Understanding drug addiction in Roma and Sinti communities

Understanding drug addiction
in Roma and Sinti communities
– Research report –
January 2012
Understanding drug addiction in Roma communities
(short report)
By SRAP Network
With the support of Executive Agency for Health and Consumers
www.srap-project.eu
January 2012
Edited by: Oana Marcu (Codici|Agenzia di Ricerca), Patrizia Marani (Comune di Bologna)
Authors:
Chap. 1,2,3,5: Oana Marcu (Codici|Agenzia di Ricerca), Massimo Conte (Codici|Agenzia di Ricerca)
Chap. 4: Maria Cauto, Luciano Serio (Società Dolce), Silvia Citton, Giuseppe Menegazzo, Favaretto Alberto
(Comune di Venezia), Iskra Stoykova, Radostina Antonova, Boyan Vasilev, Eleonora Antonova, Emilia
Mikova, also contributed: Albena Dragieva, Anelia Dimitrova, Nayden Kostadinov, Rumiana Traikova,
Zornitsa Stoichkova (Health and Social Development Foundation), Daniela Mihailova (ROS Kupate, Bulgaria),
Mathilde Archambault, Olivier Peyroux, Morgane Siri (Hors la Rue Association), Tea Sulič (RIC Novo Mesto),
Coro González Garrido, Katia García Guadalupe, Nuria Rodríguez Derecho (Fundación Secretariado Gitano),
also contributed: Natalia Gómez Fidalgo, Amparo Merodio Simón, Juan Escudero Escudero, Angela Gabarri
Gabarri, Fernando García García, Ángeles Lanza Hernández, Carmen Salvador Castel (Fundación
Secretariado Gitano, Spain), Cristina Padeanu (Parada Foundation, Romania)
1
Table of contents
Table of contents ............................................................................................................................................... 1
1.
Roma in Europe: legislation, health services and risk of drug use ............................................................ 3
2.
Methodology ............................................................................................................................................. 6
2.1.
Building a participated research design ............................................................................................. 6
2.2.
Participants recruiting and motivation .............................................................................................. 8
2.3.
Research method: visual focus groups and in depth interviews ..................................................... 11
3.
Results ..................................................................................................................................................... 14
3.1.
3.2.
Cultural attitudes ........................................................................................................................ 14
3.3.
Close social networks .................................................................................................................. 17
3.4.
Services-community gaps ........................................................................................................... 19
3.5.
Health risks & protection factors ................................................................................................ 20
3.6.
Patterns of consumption ............................................................................................................ 21
4.
5.
A transnational overview ................................................................................................................. 14
Local conclusions.............................................................................................................................. 24
4.1.
Italy – country conclusions.......................................................................................................... 24
4.2.
Italy – Bologna............................................................................................................................. 28
4.3.
Italy-Venice ................................................................................................................................. 33
4.4.
Bulgaria – Sofia............................................................................................................................ 35
4.5.
France.......................................................................................................................................... 36
4.6.
Slovenia – Novo Mesto ............................................................................................................... 37
4.7.
Spain............................................................................................................................................ 39
4.8.
Romania ...................................................................................................................................... 42
Final conclusions .............................................................................................................................. 42
References ................................................................................................................................................... 48
2
1. Roma1 in Europe: legislation, health services and risk of drug use
As health is a measure for more general social inequalities, it is widely accepted that minority groups and
young people living in conditions of vulnerability and exclusion experience higher risk of drug use, and have
overall poorer health outcomes.
As suggested in the 2002 EMDCCA research report on the topic of drug use and minorities in 16 European
countries: “black and minority groups are vulnerable to problematic drug use in the same way as the
socially excluded, white indigenous populations are, and this applies particularly to the younger generations
of some groups. It was pointed out by informants from most of the countries that participated in this study
that drug use was more prevalent amongst the younger generations of BME groups than amongst the older
generations, and many informants linked this with social exclusion”.
EMCCDA’s 2008 report on drugs and vulnerable groups of young people also underlines that a group’s
exposure to social disadvantage or inequality may result in limited individual choice and lead to earlier,
more frequent or more problematic drug use.
The present research investigated the processes that link Roma youth to drug use, in a prevention
framework, and was carried out in 6 partner countries of the SRAP project: Italy, Spain, France, Bulgaria,
Romania and Bulgaria.
In all European countries legislation on using, selling or producing drugs is intrinsically universal and non
selective. Regardless of being recognized as a minority and regardless of the citizenship status of the groups
identifiable as Roma, they comply with the same regulations, independent of ethnicity, both for legal or
illegal substances.
Legislation in all partner countries shares an approach on drugs that distinguishes between substances on
the basis of the lawfulness of their commerce and production. Moreover, it also regulates the consumption
of legal substances, e.g. by referring to drinking and driving, consumption in public spaces, forbidding to sell
tobacco to minors or using the filter of the medical prescription for using some medicines with
psychotropic or doping effect.
Differences between partner countries refer to specific aspects of these regulations: the levels of legal
consequences, according to the criteria of dangerousness of certain drugs, the criminal relevance of
consumption against dealing and production, differences in applying fines or criminal sanctions. These
specific aspects also refer to the general population following a non-selective approach2.
The few studies concerning the heath and addiction problems among the members of Europe’s largest
minority, the Roma, are quite alarming regarding the health disparities and differences in levels and
incidence of substances consumption. Research conducted on drug consumption in Roma groups in Ireland
(EMCCDA, 2008), Hungary (Gerevich, Bacskai, Czobor, & Szabo, 2010), Bulgaria (EMCCDA, 2009), Finland,
Spain, Portugal (EMCCDA, 2002) have indicated worrying tendencies such as early ages for the initiation of
1
We used the term “Roma” for sake of brevity to refer to all Romani groups; we stress however that we recognized
the diversity within the different Roma communities in Europe. In the present report we specified when we referred
to a specific Roma group (Romanian Roma, Bulgarian Roma, Sinti, etc.).
2
For details on the national legislations against drugs, refer to the single country reports in the long version of the
present report.
3
tobacco and alcohol consumption, higher lifetime prevalence for all types of drugs, stigma and
concealment of consumption. Fundación Secretariado Gitano’s research on the health of the Roma pointed
out that there are high percentages of households where at least one member has an alcohol and/or drug
problem, especially in Bulgaria, Greece and Czech Republic, with an average of 11.4 % of the households in
all contexts3. These tended to be larger families than the ones without any drug consumers.
The abovementioned research concludes that urgent efforts are needed to improve access and fruition of
health care among the Roma. At a European level it is already acknowledged that one of the characteristics
of the segregation lived by Roma groups is related to their low access to services of the national welfare.
More than once the European Union had to intervene by asking for policies that facilitate Roma’s access to
services. National and transnational research conducted in the SRAP project further underlines Roma’s low
access to services, in particular to health care and specific services related to drug use and prevention.
The barriers in accessing services are of three types:
1. Administrative barriers. Being an alien or existing inconsistencies in the regulation of the status of EU
citizens (e.g. for Romanian Roma abroad) can determine exclusion from health services, for those
interventions that are not necessary nor urgent. For example, the alien status can limit access to
prevention and health promotion programs. Another administrative barrier is the lack of medical
insurance, as the case for Roma in Bulgaria, which leads to the impossibility of accessing health care.
These types of barriers can be overcome by interventions of the NGO sector, as frequently seen.
Otherwise, government interventions can be aimed at removing the administrative barriers, following
principles of positive discrimination towards groups recognized as minorities, while applying selective
interventions for overcoming social exclusion situations.
2. Barriers related to orientation in the services system. Many services against drug consumption or for
managing health risks related to it are not first level, but specialized services. This forces people to
orient themselves in the system of services , requiring skills to identify which specialized service should
be contacted. For a population where access to basic services (universalistic and generalistic) is already
problematic, awareness of specialized services might be even lower.
In partner countries many intervention programs, promoted by institutions and by NGOs, intend to
overcome this barrier by developing outreach, low threshold services, that can accompany and orient
persons towards specialized services.
An observation coming from French, Italian and Spanish experiences is that some categories of consumers,
due to the consequences of their use, discover and access specialized services after passing through an
outreach intervention. It is the case for injecting heroin users that (as IDUs 4, not as Roma) turn to mobile
units working in harm reduction and to addiction services present in the area. This is one case where the
specificity of injecting drug use condition, meeting a tradition in addiction treatment, overcomes
segregation barriers and allows for access to services.
3. Barriers related to lack of access to information. Roma groups who live in the worst segregation and
social exclusion conditions lack minimal information on the consequences of the consumer situation or
on the existence of dedicated services. Many partners of the SRAP project have designed projects for
3
4
The results also included Spain and Portugal.
IDU is the acronym for injecting drug use/user.
4
increasing awareness of the Roma regarding the consequences of unhealthy lifestyles and for a more
effective health promotion among these groups.
One of the most negative consequences of the low access of Roma to services related to drug consumption
is that there is little knowledge about the relation between Roma and drugs. In all partner countries there is
clear evidence of consumption among Roma groups of all drugs taken into consideration in the research,
tobacco, alcohol and illicit drugs. There is still little knowledge about the spread of drug use, consumer
profiles, relationship with illegal markets, as well as risk distribution and correlated pathologies. The lack of
such information makes it difficult to apply a strong and efficient social and health policy program
We cannot forget that one of the most obvious limits for obtaining this information is the lack of a clear,
univocal, shared definition of the Roma.
The Roma are considered a national minority in Bulgaria, Romania and Slovenia, where special
governmental institutions and policies are foreseen in order to promote social inclusion of minorities.
France and Spain do not have specific legislation dealing with the Roma minority, while in Italy there is only
regional level legislation, which also proposes very special solutions, such as hosting Roma in nomad camps.
Not all the Roma present on the territory of each European country fall into these legally defined
categories. For example, Slovenian law protects as a minority only Roma of Slovenian citizenship, while
Eastern-European Roma in Italy may fall in the category of “irregular migrants” instead of “regional
minorities”. Just before the effective accession of Romania and Bulgaria to the European Union, France, for
example, has changed the rules on the legality of EU citizens’ residence. The Law of July 24, 2006 on
immigration and integration introduced strict conditions of granting residence rights for the EU citizens,
which have to prove to have a job, be a student or have health insurance and sufficient resources.
For their universalistic and non-selective character, welfare systems do not collect ethnically disaggregated
data. EU law on data protection allows for the collection of ethnic data provided that certain safeguards are
in place to protect this form of special personal data from misuse. Some of the countries who participated
in our research have strict regulations regarding ethnic data collection, although ethnically disaggregated
data can be collected for positive policy purpose. European Roma Rights Centers (2001) observes that “the
willful interpretation of national data protection laws as a blanket prohibition of the collection of data
based on ethnicity is one of the key obstacles in all five countries to developing tailored policies” (p. 33).
According to ERRC, the misinterpretation of data protection norms leads to lack of data on a number of
health and social indicators for the Roma population.
SRAP project aimed at overcoming these limits by increasing the knowledge on Roma and drug use, from a
qualitative point of view, aimed at describing and interpreting phenomena in a prevention framework.
5
2. Methodology
2.1.
Building a participated research design
SRAP project has as one of its core belief the need to increase the participation of the Roma, especially
youth, in the research and intervention processes it foresees.
The approach to research was focused on producing knowledge in a framework that bonds research to
intervention: the action research perspective underlines the need to collect data in a practice-oriented
manner and to actively involve all the target groups in this process. In this sense it was necessary to involve
all the different actors not only in carrying out research, but also in formulating its aims and main topics.
Before drafting up the research design, we carried out, between September 2010 and February 2011, a
consultation phase that had the purpose of involving all stakeholders (institutional as well as Roma youth)
in the process of defining target groups and topics for the next stages. Thus we organized focus groups with
the aim of consulting youth, professionals and the local stakeholders group (LSAC) regarding what areas of
youth drug use our research should address.
On one hand, this helped us understand what are the priorities for research and intervention that different
stakeholders perceive. On the other, it helped us create a context of mutual exchange and collaboration,
typical for participated research. Seven focus groups were organized with local stakeholders group (total of
41 participants), eight with professionals working in prevention (total of 62 participants) and eight with
Roma youth (total of 74 participants). At this point, we did not aim to gain information on specific drug
consumption patterns, on personal and community behavior and attitudes, but only to identify perceived
priorities for dealing with the emergent problem of drug consumption, as a direct input for our research
design. Nonetheless, as one can read in our first report, this first round of focus groups also provided some
hint regarding contextual trends in drug consumption, but also on relationships and experiences of young
people.
The focus groups were organized in homogeneous groups (Roma boys and girls, SRAP’s Local stakeholders
advisory committee and professionals), addressing the same topics in each of these groups. We used the
same tasks/questions for the three different target groups involved, adapted in terms of language and
complexity. Consultation focus groups were organized, across partner countries, with Roma youth aged 1228, 39 boys and 35 girls. Some were more homogeneous regarding age and gender of participants. For
example, the FG with youth in Spain was almost homogeneous regarding gender, as it involved 7 girls and
