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

were looked into; at the time of the preparation of this Selected Issue the results of the study were not yet
available 127 .
It has been found that the pregnant woman and the foetus show individual differences in their levels of resistance, or
tolerance, to drugs. Clinical signs in newborns and young infants, including the subsequent psychomotor
development, do not necessarily correspond to the length of the period for which the mother had been using drugs.
Drug-using parents’ children show a significantly better long-term prognosis than the children of alcoholic parents,
although it is beyond doubt that drugs pose health and social risks. A bad prognosis applies especially to children
living in negative social environments with all the related health, social, and psychosomatic consequences. Parents’
genetic dispositions (also applicable to alcoholism), including their mental potential, are another factor that influences
the development of a child (Lukešová, 2009).
At routine medical check-ups performed at the age of seven by paediatricians, 3752 children from the city of Brno
included in a cohort subjected to a longitudinal prospective study of pregnancy and childhood (ELSPAC) were
examined for behavioural disorders featuring hyperactivity and significant attention deficits. No behavioural
abnormalities were found in 96.5% of the children, one to two out of four abnormalities under observation were
identified in 3.2%, and 0.3% of the children, with a significantly higher rate of boys, showed three to four signs of
behavioural disorders. In comparison to the children who were found free of any abnormalities, the children with
behavioural disorders showed on average a significantly lower birth weight and a smaller head circumference, their
mothers were more likely to have a lower level of education, smoke, and have experienced psychological problems
in both childhood and adulthood, and their fathers were more likely to have had conflicts with the law. Both prenatal
and postnatal exposure to negative family factors, including parents’ drug use, have a negative impact on the
development of behavioural disorders which may progress in the course of life (Kukla et al. 2008).
Nevertheless, the behavioural disorders featuring hyperactivity and attention disorders observed in drug users’
children are caused by a range of risk factors (including genetic, biological, psychosocial, and environmental ones).
These observations have also been confirmed by a two-year study entitled Comprehensive Programme of Care for
Children of Dependent Mothers, carried out by the SANANIM civic association, with financial support from the
Sirius foundation, in several of its programmes providing treatment for drug-dependent mothers and their children.
150 children of long-term users of illegal drugs who have used the services of the organisation were included in the
study. The children are assessed in terms of four domains (psychomotor development, behavioural disorders,
speech development, and morbidity). The aim is to develop a methodological manual for working with the families
specified above. The study was commenced in October 2009 and will be concluded in 2011.
A project entitled Sunflower Garden, carried out by the Centre for the Family of the Drop-In public service company
in association with the Meta association and with support from the Ministry of Education, has been in progress since
2010. Focusing on the occurrence of developmental disorders among children at risk of prenatal exposure to drugs,
the project seeks to reduce or eliminate any disadvantage in such children’s development.
The substitution treatment of pregnant women is another area of research interest. A three-year prospective study of
a sample comprising 47 women dependent on heroin and 60 women in substitution therapy (including 36 on
methadone and 24 on buprenorphine) registered for prenatal care was conducted from 2005 to 2007. The women
dependent on heroin were statistically significantly younger in comparison to the women in substitution treatment.
The study was aimed at surveying the socioeconomic background of pregnant women dependent on opioids and of
those in substitution treatment and determining the effect of substitution treatment on the course of pregnancy and
childbirth in drug-addicted pregnant women. Substitution was proven to have a generally positive influence on the
course of the pregnancy and the health of the foetus and the newborn child. In comparison to both groups of women
on substitution, the group of women using heroin recorded a significantly higher rate of unemployment. All the
women on buprenorphine substitution, 14 out of the 47 women dependent on heroin, and 32 out of 36 of those on
methadone substitution attended the prenatal clinic. The newborns’ birth weight was lowest to a statistically
significant extent in the group of the women addicted to heroin. The significantly largest number of newborns with
symptoms of intrauterine growth restriction was born to the women dependent on heroin. The study confirmed the
greater social stabilisation of the women in substitution treatment. In addition, these women’s pregnancies were
much more likely to be intended and planned, which was reflected in their responsible attitude to prenatal care. The
neonatal abstinence syndrome required the longest treatment in women on substitution treatment with methadone.
The higher the mother’s substitution dose, the more pronounced the withdrawal symptoms in the newborn child. In
view of the duration of the neonatal abstinence syndrome in the children of the mothers on methadone substitution,
the placement of pregnant women in substitution treatment with buprenorphine appeared to be a more considerate
option for the newborns (Vavřinková and Binder, 2007b; Vavřinková and Binder, 2007c).
12.1.1 Data from the Existing Czech Registers
The extent of the problem may also be inferred from the data provided by the register of drug treatment demands,
which records whether the drug user shares a home with a child, as well as from the National Register of Mothers at
127
“Children of Drug-Dependent Mothers” study conducted at the Children’s Centre with Comprehensive Care and Supporting Family
Therapy of Thomayer University Hospital in Prague.
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