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

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The population of substitution treatment patients taking medicinal products containing buprenorphine and problem users of buprenorphine (especially Subutex ® ) overlap. In the Multiplier 2010 study (for more information see the chapter on Problem Drug Use, p. 48) focused on the estimated share of problem drug users in contact with lowthreshold facilities, data were found regarding the proportion of problem opiate users who were included in the substitution programme in 2009. The share of problem users who are participating in substitution treatment was estimated at 8% (95% CI: 7–10%) of problem drug users or 23% (95% CI: 20–27%) of problem opiate users – this represents an estimated approximately 3,000 people (mean estimate); for more information see the 2009 Annual Report. The overlap of both groups – groups of patients using medicinal products containing buprenorphine in treatment and groups of patients in contact with low-threshold programmes with problem use (administration by injection and/or not prescribed by a doctor, black market products) of products containing buprenorphine (especially Subutex ® ) – is generally described in Figure 5-2. The interface between substitution treatment and other harm reduction interventions can be viewed as a positive factor 71 and used in the treatment process, where it is still viewed negatively and as a stigma. Figure 5-2: Overlap of problem Subutex ® users and substitution treatment patients using buprenorphine-based products in 2009–2010, estimate based on available data 5.2.2.3 Sobering-up Stations Sobering-up stations – special healthcare facilities for short-term stays (in the range of several hours) and for detoxification in case of acute intoxication, particularly alcohol intoxication – are a special type of outpatient facility in the Czech Republic. The first information about the number of sobering-up stations is available from 1963, when 21 facilities with 222 beds were reported. Numbers peaked at the end of the 1980s, when 34 stations with about 330 beds were reported; in 2009 there were just 14 facilities with 137 beds. Two new sobering-up stations were reported in 2010 in the Central Bohemia and Olomouc regions, raising the number of sobering-up stations to 16 with a total of 157 beds. In 2010 sobering-up stations were located in all regions except Ústí nad Labem and Liberec – Map 5-2 (Nechanská et al. 2011; Mravcík et al. 2011a; Nechanská, 2011e). 71 The current involvement in both types of interventions is proving to be associated with a lower risk of HIV and HCV infection among injecting drug users and with a reduction in risk behaviour among injecting drug users (Van den Berg et al. 2007; Turner et al. 2011; Hagan et al. 2011). page 65
Map 5-2: Sobering-up station network in 2010 (Nechanská, 2011e) 5.2.2.4 Outpatient Treatment Provided by NGOs Outpatient treatment in the Czech Republic is also available through NGOs; some of these programmes are accredited as healthcare facilities, and some also provide substitution treatment (these facilities and their clients may also be included in other reporting systems); the common denominator is that the NGOs apply for grants from the state budget to provide their services. In 2010 the Government Council for Drug Policy Coordination funded 13 outpatient programmes that provided services to a total of 1,813 drug-using clients (Národní monitorovací středisko pro drogy a drogové závislosti, 2011j); see Table 5-13. Table 5-13: Outpatient treatment facilities operated by NGOs and client numbers in 2003–2010 (Národní monitorovací středisko pro drogy a drogové závislosti, 2011j) Year Number of subsidised Number of clients programmes – drug users 2003 19 1 590 2004 20 1 493 2005 18 1 743 2006 15 2 428 2007 13 1 642 2008 13 2 379 2009 15 2 130 2010 13 1 813 In addition, only one facility in Prague, which has been run by the SANANIM civic association since 1996, offers long-term outpatient treatment in the form of a three-month course of treatment at a day care centre. The capacity of the programme is approximately ten persons. 5.2.3 Residential Treatment 5.2.3.1 Detoxification Units Detoxification units are inpatient healthcare facilities which are usually established and operated as adjuncts to psychiatric wards and addiction treatment departments. These serve for short-term (usually one to three weeks) residential treatment aimed at managing the withdrawal syndrome prior to entering other (typically also residential) abstinence-oriented treatment. Further information about detoxification units was first obtained in late August and early September during a study conducted by the Institute of Health Information and Statistics for the purposes of the Czech National Monitoring Centre for Drugs and Drug Addiction (the National Focal Point); for more information see the 2009 Annual Report 72 . 72 On the basis of the results of this study, the Institute of Health Information and Statistics added an extra table entitled ”Psychoactive substance detoxification in hospital wards and psychiatric hospitals” to its annual collection of data on the bed capacity of healthcare page 66
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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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Page 23 and 24: Region Pardubice Vysočina South Mo
Page 25 and 26: educe drug supply (particularly to
Page 27 and 28: Map 1-1: 2010 drug policy expenditu
Page 29 and 30: Total state budget Regions Table 1-
Page 31 and 32: 1.3.2 Drug Treatment Costs Incurred
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Page 35 and 36: 2 Drug Use in the General Populatio
Page 37 and 38: Table 2-2: Prevalence rates of use
Page 39 and 40: The M-CIDI questionnaire, containin
Page 41 and 42: Table 2-6: Prevalence rates of use
Page 43 and 44: Figure 2-2: Attitudes towards crimi
Page 45 and 46: Table 2-7: Prevalence of use of can
Page 47 and 48: Table 2-8: 2010 Safer Party clients
Page 49 and 50: school curriculum and school rules;
Page 51 and 52: partly also by regional public heal
Page 53 and 54: 3.4 Indicated prevention Indicated
Page 55 and 56: 4 Problem Drug Use The EMCDDA defin
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Page 61 and 62: The general population studies (see
Page 63 and 64: Information on treatment and counse
Page 65 and 66: 5.2.1 Professional Competency of Se
Page 67 and 68: Table 5-6: Number of outpatient hea
Page 69 and 70: Table 5-8: Number of healthcare fac
Page 71: The proportions found for prescribi
Page 75 and 76: Table 5-14: Network of inpatient fa
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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
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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
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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
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9 Drug-Related Crime, Prevention of
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Table 9-2: Number of persons arrest
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Figure 9-1: Total number of persons
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Table 9-7: Sentences and other meas
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Table 9-9: Drug-related misdemeanou
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in custody, and 8 being the inmates
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(approximately 0.5%). However, only
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Table 9-15: NGOs providing drug ser
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Supported by the National Focal Poi
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was rather bizarre. For example, th
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shut down by the authorities. The l
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the regional police headquarters on
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conduct research in the area of pen
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Republic for the Period 2011-2012 f
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departments) or by the external pro
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more than 10 clients, etc. This is
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12 Drug Users with Children The aim
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Childbirth and the National Registe
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Table 12-2: Total number of mothers
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(diagnostic institutions), and reha
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12.3.2 Helping Services Help to chi
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13 Cross-border Travel, Drug Use, a
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ethnic minorities in the Czech Repu
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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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