one boy. The FG in France, for example, was extremely heterogeneous regarding age (12 to 18). It
sometimes proved difficult to select participants in equal gender distribution, because of the demographic
characteristics of each population and other contextual factors. Significantly larger numbers of boys
participated in France and in Bulgaria, while larger numbers of girls, in Spain, Italy and Romania.
Focus groups with local stakeholders advisory committee saw the least numerous participation in all
countries. Even if LS groups were formed to assist during the entire SRAP project, their participation in this
preliminary focus group was sometimes difficult to obtain. Full schedules and difficulties in agreeing on a
6
common date were the reasons invoked by these. The average number of the participants in LSAC focus
group was 5,85.
Focus groups with prevention services representatives had higher numbers of participants. Only in Venice,
there were some difficulties in involving professionals from the Local Health Agency (ASL) as the
management did not give their agreement to participate. In some cases (Sofia, for example), it was difficult
to identify professional figures experienced with Roma population. Most services related to drug problems
were therapeutic communities.
The first task was a brainstorming task on the topic of Roma Youth and drugs, organized with the aim of
exploring all the ideas familiar to participants that related the two concepts. In this manner we could
explore the importance attributed to consumption among Roma youth, the representation of the
phenomenon and the familiar situations or images linked to this topic. The topics that emerged were
grouped into categories on the basis of their meaning and co-occurrence (conceptual map task).
In the second part of the process, the main topics related to Roma youth drug use were ranked by
participants on the basis of their importance and of their accessibility (applied to research and prevention
interventions). With this latter task we intended to prioritize the problems and the resources, to identify
the criticalities and to explore potential errors to be avoided in the research process.
Participants generally appreciated the occasion to meet and discuss topics like drug consumption among
Roma Youth and expressed their willingness to participate in further sessions.
The material gathered in the consultation focus groups was then translated into a common framework that
has guided research during the field and analysis stages.
We organized a meeting with researchers and representatives of partner organizations in Milan (8-10
March). The goal was to build together the research design, the questions/topics and method for carrying
out the action research, taking into account the results of the consultation focus groups.
In order to do this, the partners who conducted the research selected keywords indicating the main topics
that emerged in each local context. By discussing these topics, we constructed a conceptual map that
represented in a short, visual form, the main areas that we would explore in our research, and thus the
main results of the analysis of the consultation focus groups. Thus, the main areas to be explored were:
-
CULTURAL ATTITUDES: refer to how drug consumption comes to be interpreted in cultural terms.
Some types of consumption are seen by the Roma as more traditional, while other are seen as
cultural contaminations. This category also refers to dominant culture attitudes to drug
consumption (which is “normalized”) and the need to take up responsibility to educate youth about
drugs.
-
CLOSE SOCIAL NETWORKS: family and friends, close social environment of youth. This area refers to
the influence of these relationships on consumption, and also to a general understanding of the
relational dynamics that characterize youth experience. It also refers to violence and manipulation
as risks deriving from close relationships.
-
SERVICES-COMMUNITY GAPS: the perception of prevention/health services and Roma youth as
being distant, awareness and capacity of services.
-
HEALTH RISKS & PROTECTION FACTORS: it refers to psychological preconditions, individual level
consequences, knowledge about drugs and access to information. This category also included some
7
specificities of growing up as Roma, like the quick transition from childhood to adulthood. We also
included here associated risks, like sexual risks or exploitation.
-
PATTERNS OF CONSUMPTION: we decided to include this area a-posteriori, even if it didn’t emerge
as a keyword. We thought that in order to conceive an effective prevention program we also have
to have a clear idea on what kinds of drugs, in what occasion, and which intensity of consumption
characterize research/intervention contexts.
Our research aims are gaining a deeper understanding of the above areas, identifying main actors and
processes in Roma youth drug use and their interconnections and, consequently, exploring possibilities and
limits for effective prevention programs.
When all the results from research with Roma youth were gathered, we organized focus groups in order to
discuss these with professionals. This action had the goal of disseminating the material we just gathered,
targeted to stakeholders, and to validate its utility for intervention.
2.2.
Participants recruiting and motivation
From the first discussions between partners, we noted that we do not share a common definition of the
Roma. In some approaches, Roma ethnic identity is established on the basis of self-identification: Roma is
the person that defines him/herself as Roma. We know, though, that this may lead to an error of underestimation. Many people may feel stigmatized to declare themselves Roma, and thus sometimes avoid this
label that has too often been associated with negative traits in public discourse. On the other hand, other
approaches consider that we can attribute ethnic identity to a person on the basis of some defining
characteristics. Some partners referred to geographical criteria (who lives in a community of Roma is Roma)
or to lifestyle criteria (Roma don’t inherit land, or Roma practice a free way of life).
Still, the selective prevention approach underlines the fact that intervention has to be specifically tailored
for the needs of the target group, and has to take into account the risks and opportunities in the life
context in which the person lives. Considering that the Roma living in different countries experience
specific, contextual risks and opportunities that can lead to drug consumption, we decided to use contextspecific inclusion criteria for defining local target groups. The criteria were:
-
Communities and persons who identify themselves as Roma;
-
Territorial communities identified as Roma;
-
Specific conditions of vulnerability (ex. Youth involved in illegal or informal activities, in drugdealing, sex workers, street children, ecc.)
The approach is that of a “galaxy of minority groups” (Dell'Agnese and Vitale 2007) whose identities are
socially and contextually constructed. Thus, as we will specify in each country section below, between local
groups there are some common characteristics, while some differences remain. At the same time, we
cannot state that all Roma groups share a common core of necessary traits. As we will underline further on,
there are significant differences between each local group, regarding the more general socio-economic and
legal status as well as the levels and patterns of drug consumption.
8
2.2.1. Contexts description
In Italy, both in Bologna and Venice, the participants were both Italian Sinti and immigrant Romanian Roma,
some of them living in authorized nomad camps, others who were beneficiaries of social housing projects.
Between different groups from the same city (in Venice, for example) but also transversally (between
different countries) there are large differences between people who live in segregated environments
compared other types of housing.
In France the participants were young immigrants, mostly Romanian Roma living in Paris and at the
outskirts of the city in squats or camps. Youth who participated are experiencing specific vulnerability
situations such as exploitation, life in the street, some are involved in prostitution and/or petty crime.
Some were contacted in their “work” place (Gare du Nord, for example), while others in the HLR Day
Center.
In Spain youth who participated were Roma, citizens of Spain or nationals of other countries. There were
participants whose realities are close to social exclusion and where the drug problem is present:
neighborhoods of consumption and close to trafficking spots (Cabañal district in Valencia, Pan Bendito and
Cano Roto district in Madrid). These are contexts with high levels of cultural diversity. In these contexts are
often concentrated a large number of social housing. (e.g. Pan Bendito district in Madrid, neighborhood
Caño Roto in Madrid: an area of relocated people who formerly lived in shacks). Most Roma population
concentrated in the neighborhood area receives relocation assistance and social support. The second type
of contexts taken into consideration in Spain were those where such extreme social exclusion situations
were not present, and Roma live mostly middle-low class groups, also in a high concentration of social
housing (San Lorenzo district in Castellón, Fontiñas district in Barrio Santiago de Compostela).
In Sofia, Hesed worked in the Fakulteta neighborhood, while Kupate implemented most of the activities in
Hristo Botev Roma settlement in Sofia and in Stolipinovo in Plovdiv (3 Focus Groups). For the interviews
however, Kupate has used Fakulteta Roma district areas, which differ the main center of the district. The
Fakulteta district is the biggest Roma settlement in Bulgaria with more than 40 000 people living there
currently. It is divided in smaller areas (the center, the Glaveva mahala, the Kambodia mahala, the
Siromashka mahala, the new district area). In the different areas there are different community status.
Thus for example in Glaveva mahala there are mainly extremely poor families who moved in Sofia from the
country sides (mainly Kyustendil area), in the new district area there are relatively rich families with big
houses, many of whom go to work in Western Europe. Kupate has concentrated the research in Glaveva
mahala and New district area, which was different from the center area used from HESED and has also
concentrated on people with police records (adults - i.e. above 18 years old; and minors - i.e. bellow 18, but
also registered with the local police).
In Slovenia, younger participants (11-16 years old) came from Roma settlements Brezje near Novo mesto
and Šmihel in Novo mesto, while the participants for the interview, aged 17 to 24, were selected amongst
the participants of the educational programs performed at RIC Novo mesto.
The diversity of the contexts explored in partner countries also indicated that the Roma community is not,
in itself, linked to a fixed social or cultural condition, that may be leading to or protecting from drug abuse.
Various risk or protection factors contextually impact on the lives of the individuals who are includable in
the Roma category. As we can see in the results section (mostly in the country reports), there are
9
differences between Roma people living in different types of areas (characterized by different social
problems).
Our choice of using contextual definitions in each country allows for comparisons between groups, mostly
on qualitative and not quantitative aspects. Moreover, we chose to privilege the target groups that were
already in contact with partner organizations, in order to use the relationships that already existed
between potential participants and social workers, a decisive factor for the success of the research process.
2.2.2. Recruiting, relationship and ethical issues
Youth were either previous participants in various social programs of partner organizations, either youth in
contact with outreach teams. The research team used informed consent letters that were read and
explained to participants, comprising anonymity and confidentiality issues.
In all contexts where the research was carried out, existing relationship between outreach workers,
researchers and participants was crucial, especially given the sensitivity of the issue of drug use, often
accompanied by stigma. Still, in many situations it becomes necessary to contact young people with the
mediation of other services or organizations. It proved to be difficult to interview participants in these
situations. Given a stronger previous relationship, instead, participants shared very sensitive information
with the interviewer, not just related to drugs, but also to other experiences like prostitution or being a
victim of violence.
Outreach workers were directly involved in selecting and recruiting participants, and in some contexts, they
carried out the entire research. In Spain, Bulgaria and Slovenia, some of the outreach workers also
belonged to the Roma community. Their role was important in explaining the research, ensuring the
collaboration and motivation of participants, and establishing trust.
2.2.3. Participants in the field research phase
Local
context
M
F
M
F
M
F
M
F
IT – BO
6
11
5
12
3
1
14
24
IT – VE
0
0
13
6
4
2
17
8
BG – HES
15
3
15
3
4
4
34
10
BG - KUP
10
9
9
9
6
4
25
22
FR
0
0
3
0
8
2
11
2
SL
7
9
5
8
6
4
18
21
ES
22
6
5
8
6
4
33
18
Total
60
38
55
46
37
21
152
105
Local
FG 11-13
Number of
FG 14-16
Interviews
Number of
10
Total
context
focus
groups
interviews
IT – BO
4
4
IT – VE
3
6
BG – HES
4
8
BG – KUP
3
10
FR
1
10
SL
4
10
ES
4
10
Total
23
58
Although girls proved to be more reluctant to speak about their own consumption, and the number of girls
using drugs was perceived as smaller than boys’ in the field research phase, in the overall field research we
obtained a proportion of 41% female participants and 59% male. This distribution was not uniform across
countries: 63% girls in Bologna, 50% in Novo Mesto, 30% in Spain, 32% in Venice. In France a low number of
girls participated in the research, as the in context where Hors la Rue operates boys are much more
numerous.
In Bologna, where many girls participated in the research, they were more available, but the use of
substances was practically null. The consumer profiles (which were also selection criteria for the interviews)
will be detailed in the results chapter (in the section “Patterns of consumption”).
Some of the difficulties in participants recruiting were: silence regarding any kind of activity connected to
drugs (e.g. Venice) or frequent dropouts from scheduled activities (e.g. France, Romania). It proved very
difficult (if not impossible) to interview young people involved in drug dealing.
These difficulties are important to keep in mind when preparing prevention activities: it might prove
difficult to work with a stable group, especially in contexts where the life of participants is not stable and
they live multiple vulnerability situations (e.g. young people working in the street, such as in France and
Romania). A significant amount of time and preparation has to be dedicated to recruiting participants and
establishing relationships of trust, if the context is new to the service or organization.
2.3.
Research method: visual focus groups and in depth interviews
The focus groups were designed to use visual, creative productions made by participants themselves, which
would reflect their perception on the drug issue. Creative research methods allow for the researchers to
partially overcome language and literacy limitations, to give more time to participants to reflect on their
own points of view, and to spend more time with them while doing something together. Moreover, visual
communication allows for ideas to be expressed simultaneously, unlike talk, where ideas need to be
11
presented sequentially. The technique of the collage has previously been used for educational purposes
and to explore attitudes, gender identity and self image (Reavey, 2010).
In our pilot study on Roma communities and drug use, we employed the collage technique: participants had
to build representations of alcohol, tobacco and other drugs by cutting and gluing pieces of newspapers
and magazines. The collage was divided into three parts: “me and tobacco”, “me and alcohol”, “me and
other drugs” in order to acknowledge the fact that the meanings associated to different drugs might differ.
In a second part of the focus groups we asked participants to express how would their family and friends
feel about substances and how do they influence health behaviors. Participants rated on a board, using
smiley faces ( - glad,  - sad,
- neutral/indifferent) the feelings of their parents, siblings, friends and
other significant persons if they knew they were using drugs, and their own feelings if they found out their
parents, siblings, friends and significant others were using drugs. This was an occasion to talk about their
networks and social support, but also about social norms and parental control.
The focus group with visual stimuli involved Roma youth aged 11-13 (prospected 2 focus groups per
country) and 14-16 (prospected 2 focus groups per country), although in some local contexts focus groups
with the younger ones (11-13) could not be held. We favored the participation of boys and girls of close
ages in the same focus. Focus groups aimed to cover especially two research topics:
-
Cultural attitudes;
-
Close social networks (family and peers).
The second research instrument used, the semi-structured interviews, were conducted using common
guidelines (attached to the present report), but the recommended style of conduction was non-directive.
We aimed to reach, where possible, a heterogeneous group of Roma youth aged 17-24, with different
consumption patterns: some participants used tobacco, some alcohol and some other drugs. We also
aimed at obtaining a 60% boys – 40% girls distribution, but this was not possible in each context, for the
