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

on the black market (for example, one respondent said there was a 60% certainty that it was indeed Subutex ® ). The
price of Subutex ® on the black market is usually around CZK 400 (€ 16) per 8-mg tablet, while the normal
(recalculated) price of Subutex ® from a pharmacy is CZK 200 (€ 8) per tablet. In total, 5 respondents had been on
substitution treatment at some point, of whom four were on it during the survey. Using Subutex ® prescribed by a
physician was mentioned by three respondents (two of them reported injecting use). One respondent was on
substitution treatment (150 mg daily) in 2010, using methadone in combination with pervitin. Another four
respondents reported a combination of both methods to obtain Subutex ® , i.e. both on the black market and on
prescription from a physician. The following practice has been described: because of a lack of money to buy
Subutex ® on prescription in a pharmacy, the user exchanges the prescription for less than the prescribed amount of
Subutex ® on the black market.
Substitution treatment with buprenorphine was more attractive to the respondents than treatment with methadone.
The clients saw the advantage of prescription Subutex ® in its availability, the disadvantage in its high price. However,
according to the respondents, legally obtained buprenorphine is still cheaper than drugs on the black market and the
income from legal employment is sufficient to cover the cost of buying it at a pharmacy. Another advantage is the
certainty that the tablet bought at a pharmacy is really Subutex ® . However, four respondents said that Subutex ® was
expensive for them, and are inclined either to complete abstinence or the use of methadone. Methadone substitution
treatment is only attractive for clients from a financial point of view as it is provided to them free of charge. The clients
see the main problem in having to attend daily to receive the dose. They perceive methadone as a substitution drug
for severely dependent long-term users with no prospect of abstinence. The main reasons cited as to why the
respondents participate in substitution treatment included:
daily access to the substitution substance,
no need to steal to obtain money for the drug,
the possibility of going to work regularly, and
the chance of complete abstinence.
More information on problem drug users in contact with different types of services is provided in the chapters on
Drug-Related Treatment: Treatment Demand and Treatment Availability (p. 55), Responses to Health
Correlates and Consequences (p. 104), and Social Correlates and Social Reintegration (p. 112).
4.3 Intensive, Frequent, Long-term, and Otherwise Problematic Forms of Drug Use
The chapter on Drug Use in the General Population (p. 28) details the results of the testing of the CAST scale used
to identify the risk of problems associated with cannabis use. When extrapolating the results to the adult population
in the Czech Republic, one can estimate that there are approximately 75–110 thousand people at high risk of
problems associated with cannabis or cannabis dependence; see the chapter on Validation Study of Cannabis
Scales (p. 31).
The data on the prevalence of current repeated drug use (use at least once a week in the last month) from
the 2008 General Population Survey on the use of psychotropic substances in the Czech Republic (Běláčková and
Horáková, 2011) were extrapolated to the population aged 15–64 in the Czech Republic. The results thus
obtained indicate that in 2008 there were approximately 360 thousand regular users of cannabis, 37
thousand users of pervitin, 36 thousand ecstasy users, and 31 thousand users of hallucinogenic mushrooms.
Sedative users, probably numbering approximately 990 thousand, are the highest in number; see Table 4-5.
Estimates of the number of users of LSD, cocaine, and heroin are rather tentative as a result of the relatively
low prevalence of these drugs. The users of illicit drugs are mainly young adults.
Table 4-5: The estimated number of people aged 15–64 in the Czech Republic in 2008 who had used the drug at least
once a week in the last month (Běláčková and Horáková, 2011)
Drug
Prevalence
(%)
Confidence
interval (%)
Estimated
number of
users
95% confidence
interval
Sedatives 13.4 12.4–14.4 989,230 915,674–1,062,786
Cannabis 4.9 4.3–5.5 361,458 314,866–408,050
Pervitin 0.5 0.3–0.7 37,414 22,083–52,746
Ecstasy 0.5 0.3–0.7 35,716 20,734–50,697
Hallucinogenic
mushrooms
0.4 0.2–0.6 31,231 17,217–45,244
LSD 0.3 0.1–0.5 22,465 10,573–34,358
Cocaine 0.2 0.1–0.3 13,928 4,559–23,297
Heroin 0.1 0.0–0.2 7,369 551–14,187
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