Special programme for the treatment of solvent abusing young people in Pécs
Zsolt Máté, social worker

Summary

INDIT is an integrated drug-treatment system consisting of several units (day-care unit, out-patient clinic and counselling centre, rehabilitation homes, half-way houses) and workgroups (drug-prevention workgroup, party-service). We understand the complexity of needs in dealing with drug-problems. We believe in the importance of integrating all levels of services, allocating the most appropriate service for every client according to their individual needs, as well as trying to provide simple access to treatment.

INDIT (Integrated Drug Therapy Institute)
“TISZTÁS” Day-care and Counselling Centre for Substance Abusers

Drop-in Club:
·	club programmes: video, board games, free tea and sandwiches
·	opportunity for relaxation (sitting and conversation)
·	computer / internet access
·	facilities for showering and laundry

Services of our Counselling Centre:
·	Providing information for affected individuals and their families about drugs, harms caused by drugs and harm-reduction
·	individual (one-to-one) counselling
·	information about educational / re-educational facilities and employment agencies
·	database of partner institutions, social welfare institutions, cultural events
·	self-help groups
·	social benefits counselling (entitlement and conditions of receipt, help with filling forms of application)
·	legal counselling
·	co-operation with various social, medical and rehabilitation organizations
·	education on AIDS, Hepatitis prevention
·	organizing prevention programmes
·	organizing recreational, cultural events for family/community

Specialized harm-reduction programmes:
·	needle-exchange
·	methadone maintenance

Out-reach services:
Street-work
·	providing information about the dangers of substance-abuse
·	free condoms
·	mobile needle-exchange
·	information on available services
·	emotional support, crisis-intervention
·	referral to other services when needed
Party-service
Preventive out-reach service with a harm-minimising view: regular presence at the most popular clubs of Pécs (University of Pécs Club (PEK) and Hard Rák Café (RÁK))

Roma program (volatile substance abuse prevention)

Pécs is the largest town of the Southern Transdanubian region of Hungary: with a present-day population of 160 thousand. This programme took place in a suburban area called „Hősök tere” (around Hősök square) situated in the North of Pécs.

Antecedents:
•	At the end of the 19th century coal mining begins in the suburbs of the town. „Hősök tere” (then called „György telep”) mine camp comes into being.
•	The socialist era brings a sort of inner migration inside the town: population of the suburban mine camps move to housing estates (to flats fitted with more conveniences). To fill in their place, Romanies/Gipsies (moved out from Gipsy-camps that were eliminated in the sixties-seventies) are relocated into the suburbs.
•	The process of segregation is accelerated by the anomic processes brought forth by the change of regime in the nineties → services move out, the Community Centre (“Művelődési Ház”) and the cinema is closed terminally, petrol station replaces the soccer court. It is characteristic that more than one third of the population of 400 in the area has lived here for less than 5 years: they regard their living here as a temporary state and move out as soon as possible. They do not become permanent citizens of the suburb, social life is reduced to minimum, so-called eroding of the society begins.
•	From the end of the 1980s Romanies/Gipsies make 60-70 % of the population. From the 1990s “Hősök tere” achieves notoriety for the presence of sniffers (solvent abusers).
Solvent abuse began to spread in Hungary in the first half of the 1970s. As a paradox, this was due to the youth welfare system of that time. For lack of preventive and continuous helping measures, endangered children were relatively simply taken from their families, and placed in foster homes some times as far as 100 kilometres from their parents. In these homes youngsters learned solvent abuse from elder residents and kept on the habit when they went home.
•	From the mid 1990s certain programmes are started to solve the situation:
o	As a consequence of “rat invasions”, public health policy measures are taken, litter collecting etc.
o	At 6 times in all, comprehensive social surveys conducted by the University of Pécs
o	In 1999, and then in 2000-2001 two non-profit organizations start projects to diminish solvent abuse. These initiatives yield few results in which lack of proper infrastructural conditions play a role (the programmes are not run on the spot).

The project of INDIT (Integrated Drug Therapy Institute) (September 2003 to January 2004)
Initiator: representative of the Pécs-Szabolcs District Local Government
Direct reason: the leader of the locally active non-profit organization (Society for Former Foster Home Residents: “Volt Állami Gondozottak Egyesülete”), who himself lives in the community, gathered the solvent abusing youngsters and started a club for them at the Community Centre (“Művelődési Ház”) reopening just then.
Problems emerging almost right at start:
•	Participants of other programmes at the Community Centre do not welcome the club
•	The expert for the club at the Community Centre resigns after a month of duty (employer’s rights and other competence not cleared)
•	Lack of expertise in dealing with addicts → request to our institute for professional help in September 2003.

Our institute signed a 6-month contract for conducting a quasi low-threshold programme containing self-help elements, working on a weekly basis:
•	From 10 September 2003 to 14 January 2004, every Wednesday afternoon, 14 meetings altogether
•	From October 2003 the district’s local government supports the club by 10,000 forints monthly (for sandwiches, tea, soda)
•	The group is open, homogeneous in gender (all males), ages: 16 to 27 years
•	Average attendance: 4-8 persons, while the full population of solvent users is 15. (Out of all only a single one, a girl did not show up, as she was refused by the group members.)
•	The group adopted the name “E ternengoj kluboj”, tried to institutionalize itself and accept its own regulations. Their efforts were broken by political fight going on in the local government running the Community Centre. The promises for material help in form of board games, television and video sets were not fulfilled by the local authority until the end of the programme.
•	Main flow of group themes:
o	Developing self-awareness, growing self-esteem
o	Dealing with conflicts, problem solving, stress management
o	Communicating actual facts (substances and their effects, harms associated with drug-abuse, legal consequences)
o	“Drug career”, the learning process of substance use
o	Giving information on the availability of services for help
o	An interactive, non-labelling, objective view considering both legal and illegal drugs
o	Psycho-education
•	Elements to involve the community: seeing families / inquires by parents, outreaching

UNEXPECTED event in February 2004:
Solvent abuse totally ceased in the “Hősök tere” district! This was confirmed at the community forum held on 8 June 2004 by several parties (police, community members and employees from the district).
The outcome is supposed to be a result of simultaneous presence, “intervention” of several helping factors.

Helping factors:
•	A period of boost in the community (Community Centre)
•	An initiative of a local civil organization (Society for Former Foster Home Residents: “Volt Állami Gondozottak Egyesülete”)
•	Spreading of a “quasi” low-threshold, harm-reductive view
•	New employment opportunities (in the framework of a programme called “MIOK” and public work)
•	Police station established at the end of 2002

Difficulties:
•	Problems in connection with starting the Community Centre
•	Political fights
•	Difficulties in working at the local non-profit organization (structure development needed)

Conclusion:
•	Outreach programmes to co-operate with local non-profit organizations
•	Gaining support from local authorities – social work in the community
•	Harm-reductive, low-threshold view and working in a group
•	Role of support by the labour-market
•	Reducing availability (dialogue with the police)

Plans:
•	Follow-up, relapse-prevention
•	Further co-operation with the non-profit sector