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Data on the clients of low-threshold facilities from other sources are also provided in the chapter on Data on Problem Drug Use from Non-Treatment Sources (p. 52). 7.3.1.1 Needle and Syringe Exchange Programmes A needle and syringe exchange component was included in 96 low-threshold programmes in 2010, which is approximately the same number as in the previous years, while the quantity of the material distributed continued to increase in 2010 (Národní monitorovací středisko pro drogy a drogové závislosti, 2011j). A comparison of the number of programmes and the number of needles and syringes supplied in the years 1998–2010 is provided in Table 7-4; the number of needles and syringes distributed in the individual regions is shown in Table 7-5. According to information available from the final reports, each injecting drug user who visited a low-threshold facility made an average of 10 exchanges in 2010 and received a total of 200 sterile needles and syringes on average. The regional distribution of the needles and syringes provided corresponds with the relative numbers of injecting (problem) drug users; see Map 7-2 (further below) and Map 4-1 (p. 50). Table 7-4: Exchange programmes in the Czech Republic in 1998–2010 (Mravčík et al. 2010; Národní monitorovací středisko pro drogy a drogové závislosti, 2011j) Year Number of exchange programmes Number of needles and syringes exchanged 1998 42 486,600 1999 64 850,285 2000 80 1,152,334 2001 77 1,567,059 2002 88 1,469,224 2003 87 1,777,957 2004 86 2,355,536 2005 88 3,271,624 2006 93 3,868,880 2007 107 4,457,008 2008 98 4,644,314 2009 95 4,859,100 2010 96 4,942,816 Table 7-5: Number of needles and syringes distributed in the exchange programmes in 2002–2010, by region (Mravčík et al. 2010; Národní monitorovací středisko pro drogy a drogové závislosti, 2011j) Region 2002 2003 2004 2005 2006 2007 2008 2009 2010 Prague 858,507 979,560 1,210,704 1,697,554 1,850,330 2,071,788 2,060,588 2,130,729 2,130,433 Central Bohemia 12,561 31,682 66,600 110,325 168,220 215,640 309,590 345,214 350,052 South Bohemia 14,883 69,004 102,621 124,454 141,825 212,791 228,872 239,690 183,278 Pilsen 23,221 44,670 88,450 116,611 157,317 189,894 207,938 188,416 190,648 Karlovy Vary Ústí nad Labem 16,608 29,299 35,756 58,680 66,382 83,462 79,834 102,467 141,437 256,071 262,418 351,561 479,383 612,259 655,882 637,887 678,007 604,191 Liberec 12,273 21,108 33,467 32,800 47,756 63,967 129,903 87,272 129,995 Hradec Králové 22,250 45,089 41,021 86,221 98,269 139,075 173,417 183,186 200,616 Pardubice 23,622 23,330 36,081 38,725 48,144 29,908 52,690 62,541 84,950 Vysočina 11,254 29,363 39,348 61,425 68,682 99,447 65,343 81,127 89,846 South Moravia 134,285 122,137 165,846 173,090 227,833 269,236 264,872 252,145 286,251 Olomouc 21,809 33,832 85,872 96,416 150,024 134,433 137,321 164,699 197,767 Zlín 19,973 11,362 41,977 52,169 69,005 115,744 89,913 111,099 96,330 Moravia- Silesia 41,907 75,103 56,232 143,771 162,834 175,741 206,146 232,508 257,022 Total 1,469,224 1,777,957 2,355,536 3,271,624 3,868,880 4,457,008 4,644,314 4,859,100 4,942,816 page 107
Map 7-2: Number of needles and syringes distributed in Czech regions in 2010, per 1,000 inhabitants aged 15–64 (Národní monitorovací středisko pro drogy a drogové závislosti, 2011j) Needle and syringe exchange programmes are complemented by the distribution of aluminium foil for smoking heroin and the distribution of gelatine capsules intended for the oral application of the drug as an alternative to injecting, in particular in the case of pervitin; for more details see the 2009 Annual Report. The results of a survey which concerned the use of capsules as a harm reduction instrument and was conducted in 2008 among low-threshold facilities and their staff were published in 2011. Emphasis was placed on the potential of capsules to reduce the intensity of injecting use or encourage alternatives to injecting application in motivated (injecting) pervitin users or in those with a damaged venous system, and the potential to contact pervitin users who were otherwise difficult to reach or hidden (Mravčík et al. 2011). In the monitoring of the tests for infections and their prevention among injecting drug users in low-threshold programmes in 