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

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.
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