The Czech Republic Annual Report 2010 Drug ... - Drogy-info.cz

The incidence of secondary diagnoses among drug users treated for disorders caused by the use of addictive
substances (primary diagnosis F10–F19) who were hospitalised in inpatient psychiatric facilities is presented in
Table 6-11.
Psychiatric diagnoses, i.e. diagnoses in Chapter V of ICD-10, were the most frequent secondary hospitalisation
diagnoses provided for drug users in psychiatric inpatient facilities, which is also implied from the character of the
care provided at these facilities. A secondary psychiatric diagnosis was provided in 30% of hospitalisations resulting
from the use of alcohol, less than 30% of those resulting from opiate and polydrug use, and nearly 50% of those
resulting from the use of stimulants. Diagnoses from the F10–F19 group, disorders related to addictive substance
use, were also frequently reported as secondary diagnoses. Other frequent secondary diagnoses were from the
group of gastrointestinal and circulatory disorders (Ústav zdravotnických informací a statistiky, 2011c).
Table 6-11: Comorbidity in hospitalisations of addictive substance users in psychiatric inpatient facilities in 2010, in % (Ústav
zdravotnických informací a statistiky, 2011c)
Primary diagnosis
Secondary diagnosis
by chapter of ICD-10
F10 – alcohol
(n=10,003)
F11 – opioids
(n=696)
I. Certain infectious and parasitic diseases 0.6 13.5 0.5 1.0 0.0 4.4 0.0 0.0 4.8 4.4
II Neoplasms 0.4 0.1 0.0 0.3 0.0 0.0 0.0 0.0 0.0 0.1
III
Diseases of the blood and blood-forming
organs
1.2 0.1 0.5 0.3 0.0 0.0 0.0 0.0 0.0 0.2
IV
Endocrine, nutritional and metabolic
diseases
4.3 1.0 1.5 9.5 0.0 1.0 0.0 0.0 7.1 0.6
V Mental and behavioural disorders 29.9 28.3 79.4 63.1 50.0 48.0 100.0 66.7 14.3 25.6
VI Diseases of the nervous system 3.4 1.0 1.0 1.6 0.0 0.4 0.0 0.0 0.0 0.8
VII Diseases of the eye 0.3 0.4 0.0 0.3 0.0 0.1 0.0 0.0 0.0 0.0
VIII Diseases of the ear and mastoid process 0.2 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0
IX Diseases of the circulatory system 8.5 1.4 0.5 15.0 0.0 0.4 0.0 33.3 0.0 1.5
X Diseases of the respiratory system 1.6 0.7 1.0 2.9 50.0 0.9 11.1 0.0 0.0 0.7
XI Diseases of the digestive system 10.9 2.0 1.0 3.3 0.0 0.3 0.0 33.3 0.0 1.7
XII Diseases of the skin 0.7 0.3 1.5 0.0 0.0 0.4 0.0 0.0 0.0 0.3
XIII
Diseases of the musculoskeletal system and
connective tissue
1.1 0.9 0.0 2.9 0.0 0.3 0.0 0.0 0.0 0.2
XIV Diseases of the genitourinary system 0.7 0.4 0.5 1.3 0.0 0.3 0.0 0.0 0.0 0.2
XV Pregnancy, childbirth 0.0 0.1 0.5 0.0 0.0 0.1 0.0 0.0 0.0 0.0
XVII Congenital malformations, deformations 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
XVIII Abnormal clinical findings 0.6 0.4 0.0 0.3 0.0 0.4 0.0 33.3 0.0 0.3
XIX Injury, poisoning 1.9 0.7 3.0 2.9 0.0 0.7 0.0 33.3 0.0 1.5
XXI Factors influencing health status 3.0 3.9 23.1 6.5 0.0 10.3 11.1 0.0 4.8 3.2
6.2.3 Drugs and Road Accidents
Since 2003, cases where ethanol and other drugs 89 were detected have been analysed in forensic autopsies of road
accident fatalities in the Czech Republic; for more information see the chapter on Drug-Related Deaths and Mortality
of Drug Users (p. 95). Active participants in road accidents (pedestrians, cyclists, and drivers) are monitored
separately 90 .
According to the data reported by forensic medicine departments, 894 persons died in traffic accidents or as a result
of traffic accidents in 2010. Of these victims, 505 (57%) were subject to toxicological examination 91 , which is a
similar percentage as in previous years. The highest proportion of positive tests was detected in the case of ethanol.
As far as the three most common non-alcohol drugs are concerned, compared with the previous year there was a
decline in the number of positive tests for pervitin and benzodiazepines, but an increase in the number of positive
F12 – cannabis
(n=199)
F13 – sedatives /
hypnotics (n=306)
F14 – cocaine
(n=2)
F15 – other stimulant s
(n=1,626)
F16 – hallucinogens
(n=9)
F17 – tobacco
(n=3)
F18 – inhalants
(n=42)
F19 – polydrug use
(n=2,476)
89
A test is considered positive for ethanol if the level of ethanol is higher than 0.2 g/kg (Czech Society for Forensic Medicine and
Toxicology, 1999), positive for cannabis if THC or its active metabolite is proven (i.e. not THC-COOH, for instance), and positive for
inhalants if the autopsy detects substances which do not develop post mortem or are not indicated in some physiological or pathological
conditions (e.g. acetone, acetaldehyde, n-propanol, n-butanol).
90
The category of other victims comprises mainly passengers in motor vehicles and fatalities who could not be assigned to any of the
three previous categories (victims of non-road accidents such as aircraft accidents, construction site accidents, passengers in public
transport accidents, etc.).
91
I.e. tested for ethanol or any drug from the following groups: inhalants, opiates, stimulants, cannabis, cocaine, benzodiazepines, and
barbiturates.
page 93