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Table 8-1: Number of clients provided with the services of Roma field workers in 2006–2010, by problem type (Mravčík et al. 2010; Kancelář Rady vlády pro záležitosti romské menšiny, 2011) 2006 2007 2008 2009 2010 Problem type Numbe Number % Number % Number % Number % r % Debt 4,477 34.1 5,314 31.9 3,779 28.7 3,722 26.8 5,943 36.4 Unemployment 2,672 20.4 2,916 17.5 2,598 19.8 3,070 22.1 3,067 18.8 Low housing quality 3,362 25.6 3,364 20.2 2,432 18.5 2,408 17.3 3,741 22.9 Problematic tenant/landlord 1,847 14.1 1,522 9.1 1,285 9.8 1,413 10.2 1,286 7.9 relations Insufficient sanitation 1,300 9.9 1,204 7.2 1,282 9.7 1,309 9.4 1,088 6.7 Truancy 907 6.9 716 4.3 1,000 7.6 679 4.9 612 3.8 Usury 277 2.1 320 1.9 696 5.3 218 1.6 143 0.9 Crime 620 4.7 574 3.4 636 4.8 532 3.8 269 1.6 Drug use 457 3.5 391 2.3 344 2.6 291 2.1 – – Gambling 268 2.0 302 1.8 323 2.5 236 1.7 142 0.9 Prostitution 63 0.5 39 0.2 51 0.4 25 0.2 24 0.1 Total* 13,116 100.0 16,662 100.0 13,144 100.0 13,903 100.0 16,315 100.0 * The aggregate number of clients classified by problem type may exceed the total number of clients because of the accumulation of problems in individual clients and because of the methods of reporting in the individual years. According to the Government Council for Roma Minority Affairs, the most commonly reported forms of risk behaviour among socially excluded Roma communities are gambling and drug use. The very low age of the first exposure of Roma children to an illicit drug, attributable, among other factors, to the high prevalence of drug use among their parents, is a major problem. The most widespread (illicit) drugs among Roma drug users include pervitin, heroin, and inhalants (Kancelář Rady vlády pro záležitosti romské menšiny, 2011). Addictive substance use was a partial focus of the research study called The Quality of Life and the Social Determinants of Health in the Roma in the Czech and Slovak Republics (Davidová et al., 2010). The project resumed the activities of the international research study Sastipen: Health and the Roma Population 2008–2009 (see also the 2009 Annual Report), focusing in particular on how social circumstances (employment, education, place of residence, age, generation, etc.) affect the subjective perception of one’s health. The findings show that there is a higher occurrence of risk forms of behaviour among individuals living in socially excluded communities. Within the Roma minority, the Wallachian (Olah) Roma are the most endangered group. The areas involving the highest risk are socially excluded Roma communities in large cities, where drugs are readily available. The most common non-alcohol drugs used include marijuana, heroin, Subutex ® , sedatives, and inhalants. The first drug use is largely initiated by a group that spends a lot of time out together, along with relatives and close friends. There is often also a quick transition to injecting use. In 2007, the government established the Agency for the Elimination of Social Exclusion in Roma Localities. The main objective of the Agency is to support the integration of Roma and translate the national strategies at the local level (Kancelář Rady vlády pro záležitosti romské menšiny, 2011). For details on the Agency see the 2007–2009 Annual Reports. In 2010 the Agency operated in 13 existing locations in Brno, Broumov, Břeclav, Holešov, Cheb, Litvínov, Most, Přerov, Roudnice nad Labem, and Ostrava, and in the Jeseník and Šluknov regions, as well as in 10 new locations (Bílina, Havířov, Chomutov, Jáchymov, Jirkov, Kutná Hora, Obrnice, Toužim – Teplá, and Trmice). The implementation of 10 situation analyses was initiated in 2010 to survey the situation in the new locations. 8.2 Social Reintegration In the Czech Republic, aftercare for drug users and their social inclusion are provided for through outpatient aftercare programmes, which may include sheltered housing programmes and sheltered work programmes (sheltered workshops, sheltered employment, and supported employment). The target group of the structured intensive aftercare programmes consists of people with the recommended abstinence period of at least 3 months. There are approximately 30 aftercare programmes for drug users in place in the Czech Republic, with the target group of some of the programmes being only alcohol users or only illicit drug users. As of September 2011, a total of 34 aftercare programmes for the target group of persons at risk of addiction or persons with a substance addiction were included in the Register of Social Service Providers, administered by the Ministry of Labour and Social Affairs. Sixteen aftercare programmes for (illicit) drug users were subsidised by the Government Council for Drug Policy Coordination in 2010, with detailed information about these programmes being available from the projects’ final reports. Thirteen programmes offered their clients sheltered housing and four also provided protected employment. page 113
