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

Table 4-4: Prevalence estimates of problem drug users obtained from questionnaire surveys among general practitioners
in 2003, 2005, 2007, and 2010 (Mravčík et al. 2008; Národní monitorovací středisko pro drogy a drogové závislosti and
Agentura INRES-SONES, 2010a)
Total number of Number of injecting Number of opiate Number of pervitin
Year
problem drug users
Number
Per 1,000
people aged
15–64
drug users
Number
Per 1,000
people aged
15–64
users
Number
Per 1,000
people aged
15–64
users
Number
Per 1,000
people aged
15–64
2003 n.a. – n.a. – 21,200 2.6* n.a. –
2005 32,000 4.4 n.a. – 17,000 2.3 15,000 2
2007 28,500 3.9 n.a. – 11,600 1.6 16,600 2.3
2010
32,900**
53,500***
4.4
7.2
23,300 3.2 20,400 2.8 12,500 1.7
Note: * Per 1,000 inhabitants aged 18 and over. ** This is the sum of problem drug users by drug. *** This is estimated directly from the
questions concerning the overall number of problem drug users among physicians' clients.
4.1.3 Problem Drug Users on the Open Drug Scene in Prague
Prague, similarly to other major cities, has for a long time been faced with the existence of open drug scenes. The
current problem concerns mainly the city centre, but also other city districts, especially Prague 2 and 5, i.e. areas in
the very centre of Prague, Wenceslas Square and Charles Square, the Vrchlického sady park, and the main railway
station, but also in the district of Smíchov around the intersection at U Anděla and around the bus station at Na
Knížecí. Dealing with the problems associated with these open drug scenes gave rise to numerous conflict situations
between Prague’s city districts themselves, as well as between the city districts and the Municipal Authority of the
City of Prague, and between outreach programmes and the officers of the state and municipal police forces
operating on the drug scene. So far, there is no comprehensive consensus or outline of a solution to this
phenomenon in Prague that would be accepted by all stakeholders. The open drug scenes are places where, in
particular, problem (injecting) drug users are found. The problems mainly relate to public nuisance; there are
complaints from residents, shopkeepers, and owners of businesses about harassment by drug users in attractive
tourist destinations of Prague and the distribution and use of drugs in public (Procházková and Herzog, 2010;
Pracovní skupina Harm Reduction při Protidrogové komisi hlavního města Prahy, 2010).
In 2009–2010, the total number of people on open drug scenes in Prague was estimated to be at least 2,500
persons during the year. The number of daily users in open drug scenes was estimated at 300–500 people on
Wenceslas Square, 50–200 people in the district of Smíchov in the area at Na Knížecí, and (in the period between
April and October 2009) 50–200 people on Charles Square (Procházková and Herzog, 2010; Pracovní skupina
Harm Reduction při Protidrogové komisi hlavního města Prahy, 2010).
4.2 Data on Problem Drug Use from Non-Treatment Sources
The results and comparisons of analyses assessing the needs of clients in low-threshold programmes in Prague in
2003 and 2010 were published (Šťastná, 2010; Šťastná et al. 2011). In 2003, a total of 30 clients of low-threshold
services participated in the study (of whom 24 were men) and two focus groups were conducted with 16 staff
members from six low-threshold programmes. In 2010, a total of 25 clients participated in the study (including 21
men) and one focus group was conducted with six staff members of low-threshold services.
This chapter presents the results of the interviews with the clients. Although the samples are relatively small and the
results therefore need to be assessed with caution, the identical methodology used in both surveys allows
comparisons to be made. In 2003, the average age of the respondents was 29 (men 30, women 24), whereas in
2010 it was 32.7 (men 36.4, women 29). Approximately two thirds of the respondents to both studies lacked
permanent housing. All the respondents from both samples had completed elementary education and the structure
of both samples was similar in terms of education. Approximately two thirds of them were unemployed in both 2003
and 2010.
In both surveys, the respondents used a similar range of drugs. Besides alcohol and tobacco, pervitin, Subutex ® ,
and cannabis were those used most frequently. Heroin use was mentioned more frequently in 2003. Most
respondents have been injecting drugs for more than two years; not a single respondent had been injecting for less
than 12 months in the 2010 study. The frequency of use was daily or almost daily in most cases.
The use of buprenorphine-based drugs was reported by 16 respondents (64%) in 2010 (15 used Subutex ® , 1 used
Suboxone ® ). The doses used ranged from 1 mg once or twice a week to 12 mg daily. Most respondents reported a
dose of 1–2 mg daily. Injecting was the most commonly reported method of using Subutex ® . The respondents also
mentioned that they commonly combine Subutex ® with alcohol, pervitin, or marijuana.
A total of eight respondents (50% of those using buprenorphine) reported the purchase of Subutex ® on the black
market, where, according to them, it is easily accessible on workdays, while at weekends its availability decreases.
The respondents also point out the high uncertainty as to whether the substance is really Subutex ® when buying it
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