The high penetration of the consumption of the designer drugs together with the psychoactive substances including the conventional narcotic drugs means new challenges for the health visitor network and the health visitors. Often the health visitors are the first and most important contact for the clients. Based on their profession, the health visitors are the one to have the possibility to recognise the presence of the psychoactive substances and the drug problems on the basis of the relationship of trust and to support the affected people within the limits of their possibilities.

The penetration and the consumption of designer drugs are considered by the health visitors as a severe-very severe problem in Hungary [1]. Contrary to the severity of the problem, 88% of these experts think that although they have heard about designer drugs and the problems originating from their consumption, they do not have the appropriate knowledge about these materials, the ways of their consumption etc. The source of their present knowledge is mostly the less well-founded content of mass communication (90%) and in a less extent the professional further trainings (66%) and the information from the experts working in the similar professions (67%). Due to the partial knowledge it is not a surprise that a third of the health visitors think that he/she would unable to recognise a drug user. During their work, two thirds of the health visitors have already met a drug user.

According to the data on the current practice, in case of a recognised drug problem, the majority of the health visitors enter a conversation with the drug user and with the direct environment of the affected person, i.e. she performs actually the so-called short intervention activity. The health visitors do the ones above by thinking that this activity should primarily be the task of an expert trained for this task.

To let the health visitors be an appropriate link between the drug users and the competent experts regarding this problem, the development of their knowledge would be expedient towards two important directions:

- it is expedient to train the health visitors about the application of the FRAMES [2] short intervention method. (Based on experience, this method can be applied not only for drug users, but for the alcohol consumers and the smokers as well.) The application of the FRAMES does not require special addictological knowledge and it is a well-applicable method during the everyday work conditions as well.

- it seems to be necessary to prepare the health visitors for the establishment of a network the experts involved in which are in possession of the adequate knowledge regarding the treatment of these special problems. After the FRAMES short intervention applied by the health visitor, an appropriately constructed network is able to select and mobilise the experts able to provide the affected person with the necessary and adequate knowledge/treatment. The establishment and the maintenance of such a network would limit the increase of the work load of health visitors and would optimise the application of special knowledge characteristic of the members of the network. It is expedient to prepare the health visitors for the establishment of the recommended network.

Budapest, 31^st March 2017

[1] The following statements are based on the survey aiming the establishment of the document “Designer drugs -  What can we do, what shall we do? Methodology guide regarding designer drugs for regional and school health visitors” made for health visitors. Within the framework of the information collection, with the help of an online questionnaire we were able to get to know the opinion of 563 health visitors regarding the penetration and the danger of designer drugs, the assessment of their own competence regarding this issue and the type of support they require to efficiently perform their job. 

[2] The elements of the short intervention of the FRAMES: F for feedback, R for responsibility, A for advice, M for menu, E for empathy and S for self-efficacy.

More information about the FRAMES method can be found e.g. at:

http://methoide.fcm.arizona.edu/infocenter/index.cfm?stid=242