Background: New psychoactive substance (NPS) use has become a widespread phenomenon
among marginalised communities in Hungary. Since 2010, a growing number of reports
in grey literature and anecdotal information among professionals have become available
on NPS use among previously unaffected groups, such as people living in rural, socioeconomically
deprived communities. In our research, we aimed to explore NPS use among these communities.
Methods: We conducted a mixed method research with convergent parallel design. Data
collection took place in 2017 in marginalised communities in villages in two regions
in Hungary, where 150 questionnaires were recorded and 50 interviews were conducted
with current NPS users. Results: According to the survey results, NPS is very easy
to access, synthetic cannabinoid receptor agonist (SCRA) are easily bought in marginalised
rural communities (79% found SCRA easy to obtain). Both SCRA and synthetic cathinones
are used regularly; 57% of SCRA users and 37% of synthetic cathinone users used the
respective substance at least once a week in the past 30 days. Besides NPS, sedative
use (without prescription) and alcohol consumption are common among the respondents.
17% of the sample has already injected NPS. The overwhelming majority of the respondents
rated regular consumption of NPS as “very dangerous” (SCRA: 75%, synthetic cathinones
72%). NPS users have limited knowledge of consequences and the social and health treatment
options available. Most themes in the interviews are associated with surviving stress,
crisis and anxiety, as well as the wish to escape from insecurity and chaotic life.
Positive effects of substance use (community, joy, energy) are rarely present. Conclusion:
People who use drugs (PWUD) living in these rural communities face the consequences
of the rural risk environment: easy access to NPS, inadequate access to services,
poor labour market situation and attributions of marginalised groups, for example
disaffiliation. NPS use is not a recreational activity in this population; individuals
mainly use NPS to get away from reality, problems, pain, poverty and marginalisation.
NPS use is a survival strategy. Effective responses have to address substance use
and social integration; we need complex interventions addressing structural factors.
