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

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An instrument is being developed for the keeping of centralised records on drug users receiving care from the individual specialised centres, their basic characteristics, and the activities (interventions) and other facts regarding the implementation of the drug policy. The Prison Service has lacked records of this type. Some of the clients leave the therapeutic programmes before completing them because they are either released on parole or transferred to another type of prison or to another prison at their own request. The situation in the area of providing court-ordered compulsory drug treatment as part of serving a prison sentence is currently problematic. It should be remedied by the act on specific health services, currently under preparation. Even though drugs are found in prisons in all the developed countries, the Czech public perceive a prison as a drug-free environment, even though there is no doubt about the presence of drugs in them. This opinion and the existing legal framework complicate the introduction of harm reduction measures in prisons. There is a lack of feedback regarding the clients’ behaviour after their release from prison, which would be useful for the setting-up and evaluation of the drug-related programmes delivered during imprisonment. There is no overdose risk assessment in place regarding opiate users; neither are there general interventions aimed at minimising this risk. There is no representative study of the efficiency of the drug-related services. The systematic training of the employees of the Prison Service providing drug-related services is currently being configured to respond to the previous shortcomings in this area. page 147
12 Drug Users with Children The aim of this Selected Issue is to provide information about the prevalence of pregnant drug users and those users who are parents of minor children and trends and characteristics pertaining to them, as well as describing specific services designed for such users and their children in the Czech Republic. First and foremost, this chapter deals with addictive substances other than alcohol and those that are illegal. A pregnant drug user refers to a woman who has used drugs during her pregnancy. For the purposes of this Selected Issue, a drug-using parent means every user who is the parent of a child under 18 years of age, irrespective of whether they currently have custody of the child or whether the child has been temporarily placed in the care of an institution or another person until they are deprived of parental rights or make the child available for adoption. In theory, a child is deemed to be every person up to the age of 18, but, in practice and in relation to the issue under consideration, children of pre-school and school age will be the main age groups referred to. At a certain stage of their drug careers, some drug users give birth to children, which raises a number of fundamental questions about the future life of such children and their health, safety, and rights. It is common practice that such pregnancies tend to be unintended or unwanted, and often the woman only discovers that she is pregnant after some delay. As a result, mothers carry on using drugs and living in unsuitable socio-economic and hygienic conditions while already pregnant. Following the delivery, newborns may suffer from withdrawal-related problems, which are addressed by specialised healthcare facilities. Drug-using mothers rarely have a good social background to which they could resort with a child after birth. Moreover, their ambiguous attitude to their further drug use complicates their ability to take proper care of the child, which frequently results in interventions on the part of the authorities involved in the social and legal protection of children because of concerns that the child’s favourable development may be endangered or disturbed. Some of these children subsequently need to be placed in alternative care. Similar problems also occur when children live with parents who use drugs or in a drug-using environment. Drug-using parents with children are provided with support and treatment by both governmental and non-governmental specialised professional agencies. 12.1 Size of the Problem Studies investigating the effects and consequences of pregnant women’s and parents’ drug use on the physical and psychological development of the child mainly fall within the domain of medicine, with a particular focus on the target group of pregnant women in relation to the development of the foetus. The degree of the impact of drug use during pregnancy largely depends on whether the use has involved experimentation, irregular use, or addiction. Occasional users who are aware of the harmful effects of drug use usually abstain during pregnancy. Problem drug users and drug addicts are not able to discontinue their substance abuse; pregnant women often postpone or neglect prenatal care. Studies and practical experience provide enough evidence that parents’ drug use affects the child’s further development. However, the environment in which children grow up during the early years of their lives, with all its health and psychosocial consequences, plays a significant and often crucial role. The use of all types of drugs, including alcohol, marijuana, nicotine, and barbiturates and other pills, may have dangerous effects on the course of a pregnancy. The main reason is that, by crossing the placenta, the drug enters the body of the foetus and endangers its healthy development. Similarly, in a breastfeeding woman, drugs may enter the child’s body with the mother’s milk (Vavřinková and Binder, 2007a). The studies on the occurrence of neonatal abstinence syndrome (NAS) and other conditions in newborns confirm that the onset and the intensity of symptoms depend on the type of drug, dose, and the time of last use. Evidence shows that withdrawal symptoms are likely to subside rapidly in the children of mothers using heroin, while withdrawal from substitution medication manifests itself later and lasts longer. NAS develops in 50–90% of the children of mothers who used opiates (both illegal drugs and substitution medication) during pregnancy and interferes in a number of organs and regulatory systems (Stará et al. 2009). Alcohol is the most common cause of congenital mental retardation, and even small doses are associated with a higher risk of birth anomalies and lower intellect (Čihař, 2009). One of the key objectives of postnatal care for drug-using women is the rehabilitation of their family. It has been shown that the success of such rehabilitation is conditioned by ensuring the primary contact between the mother and the child after birth and, where possible, by support from the broader family. The postnatal adaptation of drugdependent parents’ children may be short (with a varying course of NAS). However, it has been suggested that the use of addictive substances during pregnancy has long-term effects which may later manifest themselves in children as hyperactivity, difficulty in concentrating, irritability, speech disorders, slowness, or ADHD. As part of a study carried out at the Children’s Centre in Prague (formerly a so-called nursery home), the present psychomotor development, the maturation of the CNS, and health risks in the children of 200 mothers with a history of drug use page 148
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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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Table 5-8: Number of healthcare fac
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The proportions found for prescribi
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Map 5-2: Sobering-up station networ
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Table 5-14: Network of inpatient fa
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care centres report to diagnostic i
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cannabis, especially among adolesce
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Map 5-4: Number of all treatment de
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Figure 5-8: Selected characteristic
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5.3.3.2 Clients in Opiate Substitut
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Figure 5-10: Trends in the capacity
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Table 5-23: Number of hospitalisati
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Table 6-1: Number of newly detected
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Figure 6-5: Reported incidence of s
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The monitoring of testing for infec
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Table 6-8: Results of testing for H
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Table 6-9: Sharing of needles and s
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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 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
Page 145 and 146: the regional police headquarters on
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: more than 10 clients, etc. This is
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
Page 171 and 172: Table 9-10: Criminal offences commi
Page 173 and 174: SELECTED DRUG-RELATED WEB PAGES ON
Page 175 and 176: 2005-2009 National Strategy - Natio
Page 177 and 178: ministry, 18, 41, 42, 115 ministry
Page 179 and 180: Generální ředitelství Vězeňsk
Page 181 and 182: Mravčík, V., Zábranský, T., Kor
Page 183 and 184: Policie ČR (2011) Statistické př
Page 185 and 186: Van den Berg, C., Smit, C., Van Bru
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