New challenges in the work with street children and youngsters

by
Cristina PADEANU
Ana-Iuliana DOBRESCU
PARADA Foundation, Romania

Working with street children and youngsters, especially supporting them in the areas where they live, requires from the professionals well developed skills to adapt to the everyday changes. Almost 16 years of working on the street challenged the street workers from Parada, but in their opinion, in all this time the biggest challenge above all grew in the last 2 years: the use of the so called “ethnobotanic” drugs (synthetic cannabinoids, EMCDDA). For the professionals going out on the field and working with street children and adults (the mobile unit), the use of these legal drugs grew to almost 70% (according to their estimation) among those they work with.

Since they are legal drugs, the “ethnobotanics” are available for selling to everyone in any specialized “Spice”, “Dream” or other type of legal drug shop. But their history started years before, when selling by Internet. Therefore, the use developed especially among youngsters and those using the electronic sources of information. Once their selling was approved in shops (where they are sold as fertilizers, salt bath etc.) , the use “exploded” becoming a problem at the national level; parents, decision makers, politicians becoming concern of it.

The fact the substances are legal and their price is low (~ EUR 3 – 4 ) makes them affordable, even for people living on the street. For the street children and youngsters, facing frequent use of drugs around them, having no support from a family or the community, the challenge is even bigger as for any other group in the population.

Data provided by the Council of Europe in 2010 showed that use of “ethnobotanic” drugs increased and Romania ranks the fourth in Europe regarding use of these substances.

Actions taken by the government to ban selling of 36 substances resulted in the selling of new products with similar effects. The content of them is not well determined all the time, and even the most specialized laboratories need to adapt to the rapid changes in the structure of the substances.

Considering that only few information is known about the pharmacology and toxicology of the substances, as well as about the specific treatment (including for the psychiatric complications that may occur due to them), addressing the health and social needs of the users requires a particular attention since the degradation of body and mind is “on high speed”.

According to the statistics available at the national level, 50% of the “ethnobotanic” users have also a psychiatric co-morbidity.

The use of substances determines also negative psychological effects similar to those induced by schizophrenia. The age they start to use goes really down if they live on the street, in the environment where there is a heavy use of this type of drugs. There are even children in their almost 13 years of age that street workers have to work with them.

To make situation even worse, the desire of giving up the use of “ethnobotanic”  is far less than that of heroin dezintoxication. Even the abstinence periods are shorter than those for heroin. Above all, most of the users are affected by the anxiety and panic attacks when they become violent with them and people around. (Dr. Lucian Vasilescu, in “Dilema veche” weekly magazine, no 397, September 2011). According to the health experts “if a heroine user wants to stop can do it if he/ she is strong in this decision, but for an “ethnobotanic” user if reaches a certain threshold / limit (of use), it is no way back”.

The situation of Romania is not a singular one, the availability of such substances was identified in 21 countries in Europe, where the use is described mainly by smoking, sometimes orally used or as an infusion. (Understanding the “Spice “phenomenon, EMCDDA, 2009).  Comparing this pattern of use, in Romania most of these drugs are intravenously injected (special products being developed for being water soluble – the “salt bath”), which makes that effects rapidly occur, and the “violence” of their manifestation is higher than smoking or sniffing the substances. Consequently, the effects last for a shorter period of time and need for a new dose occurs. Moreover, due to the intravenous use, the risk for infectious diseases (such as hepatitis B, C and HIV) remains as for the heroine users.

In these conditions, prevention of the addictive behavior (with a particular emphasis on these new psychoactive substances) should start early before the drug use, activity which is difficult to handle for this vulnerable population where everyday life is a challenge.