characteristics of the population or for other issues related to gender and consumption that will be detailed
further on.
The initial question was “can you tell me about your experience with substances?”, and the following topics
in the guideline were:
- Types & frequency of drug consumption (lifelong consumption, last year consumption)
- First consumption and changes
- Recent consumption
- Social support
- Spare time and drug-free activities
- Self – evaluation & motivating factors
- Problems and coping
- Services knowledge and access
- Future
- Impressions about the interview
The interview aimed to cover especially the following three research topics:
- Service-community gaps
- Health risks and protection factors
- Patterns of consumption
12
We first conducted a pilot testing of the method, in order to identify problems and difficulties in carrying
our research, and to propose solutions. Partners carried out one or two focus groups each, and a 16 test
interviews (in all countries). The main results of this phase are discussed in the Pilot research –
intermediate report produced by the network. Following the pilot testing, we revised methodology and
proposed solutions in a participated manner, during the meeting held in Madrid (June 2011).
The research activities were developed either in school settings (especially focus groups, in Venice,
Slovenia, Romania), or in structures belonging to partner organizations (day care centers, educational
programs classrooms).
Focus groups proved quite difficult to carry out. Even if methodological literature underlines the fact that
visual research (e.g. collage) is more easy to understand and participants get more involved in such
activities that resemble play, the task was not easy to understand by many participants, attention dropped
after the first hour and group dynamic seemed difficult to control. Special attention in all kinds of group
work should be given to the number of participants: when it was too large for organization reasons, the
dynamic proved to be tiresome for both researchers and participants. The familiarity of participants with
group work settings is also important: when they have low previous experience with group discussion
settings (e.g. school or other educational settings), debating and listening to others is difficult.
Individual interviews were easier to carry out, given the availability of participants, although in some cases
they were rather short, as participants did have enough trust or were afraid that talking about drug
problems in their communities made them spies. With reluctant participants or with those that didn’t have
a background in drug consumption interviews lasted about 8-10 minutes (e.g. some of the interviews in
France, Spain). In the rest of the cases, interviews lasted about 40-50 minutes. In some contexts other
activities accompanied the research activities (e.g. pizza in Bologna), or before the interview a relaxing
conversational moment with the interviewer was foreseen (e.g. Spain). This seems to be a good practice, as
it enhances motivation to participate and it creates good sharing atmosphere.
All the interviews and focus groups were recorded, transcribed by researchers in each country and
thematic analysis was applied by coding text in categories and subsequently assigning categories to the five
macro-topics. Visual productions were analyzed by using metaphorical analysis.
Final focus groups with services professionals and local stakeholders were organized as a discussion of
national results. Interesting ideas, images and quotes from research with Roma young people were
presented to professionals, and they were invited to talk about their impressions, about the usefulness of
the information for their work and about their proposals in order to solve some of the issues. The occasion
was thus for a first dissemination and evaluation of research results. We will present the results of these
group interviews in each final section of the local results.
13
3. Results
3.1.
A transnational overview
The present section discusses the overall picture resulting from qualitative research we carried out in each
country, using common instruments and a common analysis framework. Comparison between countries is
proposed by analyzing the common points and the differences between the contexts that participated in
the research, along with an interpretation of the motivations of the actors involved in a prevention
framework. Special attention has been given to meaning making processes, and thus to what is perceived
as important or decisive for consumption by Roma youth themselves. The organization of the chapter
follows the conceptual scheme that we elaborated in a participated manner, with the five macro-topics
mentioned above.
It is important to notice that research results offer a description of the social mechanisms by which drug
consumption is understood, dealt with and maintained in the communities, especially at a discursive level.
There are also indications regarding behaviors, but the information should be interpreted as an illustration
of the phenomenon, without presenting statistically representative numeric conclusions. Qualitative
research can give an image of the dimension and spread of the phenomenon, but it mostly responds to the
interrogative “how?”, not to “how many?”.
Inferences regarding the obtained numbers is also limited because of the difference between levels of
analysis: in some contexts, research was carried out in strategic locations, covering a national area (e.g.
Spain), in others remained at a city level (cities of Venice, Bologna), while in others, at a neighborhood level
(e.g. Hesed’s research in the Fakulteta neighborhood). Another conceptually different situation describes
the target group of Hors la Rue in Paris, which is intercepted not in a Roma settlement, but on the street.
Nonetheless, reflecting on the differences between contexts is very useful, as we can understand how
young people make sense, contextually, of their social situation and how this influences their patterns of
consumption.
3.2.
Cultural attitudes
This first category, as stated above, refers to how drug consumption comes to be interpreted in cultural
terms. Some types of consumption are seen by the Roma as more traditional, while other are seen as
cultural contaminations. This category also refers to dominant culture attitudes to drug consumption
(which is “normalized”), and to the connotation of drug use in terms of ethnic or status terms.
It is important to underline that ethnic traits of Roma communities are not the only beliefs included, in our
analysis, in the category “cultural attitudes”. We treated culture not just as beliefs shared by the ethnic
group, but as fluxes of knowledge coming from different environments that are interpreted by the
individuals. Thus, cultures are also transmitted in school or in the interaction with non-Roma peers.
Thus the main cultural traits that have a relevance or are linked to drug use are:
14
The normative community pressure against drugs contrasted with permissiveness regarding specific
types of consumption. This first observation was transversal to all contexts where research was carried out.
Many of the participants in the research underlined that adults and community in general have a negative
perception regarding drugs. Roma youth living in nomad camps in Italy stated that they would never show
their consumption to community adults and family members for reasons of respect. In contrast, they would
if the adults were gadji5. Likewise, Roma youth living in the segregated Fakulteta neighborhood in Sofia
think that their adult family members have a very stereotypical perception of illicit drugs, indiscriminately
negative, because they consider them all alike, for lack of specific information. Consequently, youth would
conceal their consumption or not seek social support from these adults, in case of drug use problems.
Nonetheless, participants in Spain explained that relaying on extended family is still a strong cultural trait.
Romanian Roma participants in Paris underlined that certain drugs (like alcohol or tobacco) are perceived
by the communities in which they live as acceptable, while others (like illicit drugs) are unacceptable, thus
most often consumption of the latter is concealed.
One participant in Spain also mentioned the gypsy law as a cultural value, while another one referred to the
performance of traditional trades. In many families, young people are expected to contribute to the family
economy. Traditional trades have been (sometimes forcibly) abandoned by Roma in many countries,
sometimes replaced with other informal economies, whereas other times with unemployment, work
migration or illegal activities. In those few contexts where traditional trades are still present, they can help
keeping young people away from drugs.
In Venice, one strong message was silence: drugs were a taboo topic and this position characterized the
community of the “nomad village” where the research was carried out, like a “conspiracy of silence”. This
cannot be generalized as an ethnic trait, though, as youth who lived in apartments in Venice (thus not in a
segregated ethnic community) felt much more free to speak about drugs. The closure of segregated
communities seems to make it difficult to tackle the topic of drugs.
The importance of the extended family and the community in itself will be further discussed in the next
paragraph (Close social network). Still, we would like to underline here how the belief that drug use is
disrespectful towards family members and thus should be hidden impacts both as a risk and as a protection
factor. It is a risk factor as it leads to concealment of consumption and lowers the chance of seeking the
social support of adults of reference for dealing with drug problems. On the other hand, the control and
limitations these exert can distance young people from drugs. Though, as we will see in the next paragraph,
family control is very often manifested in an authoritarian manner and sometimes accompanied by
violence.
In Slovenia, Spain, Bulgaria, France, participants observed that smoking at a young age is a general habit in
their reference group, and that alcohol consumption by boys begins very early, in the context of community
celebrations. Young boys usually start drinking with cousins. Although this seems to be an observation
across contexts, still we need to distinguish between the culture of social exclusion and the Roma culture:
permissiveness towards drinking or smoking at young ages is not linked to traditional Roma culture, but to
social exclusion, more specifically, to lack of prevention skills and knowledge in adults.
5
Gadji is the term, in romani, used to refer to the non-Roma population in general.
15
Gender differences, drugs as promiscuity. In Spain, Bulgaria and Italy (both in Bologna and Venice), strong
differences between genders norms were cited by participants. Norms are more strict for girls, who risk
social stigma if they use drugs. In the case of tobacco, they would feel ashamed to smoke before their adult
family members (e.g. in Italy). In countries where this idea did not emerge, there was also a very limited
number of girls participating in focus groups and interviews and thus the gender issues did not come up.
In the visual task, images used to represent drugs (alcohol and illegal substances especially) were very often
associated to the sexual promiscuity of women. Examples of girls naked, dressed in sexy outfits or holding
their legs wide open, represented lack inhibition associated to alcohol consumption, and respectively to
illegal drugs consumption (in Italy and in Bulgaria). In order to represent illegal drugs, two participants in
Bulgaria used the photo of “prostitutes”. It seems that there is a clear connection between drug
consumption and what is seen as deviant sexual behavior of women, as no sexualizing images of men were
used by participants to represent drugs. Still, consumption is present for girls too, despite of parents’ and
community control. Very often girls start using alcohol during celebrations and parties, but they hide from
relatives.
This aspect has multiple implications for the patterns of drug use, as social stigma can lead to avoid
activating social support when the problem of drug use is present.
Drugs and religion. In Bulgaria, in the Fakulteta neighborhood, and in Spain, where the evangelical church
is highly present, some participants mentioned religion and their belief in God as values opposed to the use
of drugs. Nonetheless, it seems to be a local phenomenon, as religious beliefs were not cited in other the
contexts taken into consideration in our research..
Perception of drugs, fashion and celebrities. Generally, it can be said that there was a distinction between
“drugs” intended as illicit drugs and alcohol and tobacco, seen as “lighter drugs” or not drugs at all (as was
observed in Slovenia, France, Bulgaria). Nonetheless, at a practical level, especially when selecting images
to include in the collage, many participants included cannabis in the category of lighter drugs (e.g. depicting
marijuana close to tobacco, not to “other drugs”). In the same task, participants also depicted other
addictions (computers, gambling or chocolate). Many drugs were depicted by illustrating health, legal
(especially in Bulgaria) or social consequences.
Drugs were depicted by using sensorial aspects, like the pungent smell or the pale skin. Old age, wrinkles
skinny body or dead persons indicated the conditions of the body that young people associated to drug use.
Sexy women, partying people, models and catwalks reconstructed a more glamorous image of drug using.
The idea came out most clearly from the research carried out by Hesed in Bulgaria and confirmed by the
research of Kupate, in a segregated, poor neighborhood where heroin use is present. The use of certain
drugs seems associated to social strata. Participants in the research underlined that some drugs are used
mostly by rich people while others by poor people. They related marijuana, amphetamines and cocaine to a
life of entertainment and luxury, as publicized in the lives of many celebrities, while heroin was linked to
social degradation, illness and suicide. These representations might contribute to reinforce desirability of
“trendy” drugs but also to add weight to the stigma for those using “poor people drugs”. Participants in
Bulgaria observed that it is fashionable to use drugs among young people, and those who refuse to do so,
risk being labeled stupid or weak.
Another type of representations of drug use was constructed by “otherizing”, that is distancing oneself
from the image of drug users, who are depicted as different, unusual, in extravagant postures or outfits, or
16
even in racist terms, as “black people” or immigrants (mostly present in focus groups in Bologna). Women
with burqa were associated by one participant in Bologna as associated to cannabis, because the substance
comes from Muslim countries. In Venice, one participant “otherized” drugs as being characteristic of nonRoma, the gadji. Attributing negative characteristics, such as drug use, to other groups, can be useful in
reclaiming positive group identities for one’s own group of belonging, and escape being stereotyped as
drug users. It is interesting to notice that these antitheses (“us”/“clean”, “others”/“drugged” or “the poor
use heroin”/”the rich use cocaine”) appeared mostly in segregated contexts, where the pressure of
reclaiming positive group identities is higher.
There are also backdrops of this phenomenon: if some drugs are associated to desirable traits (celebrity,
richness) young people could tend to emulate this particular consumption in order to present themselves in
a more “positive” light. Similarily, in Venice, older participants (such as 20 or 25 years old), started using
drugs with an exclusively Italian group of friends. In this case, using drugs with non-Roma peers can signify
escaping the stigma of being Roma, a process often called “downward assimilation” to majority population.
As we saw, the perception of drugs can be considered a cultural trait, but it is not necessarily an ethnicallyspecific trait. It has to do with representations formed in a variety of settings, which include mixed settings
or the media. The perception on drugs, along with the information one possesses about their effects and
consequences, will also be discussed in the risk and protection factors section.
3.3.
Close social networks
This category refers to significant others, family and friends, the close social environment of youth, the
influence of these relationships on consumption, but also at a general understanding of the relational
dynamics that characterize Roma youth experience. It also refers to violence and manipulation as risks
sometimes deriving from close relationships. These topics emerged both in focus groups (where a specific
task was dedicated to the reactions of/to the family and significant others) and interviews (where we
included prompts regarding family relationships, couple relationships and so on).
Generally, we can assert that while for younger kids the close family is very important (mother, father,
grandparents), for the older, other figures gain relevance (peers, husband/wife, girlfriend/boyfriend).
Parents’ reactions to drugs would generally be negative. There was little communication with parents
about drug use in all contexts, young people felt ashamed of talking about consumption with their family.
Alcohol use was not tackled, while for tobacco, parents softly disapproved. The father was seen as a more
authoritarian figure, while the mother sometimes could offer help or warn children regarding the risks of
consumption. Much of the information offered by these adults was judged by Slovenian participants, for
example, as misleading and false.
Still, the most common reaction envisaged by young people if parents found out is violence and rage
(Spain, Bulgaria, Italy). Others were expelling their son from the house, or trying to force them into
