A qualitative study of people who use new psychoactive substances and harm reduction services in eight countries of Eastern Europe and Central Asia region
Abstract
Research examines the use of new psychoactive substances (NPS) and the harm reduction response in eight countries: Belarus, Estonia, Lithuania, Moldova, Serbia, Kazakhstan, Kyrgyzstan, and Georgia. The aim is to generate a more accurate picture of current patterns of NPS use and harms associated with it in each country through recording the lived experience of people who use drugs (PWUD) and harm reduction service providers.
The study involved desk research and semi-structured interviews and focus groups with 166 PWUD and 69 health and harm reduction service providers in eight countries.
Synthetic cannabinoids and synthetic cathinones are predominant groups of NPS and widely available, whereas synthetic opioids seem to be more present in Estonia and Lithuania. NPS users generally reflected two groups: those who have more experience with drug use, who have shifted to the use of NPS, and young people with no/ little previous history of drug use. A main risk of NPS is the absence of drug checking because users don’t know what they are actually consuming. Other health-related risks include overdoses, mental health issues and increased risk of transmission of human immunodeficiency virus and hepatitis C virus caused by unsafe use of drugs (mainly by frequent injections, sometimes up to 30 injections per night), often combined with increased number of sexual contacts and riskier sex practices. In most of countries health care service providers are not prepared to provide PWUD with quality support and counselling to reduce risks associated with NPS use. The study identified patterns of NPS use, risk behaviours and drug-related harms. It presented more accurate picture of NPS use in 8 countries of EECA region. Research identified gaps in the current treatment and harm reduction response. These findings may inform and improve current harm reduction services to meet the needs of people who use NPS.