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10.08.2006

Use of addictive substances in the Czech Republic – current situation

Attention is paid to the use of illegal drugs worldwide and, in particular, to infectious diseases spreading in the population, which can be a threat to health and the quality of life not only for individual drug users but also for their close relatives and society. The prevalence of dependency in the EU (by DSM-IV) on alcohol is 0.1-6.6% and on illegal substances 0.1- 0.2%, the highest being in the 18-49-year-old age group (Wittchen and Jacobi, 2005). The estimated number of dependent individuals in the adult population (18-65 years old) in the EU in the last 12 months is: a) 7.2 million people dependent on alcohol and b) 2 million on illegal drugs.

Published by: Mgr. Barbara Janíková
Last review: 10.09.2008
The prevalence of illegal drug use in the Czech Republic

The estimated figure for the Czech Republic (CR) in 2004 is 30 thousand problem drug users, including 10 thousand heroin and 20 thousand pervitin users, of whom 27 thousand use drugs intravenously (Mravčík, 2005). The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) defines "problem drug use“ as injecting and/or long-term or regular use of opiates, heroin, and amphetamine-type drugs. In The Czech Republic up to 60% of problem drug users (PDU) are in contact with drug services, and the number of treatment requests has been increasing since 1995 (Mravčík, 2003). The average age for a first treatment request by an individual was 22.7 in 2004 (Polanecký, 2004).

Infectious diseases

The study "Seroprevalence VHC“ of drug users who had been using intravenously (i.v.) at least in the previous 12 months schowed that 558 (77.1%) out of 760 participants had used a used injection needle for injecting. The occurrence of HIV in the population of i.v. drug users remains at a relatively low level, being up to 6% of all diagnosed occurrences (from 1986 cumulatively, there have been 827 occurrences, of which 48 are i.v. drug users). Infection with the HIV virus among i.v. users is under 1%. The occurrence of Hepatitis C among i.v. drug users is approx. 35%. The accessibility of tests for infectious diseases is insufficient and therefore the number of tests taken by the at-risk population of i.v. drug users is low (Mravčík, 2005). These tests used to be provided by low-threshold services, but since 2006 the Ministry of Health has ordered LTS to stop providing capillary tests for blood-borne diseases such as VHC, VHB, VHA, HIV etc. LTS offer services to minimalize health risks among drug users, for whom LTS, which have the goal of reaching as many people as they can, are easily accessible. The main goals of LTS are: to increase awareness of the effects of drugs and increase users' motivation for less risky behaviour with a change of lifestyle towards abstinence; reduce the number of overdoses, and reduce the spread of viral infections (Mravčík, 2005). In 2004, there were 92 LTS contact centres and street and exchange programmes in the CR. The most widely used is the exchange programme; the number of needles exchanged in the CR has increased from year to year (in 2004 approx. 2.4 milion units were changed). LTS are funded mainly by grants from the state drug policy; the condition is the achievement of "Standards of professional eligibility“ (Úřad vlády ČR, 2003), which come from the "Minimum standards of the WHO“ (1995). These standards were ratified by the Czech government and should be used as a tool for quality control.

The psychiatric comorbidity of drug users

The occurrence of more than one psychiatric diagnosis is not rare; alongside disorders activated by drug use (F10-F19), additional psychiatric diseases occur among PDUs. The prevalence of addiction in the EU is in 4th place in the frequency of psychiatric disorders (tobacco addiction excluded) (Andlin-Sobocki et al, 2005). In Europe, according to estimates, 30-35% of psychiatric patients have a psychiatric disorder and also use addictive substances at the same time (EMCDDA, 2004). Miovska (2005) says that according to data from UZIS (Institute of Health and Statistics of the CR) 15,118 patients were hospitalized in 2003 for disorders induced by drug use (F10-F19). In 2489 (1715 men, 774 women) of them additional psychiatric disorders were diagnosed at the same time, and in 920 of them an additional psychiatric illness. The most frequent were polyvalent use, personality disorders, and neurotic disorders. From the high proportion of PDUs in contact with LTS (Mravčík, 2005) it can be concluded that LTS workers are in contact with a lot of patients with a dual diagnosis. Diagnosing psychiatric disorders and knowing different aspects of a drug user´s personality could lead to choosing the optimal treatment interventions and successful treatment of both diseases (Miovska, 2005). In order for treatment to be effective, cooperation between different parts of the treatment network is needed. LTS could have contact with drug users with a dual diagnosis.

 

References:

Brůčková, M., Malý, M. a Vandasová, J. (2006). Výskyt a šíření HIV/AIDS v ČR v roce 2005. Praha: SZÚ, NRL AIDS. (Retrieved at: http://www.aids-hiv.cz/textova.htm, 28.3.06) *

Kalina, K. et. al. (2003). Drogy a drogové závislosti 1,2 : mezioborový přístup. Praha: RVKPP.

Miovská, L., Miovský, M., Mravčík, V. (2005). Psychiatrická komorbidita pacientů léčených v souvislosti s užíváním drog. Notes: in press. *

Mravčík, V., Korčišová, B., Lejčková, P., Miovská, L., Škrdlantová, E., Petroš a kol.(2005). Výroční zpráva o stavu ve věcech drog v ČR v roce 2004. Praha: Úřad vlády ČR. * Polanecký, V., Studničková, B., Klepetková, M., Šeblová, J. & Železná, Z. (2005). Výroční zpráva 2004 - Incidence, prevalence, zdravotní dopady a trendy léčených uživatelů drog. Praha: Hygienická stanice hl. města Prahy.

Standardy odborné způsobilosti pro zařízení a programy poskytující odborné služby problémovým uživatelům a závislým na návykových látkách (2003). Praha: Úřad vlády ČR. Wittchen HU, Jacobi, F. (2005). Size and burden of mental disorders in Europe: a critical review and appraisal of 27 studies. European Neurospsychopharmacology, Volume 15, Number 4, pp. 357-376.

 

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