withdrawal (Bulgaria). Regarding tobacco use, reactions include nagging, or trying to forbid it at the
beginning, but control often resulted ineffective.
17
According to young people, only few parents knew that their children smoke, while with other drugs
concealment was a frequent strategy. Participants quoted taboo or fear of repercussions as reasons not to
tell their parents about their consumption.
The father has been cited also as the consumer in the family (one case, in Spain), younger children
associated consumption to alcohol use in the family.
Siblings sometimes had a protective role (trying to prevent the younger from use), generally opposed to
consumption, but mostly did not talk with their brothers and sisters. The topic came out mostly in France
and Bulgaria.
In France, for those participants who were living in situations of vagrancy or prostitution, who also used
other drugs except for tobacco and alcohol, there was a wide gap between them, their activity and the
community. Resulting as the group who was more at risk, these participants could neither count on the
parental control nor on the social support of the family in case of problems with drugs.
In Spain and in Bulgaria interesting observations emerged regarding the relationships in the couple, for
those who are married. There seemed to be a difference between the dynamics in the couple between
consumption of the wife and consumption of the husband.
In Spain consumption by the wife, even of tobacco, was usually concealed. Two interviewed women quoted
a reaction of violence from the part of the husband, when they found out about wife’s drug use. In Spain it
seems women could expect a reaction of violence both from the family of origin, for younger girls, and
from their husbands (for the older ones).
In Bulgaria, married or engaged women used drugs with groups of friends, all women, friendships not
shared with the husband. One participant said that the reaction of the husband when he found out that she
was smoking marijuana was indifference, and even if he also used it, they did not smoke together nor did
they talk about it.
In the research carried out by Hesed, all male participants were married or engaged, except for one who
was divorced. For male participants who used drugs, all wives found it out by accident, and they opposed to
consumption, at first trying to help, then using threats of separation.
A central role was attributed to the peer group, which was the privileged group of consumption in all the
contexts, most often responsible for the initiation but also for maintaining the habit. Sometimes
consumption was initiated with peers in school, in all-Roma schools (Bulgaria), at other times with gadge
peers (Venice). This applies to the youngest as to the older. Peer groups could also be formed of cousins
(e.g. Bologna), and remained the main group where young people talk about consumption.
As many participants were excluded from work and education settings, leisure time is extended and is
usually spent in the company of peers, by “hanging around” (leisure activities were explicitly linked to
consumption in Bulgaria). In France, too, younger children (11-14 y. o.) agreed on negative reactions from
their families and siblings in case of drug use, while peers’ consumption was treated with indifference or
even celebrated.
The image of the peer group that emerges from local researches is mostly negative. The importance of the
peer group could also be seen as a potential for implementing peer-education programs.
18
3.4.
Services-community gaps
During the preliminary consultation focus the perception of services and Roma youth as being distant
emerged as a very important topic, linked with the next stages of the SRAP project, aimed at developing
prevention strategies. The factors included in this category try to explain the low access of Roma to health
and drug use prevention services, and the barriers in services use, from the point of view of Roma
youngsters.
One aspect to be underlined is that all participants in our research have already had some kind of contact
with social services, or at least with one of our partner organizations (or with its outreach workers). This
observation derives from our research strategy – we chose to base our work on previously established
relationships. This already excludes those who have never had any contact with services, thus our group
might be characterized by a better knowledge of these resources than the average population. While
assuming this limit, we can underline the general difficulty, in social research, in contacting persons who
have never been in contact with any service, because most types of fieldwork involve mediation with target
groups carried out by various organizations.
We have also seen in previous chapters that services available to people who use drugs are very different
from country to country, thus it is difficult to directly compare the situation in partner countries. We will
thus present them separately.
The initial observation of gaps between services and Roma drug users was extensively confirmed by
participants’ opinion. This is associated to a lack of information, or to imprecise, distorted knowledge
about drugs, mostly coming from the peer group. Some exceptions are: Spain, where some participants
mentioned local services specialized in addiction, Venice, where many knew the SERT6 (but also because
most of the ones who were interviewed were already users of this service), and in Bulgaria – knowledge of
methadone clinics. In Slovenia only, participants affirmed to have received information about drugs and
their health effects in school.
In Italy, Bologna, participants showed low knowledge of specific services for addiction cure, accompanied
by low trust. In Venice, distance and silence between services and users is present. The older know the
SERT service, thanks to presentation and accompaniment by outreach workers. The importance of outreach
workers (who in Venice are non Roma), is to be underlined. Information about services is also transmitted
in ethnically mixed peer groups.
In Bulgaria, the conclusion both from Hesed and from Kupate is that IDUs have knowledge about drug
abuse treatment services. Still, there are barriers in accessing the methadone programs, such as the
criteria to enter or the scarcity of places. The methadone programs and the Harm reduction programs for
needles and syringes exchange are the only well known programs due to their settlement in the Fakulteta
Roma neighborhood, where research was carried out.
Hesed also noticed that there is no knowledge of prevention programs, while young people have little
correct information on drugs.
6
SERT (Servizio per le Tossicodipendenze) is the public service provided by the National Health System in Italy
dedicated to addiction treatment, prevention and rehabilitation.
19
Participants in France, have little knowledge of service providers – only one person knew about specialized
treatment, because he has already been there. Other participants stated that for problems with drugs they
would go to the emergency room.
In Slovenia participants did not know who they would turn to help to quit smoking, for alcohol problems,
instead, they would turn to the general practitioner. Police might be called in for intervention in the
community, to calm down intoxicated people.
In Spain, the UCA and the UMAD (structures for dealing with addiction in Santiago and respectively,
Valencia) were explicitly mentioned, along with FSG as a source of support. Among the suggestions,
participants stated that more information about drugs is necessary.
One of the proposed solutions to resolve the services-community gap refers to the use of mediators, as
thoroughly detailed in the FSG report (see paragraph Errore. L'origine riferimento non è stata trovata.).
We can conclude that there is a wide need for targeted prevention programs, in order to cover the gaps in
the information about drugs, but also that promotion of existing resources is scarce and needs to be
improved.
3.5.
Health risks & protection factors
This category refers to psychological preconditions, individual level consequences, knowledge about drugs
and access to information. This category also included some specificities of growing up as a Roma boy or
girl, like the quick transition from childhood to adulthood. We also included here associated risks, like
sexual risks or exploitation.
Unemployment, social exclusion, low education dramatically influence consumption, especially in
marginalized social contexts. Using drugs can thus come to mean escaping difficulties, as participants
stated.
Having a lot of spare time which is usually spent with peers and, in many contexts, for consumption is also
one of the risk factors (as it emerged in Bulgaria and Slovenia). In Spain, some mentioned sports as a peer
activity that keeps one away from drugs.
Knowledge about drugs and consequences. In all contexts some health, psychological and relational
consequences of drug use were quoted in different measures by participants. In Bulgaria, IDUs were well
aware of some of the negative consequences of heroin use, because they experienced them, but the
consequences of the use of other drugs, such as cocaine, amphetamines, marijuana, were underestimated.
The feeling of being addicted, suicidal and hopeless weighted in the negative view of the future IDUs
shared.
In Bologna, low knowledge of consequences was also observed. Participants believed that tobacco
provoked cancer, other drugs lead to madness, alcohol increased vulnerability, while marijuana was
harmless. In Slovenia, anxiety was often quoted as connected to drug use (use to lower anxiety or
withdrawal associated to anxiety).
Positive effects of drugs were quoted (e.g. Bologna, France), often hyperbolic. In France, girls tended to
minimize their own consumption, while boys, to brag about it.
20
As mentioned earlier, consumption was generally associated to the group of peers, but if differs for some
drugs (some examples for alcohol and cannabis that were also used solitarily). This aspect can be a risk
factor (e.g. peer pressure is important for initiation), but the peer group can also be the main source of
knowledge regarding drugs.
There is a difference between the knowledge of older participants (17-25, recruited as consumers) and the
representation of consequences by younger children (11-16), with less experience with drugs. In Bologna,
for example, younger participants saw the use of alcohol as becoming crazy, dancing, jumping while use of
other drugs as making people sad, shaky or almost ill. They relied largely on the experience of consumption
of adults they knew.
Often children are exposed to adults’ consumption, sometimes family members who use drugs become
role models (Italy, Spain). In France, one participant evoked a story of family violence of an intoxicated
parent when talking about alcohol. Childhood experiences of intoxicated adults also convinced some to
resist the use of drugs.
Legal problems and involvement in illegal activities, as illustrated by participants in Bulgaria, could add
other types of risks to drug consumption. Some participants were or had been involved in illegal activities
like housebreaking, theft (Bulgaria) or prostitution (France).
Family’s reaction, as mentioned previously, would often be made of violent behavior, even though
sometimes family could offer, in some of its figures, dialogue and information.
Easy access to drugs was also underlined as a risk factor, especially when living in areas of drug traffic.
One of the risk and potentially protection factors is the availability and knowledge of services, detailed in a
previous paragraph.
3.6.
Patterns of consumption
Our initial belief that Roma youth knew other drugs, not just of tobacco and alcohol, was widely confirmed
by the results. In this paragraph we will present the main characteristics of drug consumption, which
emerged especially in individual interviews with older participants (aged 17-15), who were recruited as
consumers. If, in the previous paragraphs, we underlined that different types of drugs are known and thus
are present in the circles that young people frequent, in the present paragraph we will refer to actual
consumption: first consumption, frequency, contexts. As the dynamics of consumption associated to each
drug seem to be different, we will treat them separately.
Tobacco. In all contexts tobacco consumption sets off at a very early age (11-12 years), or a little later for
girls, but the difference was only mentioned in some contexts (13 years, for example in Bologna). The peer
group initiates to tobacco use, some young people acquire tobacco with older peers or from their own
family. The family usually was considered to have ambivalent reactions to tobacco use: they did not agree,
but they did little to stop it. Tobacco consumption was present by itself, or associated with occasional
alcohol use, and did not necessarily lead to use of other drugs, although in some cases, tobacco
consumption and marijuana consumption were seen as equivalent.
21
Alcohol. Occasional consumption of alcohol, for boys and girls, without recurring to other drugs was
referred. At social moments and gatherings most people drink, but the range is from a couple of drinks to
serious binge-drinking. While in most contexts, the age of first consumption was identified to be 13-14
years (for boys), in Venice young people claimed to start drinking already from 9-10 years old, while in
Bulgaria, at 11. In Spain, researchers underlined the presence of increased consumption during the
weekends (which is a very widespread pattern in contexts other than Roma communities). Some
specificities of consumption by girls was underlined in Slovenia (the familiarity of girls with mixed drinks)
and in Bologna (where girls start drinking later than boys, and consumption is hidden, in groups of girls
only).
Some participants in Venice underlined the excessive consumption by adults living in the village, at parties,
where mixing with cocaine was present.
Cannabis. Cannabis was the next best known drug after alcohol and tobacco and its use was considered
wide (although at times it was not identified as a drug at all).
In some cases, cannabis consumption is related to extending friendships outside of the community (as in
Bologna and Venice). In these situations, Roma young people smoke with gadgi friends outside of the
camp.
In the case of immigrant Roma (as in France), initiation to drug began after the arrival in France, in peergroup contexts.
Generally, cannabis is considered to be harmless and participants using it didn’t perceive themselves as
addicted, except for a few cases. In Bulgaria, several participants reported using it more than three times a
day, but only one women user identified herself as an addict, and has tried stopping for several months.
Cannabis was consumed either in group, or individually, and was described as a way to deal with anxiety, to
calm down, to relax or to sleep.
Heroin. Heroin consumption emerged as problematic in Bulgaria, especially in the Fakulteta neighborhood,
but also in Venice and in Spain. This is not new to the social workers, as many of these participants have
sought help or used harm reduction programs. As mentioned previously, there is a needle exchange
program based in the Fakulteta neighborhood in Sofia.
Many users in Bulgaria (Hesed) started using directly heroin, around 14-15 years, and prefer it to other
drugs, sometimes used with amphetamines. Consumption started by smoking, but as it progressed, lack of
money and tolerance leaded to intravenous use. The usual consumption was 2-3 times a day, intravenous.
The only drug-free situation was lack of money, and lack of the substance was sometimes compensated
with the use of medicines of similar effect (methadone, diazepam).
Some participants in research carried out by Kupate in Bulgaria stated that in order to protect themselves
from overdose, they use small doses. They also underlined the wide availability of heroin (other drugs, too)
in their own neighborhood.
In Venice also, there is a worrying presence of heroin in the community studied. Some described having
used first marijuana and subsequently heroin, without trying or being interested in other drugs.
Heroin users were usually very aware of their addiction, have tried to stop, but only for short periods, and
think that the only way to come out of it is to have better opportunities for a “normal” life (like having a job
or a family).
22
Cocaine and other drugs. Recreational use of cocaine was accounted for in Spain, Bologna, Venice.
Amphetamines were used in Bulgaria, benzodiazepines in Bulgaria and Spain, ecstasy and hallucinogenic
mushrooms in Spain. Most of these were used as recreational drugs, at parties, with groups of friends, and
most often, in mixes. Generally, the consequences of these substances were underestimated. Some said
they “tried everything” but don’t use regularly.
Mixes. Poly-drug consumption was common among all consumers interviewed, either simultaneously or
not. Mixes participants talked about were:
-
Tobacco consumption with maybe occasional alcohol consumption;
-
Cigarettes and marijuana or both plus alcohol (France);
-
Benzodiazepine and alcohol (Spain)
-
Amphetamines – once a month, at parties, with alcohol and marijuana (Bulgaria).
The importance of self assessment and self reflection is to be underlined. Except for heroin users, most
consumers did not perceive themselves as addicted.
We could thus see that there is a high variability not only between contexts, but also within the
communities, regarding the patterns of consumption. On the one hand we saw heroin use, which seemed
to stand out as a pattern on its own due to its devastating consequences and implications, and is present
mostly in Bulgaria and partly in Italy. While heroin use was somewhat tackled by services and was
accompanied by higher awareness of consumers (although they perceive themselves as hopeless), use of