Altogether, 987 clients (610 of them male) used the aftercare services; 720 (72%) of them used to inject drugs before they entered treatment; 583 (59%) used to use pervitin and 155 (15%) heroin. The total capacity of the facilities offering sheltered housing was 127 places. 25 clients worked in sheltered workshops (Národní monitorovací středisko pro drogy a drogové závislosti, 2011j); see Table 8-2. Table 8-2: Aftercare programmes subsidised by the Government Council for Drug Policy Coordination in the period 2005–2010 (Mravčík et al. 2010; Národní monitorovací středisko pro drogy a drogové závislosti, 2011j) Indicator 2005 2006 2007 2008 2009 2010 Number of facilities 20 18 18 18 15 16 Number of aftercare clients 865 904 883 1,041 986 987 Sheltered housing places 118 126 126 283 134 127 Number of clients in sheltered housing 244 235 261 – – – Number of clients in sheltered workshops 59 40 44 25 29 25 Outpatient aftercare was offered by 13 facilities, whose services were used by 494 clients (312 of whom were men), which represents a slight decrease against 2009. While the average age of the clients increased continuously in the period 2003–2009, it went down to 28.3 years of age in 2010. A total of 335 clients (67%) had been injecting drug users prior to the treatment; 286 (57%) had used pervitin and 82 (16%) opiates (Národní monitorovací středisko pro drogy a drogové závislosti, 2011j); see Table 8-3. Table 8-3: Outpatient aftercare programmes subsidised by the Government Council for Drug Policy Coordination, and their clients in the period 2003–2010 (Mravčík et al. 2010; Národní monitorovací středisko pro drogy a drogové závislosti, 2011j) Indicator 2003 2004 2005 2006 2007 2008 2009 2010 Number of facilities 8 14 13 10 12 12 11 13 Number of clients 460 444 336 380 389 487 443 494 – injecting drug users 320 307 218 230 236 306 235 335 – pervitin users 210 187 182 216 209 259 246 286 – opiate users 120 115 58 78 69 71 64 82 Average age of clients 26.0 26.6 27.4 26.4 29.3 30.3 30.4 28.3 Thirteen facilities provided intensive aftercare (within a long-term structured programme, typically involving sheltered housing and employment); their total capacity of 269 beds was used by 493 clients (298 of whom were men). The average age of the clients was 28.8 years. A total of 385 (78%) clients had been injecting drug users prior to the treatment; 297 (60%) had used pervitin and 73 (14%) opiates (heroin, Subutex ® or methadone). The average duration of the stay of a client in an intensive aftercare programme was 6 months. 163 clients (33%) completed the programme, 87 (17%) dropped out, and 46 (9%) were expelled (Národní monitorovací středisko pro drogy a drogové závislosti, 2011j); see Table 8-4. Table 8-4: Intensive aftercare programmes subsidised by the Government Council for Drug Policy Coordination, and their clients in the period 2003–2010 (Mravčík et al. 2010; Národní monitorovací středisko pro drogy a drogové závislosti, 2011j) Indicator 2003 2004 2005 2006 2007 2008 2009 2010 Number of facilities 14 14 15 16 15 15 12 13 Capacity 321 342 385 365 325 283 316 269 Number of clients 585 562 526 524 494 554 543 493 – injecting drug users 463 404 399 364 360 422 392 385 – pervitin users 245 260 276 304 284 317 329 297 – opiate users 224 184 143 105 104 105 99 73 Average age of clients 24.5 27.0 26.4 27.1 26.6 28.7 29.2 28.8 In addition to the facilities specified above, aftercare services may be provided by other inpatient or outpatient treatment facilities; however, their number and the scope of the services provided are difficult to determine. Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) groups operate on a self-help basis. There are currently 47 AA groups in 34 towns and cities in the Czech Republic 105 and one NA group in Brno 106 . In 2010, the labour and social projects (the so-called labour and social agencies) of established organisations (the SANANIM and Prev-Centrum civic associations in Prague, the Christian Help Centre in Pilsen, White Light I. in Ústí nad Labem, and the PASÁŽ counselling centre and the Podané ruce association in Brno) focused on improving the living situation of former drug users through improving their opportunities on the labour market. 107 . The clients of 105 http://www.anonymnialkoholici.cz/ (2011-09-01) 106 http://www.akluby.cz/page_id=292 (2011-09-11) 107 The list only includes projects aimed primarily at the users of non-alcohol drugs (active, in treatment, or in aftercare). It must be emphasised that the social reintegration of persons in need is covered by a number of projects, whose primary target group, however, page 114
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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
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Information on treatment and counse
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5.2.1 Professional Competency of Se
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Table 5-6: Number of outpatient hea
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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
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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 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: 8 Social Correlates and Social Rein
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 141 and 142: was rather bizarre. For example, th
Page 143 and 144: shut down by the authorities. The l
Page 145 and 146: the regional police headquarters on
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Page 149 and 150: Republic for the Period 2011-2012 f
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
Page 157 and 158: Childbirth and the National Registe
Page 159 and 160: Table 12-2: Total number of mothers
Page 161 and 162: (diagnostic institutions), and reha
Page 163 and 164: 12.3.2 Helping Services Help to chi
Page 165 and 166: 13 Cross-border Travel, Drug Use, a
Page 167 and 168: ethnic minorities in the Czech Repu
Page 169 and 170: 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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