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

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Table 6-18: Mortality rate for patients in the substitution register, 2000–2010 (Nechanská, 2011g) Year Number of Number of Proportion registered registered of deaths patients in patients who (‰) treatment died 2000 245 0 0.0 2001 533 2 3.8 2002 560 0 0.0 2003 789 2 2.5 2004 866 2 2.3 2005 825 1 1.2 2006 938 1 1.1 2007 1,038 0 0.0 2008 1,356 3 2.2 2009 1,555 3 1.9 2010 2,113 4 1.9 page 103
7 Responses to Health Correlates and Consequences Harm reduction has been one of the main areas of the Czech drug policy since the beginning. A network of lowthreshold facilities and outreach programmes across the Czech Republic forms the supporting system of interventions aimed at harm reduction. Approximately 70% of problem drug users (up to 80% in Prague) are estimated to be in contact with these facilities and programmes. The number of low-threshold programmes for drug users varies from year to year. Nevertheless, there has been a marked increase in the number of clients in contact with such facilities. There has also been a steady increase in the number of contacts and the quantity of needles, syringes, and other injecting paraphernalia exchanged – nearly 5 million needles and syringes were distributed in 2010. An increase is noticeable in the number of tests for infectious diseases among drug users who are in contact with the low-threshold services. Nevertheless, the level of testing drug users for infections remains low and it is necessary to continue to place particular emphasis on the higher availability of testing to the clients of the low-threshold services. There has been an increase in the number of programmes that distribute gelatine capsules as the oral alternative to the injecting application of pervitin. According to the available information, there are at least 30 programmes distributing these capsules in the Czech Republic, in which approximately a quarter of the programmes’ clients are involved; nearly 60 thousand capsules were distributed in 2010. Specific programmes for the reduction of risks in recreational settings were conducted in 2010 by a total of four organisations in five programmes – there appears to have been a slight decrease in the number of interventions performed in recreational settings in 2010. The treatment of HIV and AIDS patients in the Czech Republic and care for them is provided by seven AIDS centres and is covered by the health insurance system. The problem associated with insufficient funding is to ensure dispensary care and therapy to HIV-positive clients without health insurance, which may also concern injecting drug users. A questionnaire study was conducted in the spring of 2011 among viral hepatitis treatment centres. One of the findings was the estimate that 39 centres treated injecting drug users (mostly abstinent and only rarely active ones) for HCV in the Czech Republic in 2010. 7.1 Legal Framework, Strategies and Policies for Harm Reduction In 2010 the Government adopted the National Drug Policy Strategy for the Period 2010–2018 and the 2010–2012 Action Plan. Harm reduction is one of the four pillars (for details see the chapter on National Action Plan, Strategy, Evaluation, and Coordination, p. 9). The Action Plan defines the following areas of activity for harm reduction: develop interventions, particularly new ones, to reduce the incidence of infectious diseases, overdoses, and other health-related consequences of drug use among drug users; increase the level of testing of drug users for infectious diseases; define guidelines for harm reduction services provided in nightlife settings. 7.2 Prevention of Drug-related Emergencies and Reduction of Drug-related Deaths In the Czech Republic, the prevention of overdoses is conducted through the counselling and education of drug users as part of the services provided by low-threshold and treatment facilities. For low-threshold programmes see below; treatment is discussed in the chapter on Drug-Related Treatment: Treatment Demand and Treatment Availability (p. 55). The main educational topics include first aid in the event of an overdose, the risks of polydrug use, and the principles of safe drug use. Most low-threshold facilities also provide counselling in this area via email and the telephone. The facilities have prepared and have available a range of reference materials, some of which are also provided in other language versions. The regularly updated web portal eDekontaminace.cz focuses on sharing information on harm reduction, including safe use and overdose prevention information 101 . In the Early Warning System for new psychoactive substances, all low-threshold facilities are notified if new drugs or dangerous drugs involving higher health and overdose risks are detected in the Czech Republic (or anywhere across Europe). For example, in 2010 the facilities were notified about the risks of fentanyl 102 , and information was also provided regarding the occurrence of new synthetic drugs (legal highs), in particular cathinones (mephedrone). No other specific activities are being pursued in the Czech Republic with a view to the prevention of overdoses, such as the preventive distribution of opiate antagonists (naloxone) to drug users. Information about counselling and other services provided to drug users upon their release from prison is included in the chapter on Responses to Drug- 101 http://www.edekontaminace.cz (2011-09-07) 102 Fentanyl is a high-potency opioid. It was first seized in Slovakia in 2009, which was the immediate reason for notifying the services. page 104
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Annual Report The Czech Republic 20
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Annual Report: The Czech Republic -
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PART B: SELECTED ISSUES............