other drugs, although highly present in all contexts, was not tackled by services and most of the times
consumers were not aware of the consequences and did not perceive themselves as addicted. Another
pattern links cannabis consumption (in Italy mostly) to friendships that are not exclusively from the ethnic
group, thus coming to bare the meaning of a context integration beyond ethnic boundaries. Recreational
drug use and binge drinking during weekends and parties was another pattern that was not exclusively
related to specifically Roma environments, but widely present in other social contexts. Tobacco and alcohol
use are problematic especially for the age of initiation and relative permissiveness of the group.
Further on, conclusions in each partner country will be detailed7, comprising two types of ideas:
conclusions formulated by researchers from our partner organizations who carried out the research and
conclusions drawn by various local stakeholders from our research results.
7
The following paragraphs comprise the conclusions section of each country report. For the complete national
reports, consult the long report.
23
4. Local conclusions
4.1.
Italy – country conclusions
Linguistic minorities in Italy are protected (sixth article of the Italian Constitution), but in the current
national legislation (law 482/1999) Romani language is not included, disregarding international
recommendations (Dell’Agnese e Vitale, 2007). Institutional discourse refers to Roma and Sinti as
“nomads”, but does not clarify or state what this label means and whom does it refer to.
Spinelli (2003, quoting Liegeois, 1998), proposes an estimate of 150.000 Roma and Sinti present in Italy.
According to this estimate, 50% are Italian citizens, while the rest immigrated in Italy in different waves,
starting from the sixties. These are citizens of ex-Yugoslavia, Albania, Serbia and Romania. The most recent
arrivals are from Romania and reached their peak around the year 2000. Thus, we can suppose that the
above number incremented by little.
In Italy there is no declination of the plural identity of the Roma ethnicity at the institutional level, which
generated significant consequences. The heterogeneity of the Roma population and the widespread
discrimination in Europe and Italy has lead to serious difficulties in proposing policy for this population. One
problem refers to the scale of public action: there is no European norm for the protection of Roma
communities, but recommendations and resolutions have been formulated. In Italy, the general strategy
was to develop local policies on the basis of regional policies, thus there is a lack of national level policy
dedicated to Roma and Sinti (Dell'Agnese & Vitale, 2007).
The so-called “nomad camps” were introduced in the beginning of the eighties and intended to protect the
right of the nomadic groups to stop and park on local territories. Instituted by local and regional legislation,
they remained the main response to the presence of Roma and Sinti, even with the arrival of immigrant
populations, bearing different traits than the local ones and definitely not nomadic. Today nomad camps
host stable populations, of different nationalities. In most Italian cities and regions there are camps
managed by the city halls and social services (“authorized nomad camps”), but often we can also find
“abusive nomad camps” which refer to squats or occupied areas where illegal immigrant Roma live.
In Emilia-Romagna region there are 14 authorized nomad camps, inhabited by Italian Sinti (82%) and EastEuropean Roma (16%). The Regional law number 47, issued on November 23, 1988, institutes the
regulations for nomadic minorities in Emilia-Romagna. As part of the protection of ethnic minorities on its
territory, the Emilia-Romagna disciplines the presence of Roma and Sinti, intending to contribute to the
implementation of the right of travellers to transit and park, while not precluding goals of integration in the
regional community.
These aims are pursued by:
a) activities to promote the protection of forms of expression, cultural traditions, art and craft of
production typical of nomadic peoples;
b) carrying out-equipped rest areas;
c) the development of transit areas;
d) implementation of-equipped rest areas to use;
e) professional training and implementation of the right to education;
24
f) measures to help people craft activities.
In the achievement of the purposes aforesaid Emilia-Romagna Region contributes by awarding grants to
municipalities and associated individuals the role of purchasing parking areas, and transit areas, in view of
infrastructure construction in these areas.
The law that regulates nomad camps in the Veneto region, instead, is law number 54 issued on December
22, 1989. Venezia hosts one such “village” with 120 persons. In the Veneto region, instead, there are about
15 camps in the provinces of Venezia, Padova, Verona and Vicenza.
We can see that, in both local contexts, regional legislation regarding Roma minorities is obsolete, issued in
the late ‘80s, thus before the post-socialist migration of Balkan and Romanian Roma and before EU
enlargement. Reviewing these provisions is highly necessary in order to update to the more recent changes
in Europe, but also to address EU warnings against the “nomad camp” policies across Italy.
In camps, great attention is given to children’s access to education (e.g. in Bologna 91% of children
between 6 and 14 years old go to school). Still, nomad camps remain ethnically segregated spaces, and thus
social apartments or other arrangements are preferable as living solutions in a context of integration. In our
research, we included families who live in social apartments, beneficiaries of housing integration projects,
who show different social situations from those living in the camps.
There is no specific National health policy for Roma and Sinti, as the National Health System has a
“solidaristic and universal character” (Ministero della Salute, 2008). Still, access to health services for noncitizens is determined by the legal status of the person - regular or irregular migrant, resident or nonresident. For resident Roma and Sinti, the services of the National Health System are fully available,
including hospitals, medical centers, general practitioners, specialized practitioners and the SERT (services
for addictions). Non-resident citizens8, instead, only have the right to emergency services, but can access
private, charity structures or low threshold services. In Bologna, for example, they can access an open, free
and private clinic, which counts up to 145 patients an year. Moreover, low threshold and outreach services
for addictions are present both in Bologna and Venice.
Access to social services is also conditioned by having regular residence in the city, except for urgent
actions or actions that cannot be directly carried out by the state or region of residence. Some services
available for non-residents too are shelters, drop-in, minors centers for out-of-family care, outreach units
on the territory.
The prejudice that sees the Roma as having a low access to health care for cultural reasons has not been
confirmed by research carried out in Italy. People seem to be well aware of their health problems and
would like to have an easier access to health services (Monasta, 2010).
Few studies were carried out on the health condition of the Roma living in nomad camps in Italy, and they
underline the precarious health situation of the Roma population. Life expectancy is generally lower, there
8
According to the law for foreigners (law decreet 286/25 july 1998, Unique text regarding the immigration
discipline and norms on the condition of the alien and the Ministry of Health circular n. 5 issued on 24 march 2000 –
Application indications regarding the law decreet issued on 25 july 1998 n. 286 – Dispositions regarding medical
assistance) the right to medical assistance (which is only one of the possible declinations of the right to health) is
guaranteed to immigrants and their families who are registered with the National Health System and are regularily
present on Italian territory. Registration with the National Health System is thus linked to having a regular job. The
situation gets even more complicated, with differences in regulations between different Italian regions, for Roma who
are citizens of a European state, but are not registered with the Italian National Health System.
25
is high risk of cardiovascular diseases and high blood pressure (as indicated by a study conducted by GualdiRusso between 2000 and 2003 in Bologna). In Lazio region, the Epidemiological Observatory indicates that
“nomadic” populations have 18.4% of underweight births (compared to 5.7% in the general population), 9%
infantile mortality (compared to 5.6%), 24.2% mortality in the first year of life (compared to 9.4%). Data
collected by the Institute San Gallicano in Rome between 1999 and 2000, warned regarding several
worrying tendencies registered in the Roma and Sinti population: the spread of infectious diseases, HIV
infection, sexually transmitted diseases, drug addiction, care in pregnancy and induced abortion.
Few local actions have been implemented in Italy for Roma and Sinti but they do not have a specific focus
on drugs (but refer mostly to vaccination campaigns and improving access to health services). To this day,
we do not have data generated by studies and investigations at national level on the consumption of legal
and illegal drugs - marijuana, cocaine, heroin, alcohol, etc. in the Roma and Sinti communities in Italy.
SRAP research phase in Italy intended to cover the gap in the information available to professionals for drug
use prevention. It was conducted in two contexts: city of Venice and city of Bologna. In Venice, the research
was carried out in a municipality village for nomads hosting 40 houses, and with 30 families who were
transferred in social apartments. The nationality of Roma participants was Croatian, German and Italian.
In Bologna, instead, the research was carried out in a camp hosting 29 families and with some families living
in social housing. We did not, at this stage, analyze situations of irregularity or abusive housing, although a
team in Bologna established contacts with some families abusively inhabiting agricultural lands, which
could be a focus of future actions.
In both contexts one of the most important factors in carrying out research was the existence of previous
trust relationships with participants. Building such relationships is a matter of time, and in absence of trust
approaching such issues can be difficult and long, if not impossible. In Venice, some of the participants
were recruited with the mediation of other services, which led to difficulties in obtaining rich information
about drug experiences. Sometimes participants had a defensive attitude regarding the use of drugs in their
communities, minimizing the presence of substances, alcohol included. It can be due to the general
disapproval of drug use in these contexts and can lead to hiding consumption and not seeking help for
problems related to it.
In Bologna, many girls participated in research, as opposed to other research contexts. Girls were also more
willing to address drug consumption issues, seemed open and available. This was also due to the
characteristics of the context of the camp in Bologna, where generally boys are less numerous.
Reaching the intended numbers of participants was generally difficult and selection was largely dictated by
the availability of persons willing to be interviewed.
Regarding the topic of cultural attitudes towards drugs of Roma in Italy, both contexts revealed a general
disapproval of use and abuse, the topic being taboo. Nonetheless alcohol is largely consumed, especially in
community celebrations. Disapproval is stronger for the consumption by girls, which leads to hidden
consumption, with serious implications for addictions prevention and cure.
Youth who live in non-segregated contexts (e.g. social housing) generally feel more free to talk about drugs,
so it is potentially easier to address interventions and prevention programs. Use by youth living in these
contexts is linked to non-Roma peer groups, while for youth living in segregated communities, their
experiences take place usually within these contexts, with cousins for example. The importance of the peer
group is once again reasserted, for the initiation and for maintaining consumption.
26
The family is seen as the main resource in case one experiences drug problems, and only if this fails, one
would seek external help. This indicated the importance of tackling, in prevention programs, family capacity
in dealing with members’ drug problems.
In Bologna, the role of the Evangelical church was also underlined, especially in preventing the first use of
drugs.
Distance between specialized services and the communities was attributed to scarce knowledge of their
offer for the part of Roma and Sinti youth, but also to the limited intercultural capacity for the part of the
services. On the other hand, the ones who already had contacts with Sert (specialized services for dealing
with addiction) assert their usefulness and would recommend it to others in case of need.
The knowledge of drugs and their consequences is generally scarce, drugs are known by myths and
collective imagination. Positive effects are often over-evaluated (e.g. disinhibition, sociability, fun, energy
or strength).
In the patterns of consumptions of Roma and Sinti youth in Bologna and Venice, the age of initiation
appeared to be very low, especially for tobacco and alcohol. At the age of 11 or 12 girls and boys start
smoking, while the first alcohol use appeared to be at 9-10 years in Venice, while at 13-14 in Bologna. For
girls, first consumption of alcohol can occur a bit later (16 years).
Gender differences are very strong when it comes to patterns of consumption, reflecting both social norms
and parental control for girls. While for boys consumption of alcohol sets off as an initiation by an older
male adult, for girls it usually occurs in feminine groups, and it is hidden. Rarely girls go on experimenting
other substances, while boys can carry on with cannabis and other. Cannabis consumption spreads in
manners and contexts similar to that of non-Roma, while ecstasy and cocaine are tested with friends at
private parties or at beach parties.
In Venice, instead, heroin use was also present, assumed by inhalation, besides cocaine and cannabis (the
latter more widespread and seen as harmless), while synthetic drugs were not quoted. Cannabis
consumption occurs, in this context also, in ethnically mixed peer groups, and can be seen as a habit that
Roma acquired by contamination from the gadji.
To conclude, prevention programs in Venice and Bologna should pay careful attention to:
o Young age of initiation;
o The problem of taboo and thus of the inaccessibility of consumption in some situations.
What derives is that prevention workers should work in a framework of active, nonjudgmental listening. Even if trust relationships are necessary in building effective
interventions, the fact that the prevention worker is not a member of the community can
be of help in managing dense relational networks (between the inhabitants or in the
extended family) associated by the user to fear of stigmatization.
o The importance of transmitting accurate information on substances, on the consequences
of use and on the existing services.
o If drug use is seen as the assimilation of a non-Roma habit, attention should be given to
proposing contexts and activities of non-segregated interaction between young Roma, Sinti
and non-Roma. Interventions would benefit from being organized outside the camps.
27
o Enhancing services capabilities for working with this target, using mediation and peer social
workers, while offering them specific training.
o Traditional prevention channels (e.g. high-school based prevention) might not be effective
in reaching targets over 14 years old (who register a low school attendance). Programs
should already begin in secondary school.
o Consider the differences between living contexts (camps versus apartments) for what
regards consumption but also the willingness of young people to get involved in prevention
programs and dialogue about drugs in general.
4.2.
Italy – Bologna9
4.2.1. Conclusions formulated by professionals
Services and professionals focus group was organized with 19 participants from services dedicated to the
Roma, drug prevention or addiction cure. Although the high number of participants hindered the dynamics,
some very interesting conclusions emerged from their reflection on our research results.
Professionals found it interesting that many aspects that emerged regarding drug consumption in Roma
communities are very similar to those of non-Roma youth. The contexts and the types of groups where
they enter in contact with drugs were considered similar to their non-Roma peers so the idea was that
services who carry on peer-education activities should include Roma youth in their targets.
Even if similarities with non-Roma youth were strong, there were still some specific aspects for youth in
Roma communities, like the strong connection with the families, stronger gender differences, entering
adulthood early, with the creation of their own young families.
An important aspect was the positive response of parents, who all agreed and signed the informed consent
for participating in the research. This was surprising for professionals, as they thought some communities
were very closed and thus reluctant to collaboration, especially on the sensitive topic of drugs.
Professionals realized that many of the barriers were due to stereotyping and prejudice, and that Sinti and
Roma do not need “special services” but should be encouraged to access services outside of their
segregated living space (the camps). Mass-media prevention campaigns could also work they noticed, as
Roma youth do use new media.