2010 (Národní monitorovací středisko pro drogy a drogové závislosti, 2011i), a total of 43 lowthreshold programmes provided their responses (see also the chapter on Drug-Related Infections on p. 83). Thirty (70%) of these programmes conducted a capsule distribution programme, and had issued 56,868 capsules to approximately 24% of their pervitin-using clients (weighted by the number of capsules distributed). Table 7-6: Information about the gelatine capsule distribution programmes in low-threshold facilities in the Czech Republic in 2008–2010 (Národní monitorovací středisko pro drogy a drogové závislosti, 2008a; Národní monitorovací středisko pro drogy a drogové závislosti, 2010a; Národní monitorovací středisko pro drogy a drogové závislosti, 2011i) Year Number of programmes which responded to the questionnaire Capsule distribution programmes Number Percentage Number of capsules distributed 2008 50 16 32.0 23,865 2009 20 14 70.0 28,638 2010 43 30 69.8 56,868 In the 2010 monitoring of the testing for and prevention of infectious diseases, the low-threshold programmes generally reported distributing an increasing quantity of needles, syringes and injecting paraphernalia, condoms, and gelatine capsules. Positive changes were mostly reported in client behaviour regarding the principles of safe drug use (Národní monitorovací středisko pro drogy a drogové závislosti, 2011i). The needs analysis conducted among the clients and staff of the low-threshold services in Prague (see also the chapters on Data on Problem Drug Use from Non-Treatment Sources on p. 52 and Risk Behaviour of Drug Users on p. 90) shows, among other findings, that the high level of adherence of the clients is closely related to the basic service – needle and syringe exchange. Both the staff and the clients considered the free nature of the service crucial. Positive views were also obtained regarding the provision of medical attention and, in general, the availability of counselling in the health care, social, and legal areas. The reported deficiencies of the services included the low capacity of the programmes (in particular, of the contact centres), strict rules or, on the contrary, the absence of clear rules in the contact room (Šťastná, 2010; Šťastná et al. 2011). page 108
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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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Table 4-4: Prevalence estimates of
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The general population studies (see
Page 63 and 64: Information on treatment and counse
Page 65 and 66: 5.2.1 Professional Competency of Se
Page 67 and 68: Table 5-6: Number of outpatient hea
Page 69 and 70: Table 5-8: Number of healthcare fac
Page 71 and 72: The proportions found for prescribi
Page 73 and 74: Map 5-2: Sobering-up station networ
Page 75 and 76: Table 5-14: Network of inpatient fa
Page 77 and 78: care centres report to diagnostic i
Page 79 and 80: cannabis, especially among adolesce
Page 81 and 82: Map 5-4: Number of all treatment de
Page 83 and 84: Figure 5-8: Selected characteristic
Page 85 and 86: 5.3.3.2 Clients in Opiate Substitut
Page 87 and 88: Figure 5-10: Trends in the capacity
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
Page 99 and 100: Table 6-9: Sharing of needles and s
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 and 110: Figure 6-13: Comparison of trends i
Page 111 and 112: 7 Responses to Health Correlates an
Page 113: Table 7-2: Selected services of low
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
Page 139 and 140: Supported by the National Focal Poi
Page 141 and 142: was rather bizarre. For example, th
Page 143 and 144: shut down by the authorities. The l
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Page 147 and 148: conduct research in the area of pen
Page 149 and 150: Republic for the Period 2011-2012 f
Page 151 and 152: departments) or by the external pro
Page 153 and 154: more than 10 clients, etc. This is
Page 155 and 156: 12 Drug Users with Children The aim
Page 157 and 158: Childbirth and the National Registe
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Page 163 and 164: 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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