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In 2010 the very first representati
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In the Czech Republic, the treatmen
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PART A: NEW DEVELOPMENTS AND TRENDS
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ange applies to addictologists who
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Republic has been reporting the hig
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Wenceslas Square and in the surroun
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Regions of the Czech Republic to ca
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Region Pardubice Vysočina South Mo
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educe drug supply (particularly to
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Map 1-1: 2010 drug policy expenditu
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Total state budget Regions Table 1-
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1.3.2 Drug Treatment Costs Incurred
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Table 1-9: Costs incurred by health
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2 Drug Use in the General Populatio
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Table 2-2: Prevalence rates of use
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The M-CIDI questionnaire, containin
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Table 2-6: Prevalence rates of use
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Figure 2-2: Attitudes towards crimi
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Table 2-7: Prevalence of use of can
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Table 2-8: 2010 Safer Party clients
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school curriculum and school rules;
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partly also by regional public heal
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3.4 Indicated prevention Indicated
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4 Problem Drug Use The EMCDDA defin
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Table 4-2: Prevalence estimates of
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Page 81 and 82: Map 5-4: Number of all treatment de
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Page 85 and 86: 5.3.3.2 Clients in Opiate Substitut
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Page 89 and 90: Table 5-23: Number of hospitalisati
Page 91 and 92: Table 6-1: Number of newly detected
Page 93 and 94: Figure 6-5: Reported incidence of s
Page 95 and 96: The monitoring of testing for infec
Page 97 and 98: Table 6-8: Results of testing for H
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Page 101 and 102: tests for cannabis; see Table 6-12.
Page 103 and 104: Pervitin was the cause of a fatal o
Page 105 and 106: Table 6-15: Deaths with the presenc
Page 107 and 108: Table 6-17: Fatal drug overdoses in
Page 109: Figure 6-13: Comparison of trends i
Page 113 and 114: Table 7-2: Selected services of low
Page 115 and 116: Map 7-2: Number of needles and syri
Page 117 and 118: Table 7-8: History of HBV, HCV, and
Page 119 and 120: 8 Social Correlates and Social Rein
Page 121 and 122: Altogether, 987 clients (610 of the
Page 123 and 124: 9 Drug-Related Crime, Prevention of
Page 125 and 126: Table 9-2: Number of persons arrest
Page 127 and 128: Figure 9-1: Total number of persons
Page 129 and 130: Table 9-7: Sentences and other meas
Page 131 and 132: Table 9-9: Drug-related misdemeanou
Page 133 and 134: in custody, and 8 being the inmates
Page 135 and 136: (approximately 0.5%). However, only
Page 137 and 138: Table 9-15: NGOs providing drug ser
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Page 151 and 152: departments) or by the external pro
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Page 155 and 156: 12 Drug Users with Children The aim
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(diagnostic institutions), and reha
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12.3.2 Helping Services Help to chi
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13 Cross-border Travel, Drug Use, a
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ethnic minorities in the Czech Repu
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LIST OF TABLES Table 1-1: Overview
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Table 9-10: Criminal offences commi
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SELECTED DRUG-RELATED WEB PAGES ON
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2005-2009 National Strategy - Natio
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ministry, 18, 41, 42, 115 ministry
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Generální ředitelství Vězeňsk
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Mravčík, V., Zábranský, T., Kor
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Policie ČR (2011) Statistické př
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Van den Berg, C., Smit, C., Van Bru
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