They concluded they found it more useful to analyze the situation based on similarities with other groups
and not on differences, which were often stereotyped. Most of them agree that interventions should be
carried out outside of the camps, and that professionals should be trained to overcome prejudice.
As a group who suffers from being stigmatized, young Roma should benefit from programs that also aim at
increasing their self-esteem.
9
Research and report by Coop. Dolce
28
One observation is that creating and applying prevention strategies is very difficult when the situation of
the communities is problematic under multiple aspects: schooling, employment, and poverty in general are
amongst the priorities of intervention in these communities. Thus, social problems should be addressed in a
holistic manner. Nonetheless, one participant observes that very often these are addressed in providing
welfare framework, with little attention to the collaboration between the Roma and the services.
Despite previous experience of educational interventions in Sinti and Roma communities, and especially in
camps, places where intervention is more complex because it takes place in a private space, the work done
during the SRAP project confirmed good practices and brought out some very interesting aspects to take
into consideration for future prevention interventions.
4.2.2. Research conclusions
The issues addressed by the project, namely the use of substances, are very complex and delicate to be
treated inside camps where drug use and trafficking is widespread and sometimes represent a source of
money for many families. In light of this, our intervention has required a greater effort to the staff, to be
accepted, listened to and respected by this community.
First, it confirms the priority to establish a "good relationship", in short time, giving space for conviviality
and mutual understanding. It is not necessary only to know people who live in the camps, as often happens.
The social workers have to make themselves known and tell their stories, without giving personal
information about themselves; however, he/she enters into someone else's home and so he/she must
present him/herself.
The social worker needs to demonstrate himself nearby, helpful but not like a friend, he should not be
allowed as a peer, or as a relative. In order to build a relation of trust, we must pay close attention to
these balances.
For Sinti people, as Roma people, the hospitality is important and sometimes in a short time they tend
to make "friendly relations". However we have to remember that at this stage of the Project they are
very careful and scrutiny the operator, they want to know him, to see if they can trust, or ask specific
help, relying on the hypothetical relationship just built.
Mediation. When conflict takes place, one should try to mediate, understand the criticism and refrain from
judgement.
It could be very compromising to expose another person. What happens is exactly the same that happens
between gadji, however, in these communities is amplified taking into account the importance of the
family. Social worker should forge strong relations, while keeping a certain distance, appearing and feeling
assertive.
Authority is another important aspect, sometimes difficult to combine with strong ties, however, in order
to obtain the support of the community you should not be intimidated or hesitant. Head held high with
humility and respect towards the people with whom you relate!
29
Good knowledge of the issues to be addressed. Whit SRAP Project the operators have earned the
confidence showing that they were aware of substances, effects, places of consumption, common mode of
consumption.
The participants who were interviewed, made abundant use of multiple substances. Some have moved
away from that world, but they know it well, and it would be interesting to involve them as mediators in
preventive work. However, the peer educator is a delicate figure, which not necessarily acquire more
credibility and authority in the eyes of peers.
The same interviewed boys showed some scepticism when we proposed a collaboration, because they
could find themselves in an uncomfortable position, continuing to live in the camp, halfway between the
operator, institutional figure and Sinti / Roma users of substances.
In any case, a confrontation with them would be very good for social workers, in order to study the best
way to inform and prevent. As affirmed a Sinti boy during an interview, "is not necessary to be a peer to talk
about certain things, it may well be a gajio and perhaps is even better, but he must know what he's talking
about" (Interviews Sinto “Becks”, M, 21 and Interview with “Timoteo”, M, 23). If the social worker does not
know the substances and methods of approach, he/she does not gain credibility in the eyes of users.
It's necessary to be able to reach young people, know their relational dynamics, their places, to understand
their approach to substances. Specifically, it’s necessary to know adolescents, as big differences were not
revealed in research between gadji and Sinti.
The fears, modalities of relationship, the reasons of the first approach, i.e. wanting to feel older,
appearance, the desire to integrate into the group, are exactly the same things that arise between any
groups of adolescents.
However, their knowledge of the substances is very superficial, even for those who have tried them. They
do not know exactly what ingredients the drugs contains, or what the drugs are, much less the damages
provoked by consumption.
The younger ones refer to stereotypes and to hearsay, like many girls also do. Older ones, who have tried
ecstasy, cocaine, hashish, generally refer only to the sensations or side effects they experienced.
One first way to conduct prevention is to begin to talk about these issues, to inform, to create curiosity.
Unlike the stereotype, Sinti proved to accept with pleasure interventions for the health of their children.
It proved very important to involve children aged eleven and more, because at that age they begin to
smoke cigarettes. In the camps, as in the street, boys aged 13 or 14 have already tried alcohol and some
more than alcohol. Participants of this age identified the need to know aspects regarding the use/abuse of
new drugs, substances on which they have scarce information. They also mentioned drugs such as Red Bull
and their widespread consumption.
Interventions for prevention should be carried out outside the camps, as well as many other activities.
Children and young people want and need to leave the camp, to try new things, to play. All the girls have
agreed to participate in the project mainly because we planned to go out of the camps, where they are
confined every day! Parents were pleased that their children were involved in something different. Once
we built confidence, they were happy that their boys and girls could live experiences different from the life
in the settlements.
30
However, we have to ensure continuity of action to avoid a sense of abandonment once the project ended,
as often unfortunately happens. These communities already feel marginalized, so it would be desirable to
avoid creating a sense of exclusion and abandonment once the project ends.
The family emerged as central in the life of young people, as they would turn to the services only when
they don’ have a strong family support. In light of these statements, it would be important first of all to
inform the families about the services on the territory and how they work.
Tools should be given to families, by increasing awareness among adults in prevention intervention
involving parents and the whole family. Problems are usually treated into the family, and young people
primarily come the family to ask for help.
Young Roma start drinking, smoking, using drugs in situations of distress, just like the gadji. They may start
if they do not know what to do with their life, if they have no possibilities, no life project. Interventions that
tackle employment are unfortunately short term and lack planning. There are high levels of unemployment
among Sinti, and thus some are constrained to work in informal and illegal markets. Low knowledge of their
rights and duties as workers pushes them to the black labour market and sometimes, to work in the illegal
drug market.
In our research participants strongly expressed their dreams and desires to be able to build a “normal
future”, which for them represents having a house, a family and a job.
______________________
During the course of SRAP project we came in contact with other realities, which we had not foreseen as a
target.
Within the Sinti community in Bologna there is a segment of the population that does not live in the camps
opened by the Municipality.
These are extended families who consider themselves "nomad" or "Sinti" but live outside the areas
allocated to them by the Municipality.
They bought with their own means some portions of agricultural land on which they have built mobile
homes and have parked their caravans.
Actually there is a dozen of these "micro-areas": families living in caravans and work as hawkers,
roundabout attendants and food vendors. They work not so far from Bologna with their roundabouts and
they usually sell hamburger with their vans during country fairies or concerts.
Living in these areas is illegal because it is a space reserved for agricultural activities.
In order to talk about addiction, use and abuse of drugs it was necessary first of all to tackle the issue of
living conditions. One of the most important point of SRAP project is “health”, which also means “living
well, in a safe way”, so you can’t live well if you feel threatened to lose your home because it is illegal. And
also you can’t talk about prevention to drugs if you’re worried about your home.
31
So, during the SRAP Project we decided to dedicate time for knowing better these families in order to solve
together their problems with the condition of their home.
32
4.3.
Italy-Venice10
4.3.1. Conclusions formulated by professionals
The focus group with professionals was held at the Council of Venice City Hall. The first part of the meeting
allowed participants to understand, in a general manner, how Sinti and Roma often access services and
how they want to present themselves in the eyes of others.
For Kossovo Roma marriage is perceived as a solution to their problems, the moment that marks the
passage from a life of fun to a life of responsibility. They do not want to be identified as Sinti or Roma but
they care a lot about integration, and often hide their origins, especially the women, as if it was a negative
attribute. They claim it only for instrumental reasons.
Italian Sinti, instead, are often very proud of their ethnic belonging, and strengthen it. It is also the case for
many young boys and girls born in ethnically mixed families, who use their ethnic belonging to evoke traits
of male bullying.
The SERD data indicates that many young Roma arrive to them signaled by the Prefecture for illegal
substances possession. They often arrived accompanied by their entire family, that pushes for cure. This
method brings compliance to treatment in the initial stages, but family tends not to participate in following
stages or at parent therapeutic groups. Another motivation for accessing the Serd is the possibility to
lighter or attenuate a criminal penalty, even when alcohol consumption is not authentically, but
instrumentally perceived as problematic.
Services professionals believe that in the Chirignago (Circus) area, smoking cannabis is seen as a wrong
behavior by youth and there are only few who do it. On the contrary, in our research we found out that
cannabis is a drug used for showing an older appearance and is familiar, just like smoking a cigarette.
Girls are not seen as consumers by professionals, except for tobacco consumption. The biggest perceived
problem with girls are youthful marriages and pregnancies. Thanks to the focus group we could explore
how girls see themselves, their environment and drugs, even if they can feel more blocked than boys in
situations where they have to reason on themselves.
Professionals underlined that in order to create a trust relationship with services users it is important to be
present on the territory. Very often social workers propose deals: “I can help you if you enter a program”.
Regarding our research results, professionals considered that:
-
They don’t see great difference between the behavior of Sinti/Roma and gadgi in the way they
participated in focus groups.
-
There is a strong protection from the Sinti/Roma community, especially towards women;
-
They confirm our research results, which they recognize as typical of their work experience;
The group did not propose urgent actions, the only advice was given by outreach workers, and referred to
the importance of designing street-based interventions, where social workers would try to meet young
Roma: “often outside a supermarket gathering information and emotional states can be easier” than
10
Research carried out by the Municipality of Venice
33
waiting for them to access services. All agree on the fact that specific services designed for Roma and Sinti
could not work. It seemed that the image we evoked with our research results was a clearer picture of their
previous impressions.
Participants also agreed on the fact that in judging phenomena to target when working with Roma youth,
drug use would not be the top priority, rather they would work on intergenerational dialogue and
adolescence.
4.3.2. Research conclusions
In Venice we noticed that some cultural aspects are very similar to those of Italians, Roma people are
reserved when talking about drugs and certainly do not enjoy advertising their "misfortune". The
representation of illegal drugs is related especially to sickness, while they seek solutions inside their closest
networks. In the case of the village environment, the fear of even more negative representations to a
community who is very stigmatized, leads to an underworld where problems are hard to detect.
In services, there is certainly a lot of confidence despite years of work within the village. Services that have
worked there over the years took care of aspects of logistics, conflict mediation, economic support, rather
than school support and did not create a fertile terrain for clarifying other issues. More than in services
there is an obvious trust in people – social workers suggest that in the future we must make use of
mediators who already have a strong relationship with the target group to be able to introduce issues,
using existing resources and ensuring continuity after the project. On the other hand, of fundamental
importance is the involvement of peers in the sharing of objectives of the project and at least in the early
operative starting stages. We understood that the ordinary channels of prevention regarding these issues
have not reached this target group. If we think that the school and especially high school years have been
the subject of preventive methods or other stimulus and dialogue on drugs, we understand that those who
do not access the topic in high school remained uninvolved. Only recently a few (very few) schools have
introduced the topic of alcohol and tobacco prevention.
Certainly in our next action we will not consider high school as a place of contact with youth. For those in
the age group 13-15 we will have to separate or create a less structured situation in which to foster a
"hook" not necessarily starting from the drug issue.
Despite the village appears as a more "protected" environment because of its internal culture, compared to
those who have chosen the integration in the apartments and cultural "contamination", we are not sure if
this is true for consumption too. Certainly, the teenager who is out of the village is a little more openminded and less fearful of the family, understood in a wider sense, but this does not mean that those living
in the village are not in contact with the habits and customs of the area. Access to any type of substance in
the general youth population is very easy, although groups of young people mingle and attend places of
entertainment common to the whole population where prevention programs already exist, that is why we
consider we shouldn’t force teenagers (15 – 18 years) to participate in the activities (difficult to manage)
but rather to provide them with informational materials, if possible built or reviewed with peers, and to
make available social workers that know them better and can work in interviews and / or special meetings.
34
For younger kids still in high school, the context of the school can be used as a place to treat the drug issue
in a play mode in general with the particular aim of freeing the subject from the cultural taboos
surrounding it.
In order to facilitate the dialogue and the emergence of possible problems related to consumption, in our
opinion it could be useful and interesting to form services involved with this target that do not have a
specific focus on this issue. Often the lack of knowledge or even judgmental stereotypes of social workers
do not facilitate the emergence.
Drug services as they are structured and recognized in our area that is useful to propose them to an older
target group, so that parents can use it for their children or themselves or to take more care if any
problematic situations occur. For the distrust that emerges it is more useful to discuss the issue of
prevention, as provided by the project workers who encourage and maintain relationships of trust and then
introduce the issue.
At this time the knowledge of services and their offers on the drugs issues must be an opportunity in case
of need and not as a response to a need that others have rated as submerged, otherwise the additional risk
of closure is high.
4.4.
Bulgaria – Sofia11
Summarizing the main results and finding of the research, the following recommendations and suggestions
for further preventive program should be taken in consideration:
11
12

