handful of centers countrywide, usually private and operated by various religious institutions. Even if they are non profits, they can cost between 150 and 400 euros per month, and very rarely can afford to offer places for free or at reduced rates.

Between 2016 and 2017, Stefan initiated and managed a program meant to offer rehabilitation to poor drug users in a center at Sura Mica, nearby Sibiu city, run by international ecumenical organization Blue Cross . About 50 people took part in the programme during the year it lasted.

The cheapest stuff is also the most dangerous.

“It was clear that a tough home situation made things more difficult,’ Stefan said. ‘We saw in the program that the more difficult the background of the patient, the less likely they were to make a successful recovery, even though these were the ones who needed help most.’

“You don’t treat anyone as hopeless when they come in, but in some cases you could see that it’s the case even if you didn’t want to admit it, even to yourself. There are those who were already very sick with AIDS in its advanced stages or other diseases, or with severe mental problems, or those who lived in the streets or from families where everyone was on drugs, or maybe had a combination of all these things.’

State Failure

In 2014, Romania reduced drug-related penalties: for possession of drugs for personal use, you can now get between 6 months and 2 years, but in practice it can always be replaced with fines or community service.

But the overall mentality is still to see drug use as a crime, says Dumitriu, which is an obstacle to caring for the users that need help.

The lack of nuance is dangerous. Marijuana and legale are treated almost the same despite the former being practically harmless and the latter potentially deadly. When marijuana (and other well known drugs) become more expensive, people are pushed towards increasingly dangerous substances like legale.

The most doomed, as always, are the poor.

The lack of any public debate about drugs too means consumers and their entourage remain uninformed about the risks and effects of individual drugs, leading to wrong choices. Legale are a black box to most, but a very few well informed users or dealers. There’s no way authorities can act efficiently in this context.

The most doomed, as always, are the poor. The cheapest stuff is also the most dangerous. Institutions that should normally help them tend to hate them (especially if they’re poor and Roma). Furthermore, Romania remains a country where the public health system is so bad that every Romanian relying on it knows they’re playing Russian roulette. When you can die from even the flu, what are your chances with addiction related health problems.