It is necessary to raise the awareness of Roma youth on all aspects of the behavior of
addiction. Individual and group work is needed for developing (1) skills for self-monitoring, selfreflection and self-control, (2) more effective coping strategies for frustrating everyday
situations, (3) internal motivation to stop the drug use and to overcome the behavior of addiction
and (4) skills to plan and achieve long-term goals;

The most powerful change in the behavior of adolescents can be achieved in changing the norms in
the circle of friends and by the development of adequate communication skills related to this topic
in the family members – between the parents and the child as well as between the wife and the
husband;

In the field of drug use prevention among Roma community it is crucial to improve the level of
correct knowledge about the essence and the impact of the ATOD12 for the human physical and
mental health;

The drug abuse treatment services are known only by the IDUs - heroin addicted participants. The
methadone programs and the harm reduction programs for needles and syringes exchange are the
only well known programs due to their settlement in the Faculteta Roma neighborhood.
Research and report by HESED
ATOD is an acronym for “alcohol, tobacco and other drugs”.
35

The psychological support in the process of the treatment is poorly known and underestimated.
Thus, it is important to improve the knowledge about the whole treatment process and about the
existing drug abuse treatment services and professionals in the field.

Using positive role models among the youth favorite celebrities could be effective intervention in
the process of identity development of the Roma youth.
4.5.
Bulgaria13 – Sofia and Plodviv
The main results of the research carried out by Kupate bring the following recommendations for the
limitation of drug abuse and prevention programs:
Actions should be taken by the state and local services with the assistance of the civil groups engaged with
improving the knowledge of Roma youth on the aspects of drugs addiction. It is clear from the research
results that many of the young Roma do see the drug abuse as a problem only in the cases where heroin
and cocaine are involved.
The prevention programs should be run with a serious initial planning regarding place, vulnerable groups
and regulations for participation. The results of the programs should be monitored carefully and improved.
The social network – families and community should be actively involved in the prevention programs, to
improve the support for the addicted persons.
4.6.
France14
4.6.1. Conclusions formulated by professionals
During the final focus groups we organized in order to discuss research results with professionals form
services, we started by talking about the vocabulary young people use to talk about the idea of addiction.
Participants observed that the notions of hard drugs and soft drugs are currently out dated. We would thus
prefer the terms of ‘hard-’ and ‘soft-’ consumption, for the sake of accuracy.
Considering young people from Gare du Nord (train station), participants indicated that they do not see
consumption at Gare du Nord and that drug-use is not really referred by young people. They perceive the
behavior of the young people similar to that of non-Roma “suburban youth”.
The participants from the association Rue et cite observed that young Roma consume hashish, but do not
progress to other drug-use that they see in other young people. However, it must be noted that young
Roma consume alcohol and cigarettes at a very young age. Indeed, during family parties the youngest
children open beers and light cigarettes with the adults. The only cases of cocaine or other use are limited
to small groups who are involved in petty crime.
13
14
Research and report by Kupate
Research and report by Hors La Rue
36
Regarding the various perspectives on implementing prevention projects, we discussed the following
recommendations:

Establish common semantics to better describe the phenomena,

Work with groups who respond to various themes (addiction, health…),

Carrying out successful mediation with representatives from the center who meets the young
people in the places where they hang out,

The need to support, especially in the beginning, young people coming to the centers, with the
possibility that they can later go alone,
Two places seem particularly appropriate: the « tête à tête » center at the Rosny 2 shopping center, and
the health center in the “Goute d’or” neighborhood.
Finally, the participants showed interest in being informed on the progress of our research, both at a local
and international level.
4.3.2. Research conclusions
Addictive behaviour of the interviewed young people seems to be linked to specific settings: alcohol and
cigarettes are essentially consumed in a familial atmosphere and marijuana is consumed among peers who
also share an activity that is often rejected by their community. Drug use is above all a social act that
determines belonging in a group. Drug use is not perceived as an individual act related to some uneasiness.
When the question of services came up, young people seemed to be concerned by the physical
consequences of their drug-use. They evoked hospitals, emergency rooms, and doctors, but never the
psychological or educational worker. Sometimes, their representations of physical consequences are similar
to those of STDs (“I got tested, everything’s fine”). For young people in situations of prostitution, marijuana
is often a pretext used by the community to reject these young people for whom their sexual identity is
uncertain and who are late to be married. Marijuana-use by the group thus serves as an escape from the
prostitution practice and from family pressures which require both material and familial success, which are
often the motivations for migration. Among these young people, whose consumption classifies them as
“failures” and this failure is often internalized by the young person (they do not wish to see their siblings on
the same path). The accompaniment of this population towards existing structures requires working with
the group and not only the individual and by intermediary of professionals who bring cultural mediation.
The familial aspect is often one fundamental piece of information that professionals must take into
account. The most vulnerable categories are often young un-married men who prostitute themselves in
order to earn money.
4.7.
Slovenia15 – Novo Mesto
What did we learn in the research:
15
Research and report by Ric-Novo Mesto
37
- Condition to working with Roma is mutual trust.
- Individual approach to older Roma is a good decision, but you have to be careful about the timing.
- Extremely low level of focus (30 minutes).
- It's good to have help when working – problems with translating.
- They have hard time developing associations. They have problems following the instructions.
- They take refuge in fast, socially accepted answers.
- They demand attention.
The participants in the professionals focus group confirmed that the 7 statements represent the foundation
of any kind of work with Roma.
Condition to working with Roma is mutual trust was intensely discussed, as any form of placing non-Roma
above Roma definitely leads to increase of the gap and inability to cooperate. That is why we should allow
Roma to decide for themselves if they want to us interfere in their lives.
One of the participants has suggested the possibility to carry out the same kind of research in the local area
(implementation of focus groups and interviews) also amongst the non-Roma population. He proceeded
from the presumption that there are no differences in the attitude towards legal and illegal drugs between
Roma and non-Roma youth.
The participants warned about great differences in individual Roma settlements in the vicinity of Novo
mesto. The differences are shown in the level of social and economic development. Participants speak
about the occurrence of strong economic differentiations in the Roma communities itselves. In individual
settlements the differentiation is between poor families and families who created better economic
situation (also with the help of financial manipulations).
The state has developed wrong strategies of financial aid for Roma. Financial actions, which are not
supported enough with the demand for their active participation, do not contribute towards their
“empowerment”. The consequence is that Roma expect “help” from the state, but they don’t feel the need
for their own active inclusion into changes.
There were no special responses from the participants of the group following the exposure to pictures and
findings, connected to smoking, alcohol and illicit drugs. They have confirmed that Roma start smoking very
early and that they are discovering that alcohol can bring a lot of bad into their lives. They say that mothers
in Roma families actually forbid smoking and drinking when concerning their children, but these bans soon
get lost, they are not valid.
The group also debated about the possibilities of peer influence amongst young Roma. The participants
have agreed that peer intervention is not possible among Roma youth. Families are closed communities,
many times quarreling with other families. The relations between families are also transmitted on relations
among children. Trust is limited to family members.
The participants also stressed the problem of “leisure time” with Roma youth. They discovered that their
lives are “goalless”. Unstructured and inactive spending of leisure time could present a threatening factor
for Roma youth. At the same time they stressed the fact that they have noted the tendency of Roma youth
to be included in groups of non-Roma youth (there are more and more mixed couples). The wish of Roma
youth to be connected with the non-Roma youth brings advantages (to identify themselves with non-Roma
they take part in educational programmes or they tend to stay in them longer) and also disadvantages
(faster acquisition of influences of consumer society, the increase of the meaning of material goods).
38
4.7.
Spain16
4.7.1. Conclusions formulated by professionals
The two final focus groups were organized with 6 participants from the Local stakeholders advisory
committee and 8 participants as experts (prevention professionals). Further on we will discuss the main
topics and conclusions discussed with them when we presented them some research results.
Professionals considered that the Roma population is so heterogeneous that it is very difficult to design
intervention.
In situations of social exclusion, profiles are very different, and they might only have in common the
context in which they live. There are differences between environments: in cities there is generally more
awareness on drug issues.
Existing services. Traditionally, services are focused on offering care for drug addicts, and there was
virtually no prevention work aimed at the younger population, while preventive work was excluded from
national health programs, thus only developed by private bodies. When a person had drug problems,
accessing services meant that the problem would just “go away”. The image of services was that of
outpatient settings, “detox” structures.
It has also traditionally been a taboo subject, that could have incorrect political connotations (social
rejection by the existence of centers for drug addicts). This might be a reason for the low knowledge about
services among our research participants.
Services were invisible to the target population, and kept hidden in their actual locations. Such structures
are seen badly in the neighborhoods, as the perception is that the number of addicts in the area will rise
and that crime would increase. The stigmatization of care centers hampered for decades the standardized
approach to services. Currently there is a general rejection and poor visibility of the centers that affects
knowledge about these by the population, especially the youngest.
There are difficulties in working together with other services and there is a lack of adaptation of the
resources in the care of the Roma population. Currently, lack of economic resources put prevention and
substance abuse care in a second place.
One other barrier that professionals ignore certain cultural codes (e.g. those of the Roma from Romania),
and are thus poorly adapted to give attention to specific groups. Professionals assume that Roma people
are different, care services for drug addicts were not designed to work with women, while developing
cultural knowledge is highly necessary.
Mediation could work to fill in this gap. Prevention must work with figures of professional mediation, since
they could apply their cultural knowledge. There are no prescriptions regarding mediation, but it must be
acknowledged that the system is designed to work with different cultures.
16
Research and report by Fundación Secretariado Gitano
39
Trust. The relationship developed between the professional and the person needs to be characterized by
trust and respect. Trust is also necessary in clinical intervention. Professionals should listen actively and
transmit empathy.
Flexibility. Protocols are rigid, while flexibility is needed in care. Services need to be more flexible and
specialize in intervention. Attention must be flexible, and sometimes this requires skipping the protocols.
Prevention strategies. In the prevention activities we need to work on the expectations that young people
have. In individual cases in excluded contexts is could be useful to carry out intervention with the extended
family.
The figure of the elderly (e.g. grandparents) and their influence on younger people can be considered both
a risk and protective factor. Young children see consumption in their family as negative, but there are gaps
in prevention and children often end up consuming, just like significant adults.
Best results are obtained in individual interventions, the intervention group would be secondary. The
intervention must contemplate more concrete situations and develop preventive intervention actions
visually. Furthermore, interventions must be continuous in time. The presence and continuity of
professionals is important. Professionals should collectively coordinate the messages to be conveyed.
The intervention with the peer group must be addressed in services and in living contexts. Peer groups are
not equal in age and experience, while they share a cultural belonging.
Raising awareness on multiple levels is also an important issue for the future: it refers to healthcare
professionals and to Roma likewise, as better intercultural capacity for professionals and better knowledge
of services is necessary. Raising awareness should also include families and the communities.
Experience tells us that group workshops encourage individual people to access services.
Prevention activities in schools can reduce damage and normalize the assistance for young people. We
noticed that few young people approach services, and in order to improve this collaborative work with
these should be carried out. More specific programs are needed for young Roma.
Actual consumption. There is a clear lack of statistical data regarding consumption within the Roma
population. In situations of exclusion consumption is normalized, but this process takes place in the general
population, also.
It is necessary to break the myths regarding the consumption of drugs. Roma youth have plenty of free
time and freedom, especially the boys, thus it is important to work on time management and on alternative
activities.
Professionals found that our research brought new information regarding gender differences in
consumption. Sometimes women felt that men were more legitimate to use alcohol and cannabis, even
though they did use substances with other women. They usually hide their own consumption in front of
husband and family.
Actions designed for prevention with Roma youth should not only foresee the achievement of specific
objectives, but should be designed in a holistic perspective.
Concepts of social inequality and racism always have to be a point of attention in interventions. At the
same time, professionals should keep in mind the unity among the Roma, the general public lacks this
perception.
40
4.7.2. Research conclusions
As mentioned earlier in this report, the phenomenon of internal diversity of the Roma population is
growing every day. The same variables that mark the differences within the larger society, also affect Roma
groups and create diversity within it: age, sex, gender, area of residence, economic status, type of work,
academic and cultural level, etc. Therefore, it is difficult to draw conclusions that are valid and can be
generalized to all Roma. There are some characteristics shared by the Roma, but these are experienced by
people in different ways, in terms of opportunities and practical realities.
Some aspects were underlined by our research:
Gender perspective: the role of women in the Roma community is related to health behaviors and
therefore is crucial in the prevention or drug use. Women are caregivers and transmitters of cultural norms.
They are thus protected by the community as they come to embody cultural identity. As a consequence, it
is common for women to hide consumption from the rest of the community, which is a particular risk factor
for women. On the other hand, certain traditional rules, such as forbidding the use of tobacco or alcohol to
women or forbidding sex outside marriage, can also work as protective factors (apart from ethical
considerations). Nonetheless, consumption by women is still present.
Age: if we look at the national survey data on smoking and alcohol use initiation by young people in Spain,
compared with the young Spanish gypsy population, we observe that the age of first consumption is lower
in Gitano and Roma groups.
Another aspect to consider regarding young Roma population early entrance onto adulthood, as compared
to non-Roma young people: it is common that youngsters support their family by working in trades and
jobs (e.g. hawking), or by taking care of younger children (for girls). This can be a risk factor or a protection
factor.
The influence of age has to be taken into account when thinking about the social support that young people
receive from their family, along with the fact that consumption is allowed for men more than for women.
Different contexts: Just like for the general population, consumption is related to the living context. We
identified two types of contexts:

Contexts close to social exclusion, where access to drugs is easy and normal. Social factors, rather
than individual factors, have a higher influence on consumption.

“Normalized “ contexts in which consumption, if present, can be attributed to personal factors
rather than social conditions, the latter having a weaker impact.
Closeness and empathy: The quality of work and perceived empathy are the criteria that young Roma used
when assessing the quality of care.
The importance of anonymity and privacy: the protection of the identity and privacy of individuals allows
to gain rich information in qualitative and quantitative research.
SRAP research conclusions can be corroborated with the conclusions and recommendations formulated in
FSG 2003-2008 research report. Regarding the training of the professionals in the social and health field, we
can emphasize the following:
41
-
The need to include content on culture and the Roma community at various levels of training:
o
o
o
Initial training or undergraduate degrees in social sciences, health sciences and education,
Specialized training or graduate,
Continuous training of professionals;
-
Creation of spaces for reflection and debate among professionals working with Roma for the review of
professional practice;
-
Training of mediators / AS Roma / as in health promotion.
Regarding the development of tailored materials, we recommend that:
-
Manuals and training guides and reference documents should be made available to professionals.
-
Informative materials should be adapted to the Roma population;
-
They should use simple, clear, visual language;
-
Audiovisual materials should be devised for group work.
Some strategies should be aimed at the inclusion of difference:
-
Creating alarm systems to identify health inequalities;
-
Creating maps that identify areas of greatest health inequalities;
-
Response actions of "service portfolio";
-
Adaptation and flexibility in protocols and procedures (adjustment of schedules, active uptake of users,
etc);
-
Use of professionalized intercultural mediation;
-
Humanistic approach in assistance and intervention.
4.8.
Romania
Based on the review of the information regarding the availability of the prevention projects and programs
developed in the country and the qualitative research developed in the project, few conclusions and
recommendations were elaborated:
Conclusions of the report
Legislation and national context. Legislation regarding drug demand reduction is in place, based on the
National Strategy Against Drugs.
Treatment services are available at the level of public and private institutions and organizations, but
different criteria apply, in terms of being accessed by those in need for them, however these are not
related to the race, ethnicity or gender.
Prevention projects and programs are available in the country at the national or local level, but they do not
reach those living on the street, disadvantaged children and youngsters not being enrolled in the school or
42
having contact with the professionals. However, harm reduction activities are available on the street,
therefore some of these persons might be in contact with specialists from the not-for-profit and nongovernmental organizations who develop these activities.
Prevention programs or projects are available, but they are not continued to the same students/
youngsters or replicated to other groups for a few years due to mostly lack of funds. These projects/
programs are not available to the youngsters not going to the school, most of them being available as part
of the school programs. There are available a few counseling and prevention/ education activities as part of
the harm-reduction activities developed by non-governmental organizations.
Data regarding drug use in the population or among specific groups (intravenous drug users, adolescents at
risk etc.) are collected and reported without being asked questions regarding the ethnicity.
However, from the National Report on Drugs issued in 2011 (National Anti-Drug Agency) resulted that use
of drugs increased in the population, with a slightly decrease of tobacco and alcohol use.
In this context, data collected through the qualitative research coordinated by CODICI is important because
provides specific information on the perception, attitudes and behaviour of the Roma youngsters regarding
drug use. In analyzing data it is important to consider the fact that any inferences cannot be done to a more
extended group than that of the people involved in the research and any general conclusions cannot be
formulated due to the type of the research.
Regarding the attitudes, perception towards and use of drugs do not differ much among the interviewed
and focus group participants (Roma youngsters) compared to the youngsters of the same age (no matter
the ethnicity) that PARADA professionals came into contact. This is probably due to the fact the involved
youngsters live on the street, in disadvantaged families or in placement centers, mixing with other people
and adopting the lifestyle in the city. It might be that Roma youngsters probably living in still very
traditional families, mostly in the rural areas would think/ behave in a different way.
The influence of peers and the living environment are very important for youngsters in starting the use of
drugs.
There is a lack of knowledge among the interviewed youngsters regarding the availability of treatment, as
well as low addressability among youngsters living on the street or in disadvantaged families, due to lack of
acceptance of medical services, lack of awareness and correct information regarding the negative effects of
drugs, tobacco and alcohol, and the attitude “it cannot happen to me, I control my use of substances”.
Most of the interviewees received emergency medical services, but the regular ones because they do not
ask for them. Only one interviewee received substitution treatment.
From the drawings developed by participants at the focus groups resulted the impact of media in setting
models to be followed as examples in life. Most of the children used pictures of famous actors, singers, TV
presenters in order to express their ideas about smoking, drinking alcohol and using other substances.
Together with these, children used images/ words expressing stereotypes (by now) regarding the negative
effects of drugs, mostly on health, without showing convinced of that. However, from the group
discussions, resulted that in the reality these children live the opportunity for smoking, drinking or using
43
drugs is available (school mates, parents, sisters/ brothers/ other relatives, different acquaintances being
users; legal drugs, tobacco and alcohol are available in all neighborhoods).
Recommendations regarding prevention of drug use among youngsters resulting from the qualitative
research and from the work at PARADA:

It is very important that prevention activities are developed for disadvantaged groups, where
information sessions are organized in the meeting places of the youngsters not attending school
classes or living in the areas with heavy drug use.

Prevention activities need to emphasize on the development of the life-skills (on the refusal skills
and assertiveness), an adapted and “short” version being available for the youngsters not living in
formal houses, but on the street or in abandoned houses/ improvised shelters, where trainers are
street workers, and opportunity to have an interactive presentation is very hard to find.

Availability of the prevention activities for a long period of time, being continued/ repeated for a
few years.

Availability of the prevention materials with information regarding the available services and
people that can be contacted to ask for support.

Prevention sessions need to be interactive and emphasize on the fact that one drug cannot be used
to become sober.

As much as possible, the prevention projects need to include informative sessions involving
parents/ support groups with peers. Lack of education/ knowledge regarding harmful effects of
substances among parents, including their acceptance attitude towards use of alcohol and tobacco
that encourage the use of drugs among youngsters.
44
5. Final conclusions
The action research phase foreseen in the SRAP project aimed at shedding light on the situation of drug use
and addiction in Roma communities in 6 partner countries (Italy, Bulgaria, Romania, Spain, Slovenia and
France), taking into consideration diverse Roma populations, some living in segregation conditions.
The research targeted youth aged 11-25, with different research instruments, that allowed us to
reconstruct a series of psychological, social and cultural processes that explain drug use at this age. In its
core dynamics, consumption by Roma youth does not differ much from that of their counterparts in the
general population. Still, poverty, segregation, low access to education, employment and health services
keep them at higher risk.
We also explored cultural values that, in Roma communities in our study, influenced the perception on
drugs and addiction. One important observation was that such beliefs and values are not always just
“ethnic” (limited to Roma culture), but they were also built in interaction with non-Roma peers, at school,
or from the media. Nonetheless, in some closed communities, the drug issue was taboo, and people tended
to put distance, in their discourse, between themselves, their own community, and drug use.
Profound gender differences seem to characterize young Roma’s experience of the social sphere. Different
norms apply for boys and girls, the onset, frequency and contexts of consumption are different between
boys and girls. Promiscuity is a trait easily associated to girl consumers, who suffer from stigma, and fear
rejection or violent reactions from the family and community.
Using visual research methods allowed us to gain a vivid understanding of the images that young Roma
people (aged 11-16) associate to drug use. Participants associated images referring mostly to medical and
bodily implications of drug consumption (old age, pale skin, death, loss of weight), but they also associated
drugs to glamour, celebrities, models and fun. These antithetical dimensions of the representation of drugs
also appeared in other oppositions: drugs for rich people (cocaine, marijuana) versus drug of the poor
(heroin), drug use as an emblem for boys vs. stigma for girls, or attributing drug consumption to outgroups (drugs in Roma communities as a cultural contamination from an antithetical “other”). Thus
discourses about drugs in Roma communities intersect axes of gender, economic inequalities, age and
convey implicit definitions of group belonging and of the out-group. At the same time, as qualitative
research has widely documented for youth, drugs bare positive meanings and negative meanings for young
people, at the same time. The consequence for prevention is, as some participants asserted, that it is not
sufficient to address negative consequences of drugs in prevention programs, but positive perception on
drugs should also be tackled, as one important factor in the outset and initiation. At the same time,
prevention programs should propose alternatives for youth to experience positive effects associated to
contexts of drug use (e.g. of peer group interaction) in healthy activities.
If family of origin was largely expected to influence the life of young people, relationships, communication
and parental control strategies are often not adequate for creating a climate of mutual understanding and
help. Fear of parental violence or extreme reactions was often quoted by participants. Hiding consumption
in order to keep up with the required image of a good Roma girl or wife strongly emerged from the
discourses of our research participants. Reflection on intergenerational gaps, on fear of “coming out” as a
user and on taboo are necessary steps to consider if involvement of the families should be envisaged.
45
Research added reflections on the dynamics of drug use in acquired families, between husband and wife
and generally in young couples. While the wife can pressure the husband to quit, when both husband and
wife consume, consumption remains solitary or carried out in groups of the same sex.
The role of the peer group in the processes linked to drug consumption, remains crucial for young Roma, as
for adolescents in general, an indication that supports the idea of developing peer education prevention
programs.
Awareness and mediation campaigns should be directed towards increasing knowledge of specialized
services for health or for addiction, while outreach work and mediation should be at the basis of
intervention designs for Roma’s health. Outreach services frequently established contact with Roma users,
but they are mostly limited to IDU harm reduction or treatment, while often legal status (for immigrant
Roma), lack of medical insurance or low school attendance exclude Roma youth from general prevention or
health promotion programs.
We could notice that there is high variability not only between contexts, but also within the communities,
regarding the patterns of consumption. On the one hand we saw heroin use, which seemed to stand out as
a pattern on its own due to its devastating consequences and implications, is present mostly in Bulgaria and
partly in Italy. While heroin use was somewhat tackled by services and was accompanied by higher
awareness of consumers (although they perceive themselves as hopeless), use of other drugs, although
present in all contexts, was not tackled by services and most of the times consumers were not aware of the
consequences and did not perceive themselves as addicted. Another pattern links cannabis consumption
(in Italy mostly) to friendships that are not exclusively from the ethnic group, thus coming to bear the
meaning of a context of integration beyond ethnic boundaries. Recreational drug use and binge drinking
during weekends and parties was another pattern that was not exclusively related to exclusive Roma
environments, but widely present in other social contexts.
Among the worrying trends identified in the patterns of consumption of Roma adolescents are the early
onset of tobacco consumption (11-12 years old), exposure to consumption of alcohol by adults (either
binge drinking or alcoholism), underestimation of the consequences of many drugs (starting with cannabis,
widespread and considered to be harmless, cocaine or amphetamines), presence of injecting drug use of
heroin in specific contexts (Fakulteta neighborhood in Sofia, Venice, Spain). Recreational drug use and
binge during weekends was a pattern that brought Roma youth closer to youth drug culture in general, and
in some cases drug use came to mean inclusion in gadji groups.
These results on the patterns of consumption of Roma youth support the idea of specially designed
interventions, dedicated to these communities, for what regards interventions aimed at increasing
awareness, facilitating access and eliminating barriers in health and social services fruition. Our research
also indicates the need to use specific instruments in order to “hook” young Roma and get them in contact
with services (outreach teams, mediation). Nonetheless, generalized consumption patterns in communities
we explored only refer to tobacco, alcohol and cannabis, while for other drugs, there is a high variability
between contexts and within contexts, both in the availability of substances, in contexts and intensity of
consumption. For example, recreational use of magic mushrooms in Spain bares different meanings and
dynamics for users than injecting drug use (heroin) in Sofia. Likewise, recreational use of amphetamines
and alcohol during parties (emerged in Sofia) is extremely different than heroin addiction, in the same
context. While the first is associated to the desire to emulate “rich people” entertainment, and to a lack of
awareness of the consequences, the latter is linked to feelings of hopelessness and painful awareness of
46
bodily implications. Prevention programs should draw from local specificities and activate contextual
resources, from the services system, as well as from the family, community and youth groups, in order to
reach long term sustainable results.
The present research contributed, at local levels, to increasing knowledge regarding the types of drugs, the
levels and contexts of consumption and the personal and community beliefs, behaviors and attitudes
towards drugs and drug-related services. On a transnational scale, it helped us grasp ideas regarding the
intersections between culture, understood as the sense of ethnic belonging (represented mostly by family
and community), and drug cultures, gender cultures, school, or media cultures. The multiple comparisons
between different contexts (at policy and practice levels) allowed us to explicit some of the mechanisms of
inclusion and exclusion from health and drug related services.
Further research needs to link social inclusion to processes to drug consumption dynamics, explore their
points of contact and mutual implications. Our research interestingly pointed out how young Roma’s access
to drugs is linked to breaking down segregation and to participation in non-Roma peer groups. Still, we lack
information on how illegal markets and involvement in drug dealing contribute to facilitate consumption
and multiply negative consequences for the individuals. Future research should also deepen the
understanding of how non-segregated interaction influences services awareness, access rates, competence
and knowledge capitals.
One other central point of interest regards stigma and secrecy and their influence on the possibility of
developing family and community level interventions. Future research should also reflect on how individual
access to specialized services can be designed as an opportunity for dealing with other problems in the
families, in a holistic approach, and thus to multiply the impact of individual interventions. As we
thoroughly experienced in our fieldwork, individual contact with services can lead to relationships of trust,
on which to build further interventions involving other members of the community.
47
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