Tomas Zabransky

HIV and drug use in Czech Republic: the end of idyllic story?

Marihuana and the "Gateway Theory"

The utilisation of cannabis compounds in recent medicine

Drug services in prisons: opportunities for drug interventions and for collaborations of NGOs and prisons

Introduction to the Special Issue

http://www2.criminology.fsu.edu/%7Ejdi/journal/2007/czechintro.pdf

Methamphetamine in the Czech Republic

The Czech Republic has a relatively long tradition in the addictive and problem ue of methamphetamine, which is called “pervitin” locally. This paper attempts to gve as complex a picture of this phenomenon as possible by analyzing what is kown about the Czech methamphetamine situation through scientific monitoring and research. It begins with a brief historical overview and then utilizes extensively the system of five key indicators (surveys, treatment demand, problem drug use estimates, blood borne diseases, and mortality) and some of the core indicators (namely, drug related crime, price and purity data, and estimates of market value) of drug epidemiology that were developed by the European Monitoring Centre for Drugs and Addiction. By summarizing and carefully interpreting this data, the specifics of the Czech pervitin scene are described and future directions of possible research are identified.

Prevalence of Hepatitis C Virus Infection among Injecting Drug Users in the Czech Republic and Its Predictors

Aim: To determine the prevalence of, and factors associated with, hepatitis C virus (HCV) infection in the population of Czech injecting drug users (IDUs). Design: Multicentric cross-sectional study. Setting: A convenience sample of injecting drug users was recruited using the snowball sampling method. Participants: Sample of 760 IDUs from 9 different Czech regions. Measurement: We used one-drop instant blood tests to determine the anti-HCV antibodies status; a structured questionnaire was completed during the interview with the researcher. We calculated the ratio of positive findings and performed univariate analyses of correlations between predictors and independent variables. Finally, we created a logistic regression model that controlled for age, region of residence, reported sharing of injection paraphernalia, and length of injection drug use and for the interaction between length of injection use and imprisonment in order to assess the predictive value of imprisonment in an individual’s history. Findings: 226 participants (29.74% of the tested sample) were found to be anti-HCV positive. After adjusting for the sensitivity of the test, the ‘true proportion’ was 34.97% (95% CI: 31.56 – 38.35). Many correlated independent variables were found in the univariate analyses. In our logistic regression model, we have found that imprisonment increases the odds of being anti-HCV positive by a factor of 4.3. Conclusion: Anti-HCV seroprevalence remains relatively low in the Czech IDUs population compared to similar populations in the developed countries. Regional differences exist in anti-HCV prevalence within the Czech Republic. The strong association of anti-HCV prevalence with imprisonment history when controlled for other potentially clinically important factors suggests the need for more effective preventive measures in Czech prisons.

Editorial: Substitution treatment as implementation of inter-disciplinary collaboration

Viral hepatitis C in IDUs in the Czech Republic – seroprevalence and new infections

The presentation sums sup the results of the HCV seroprevalence study in the Czech injecting drug users. It focuses on the factors associated with increased risk of being infected, and practical impacts of these findings for prevention and for drug policy. In the discussion the methodological difficulties and limitations of the study are reviewed – particularly the sampling method used, the reliability of self-reporting on risky behaviors, and the properties of radpid tests – and some possible further steps are proposed. In the last part of the presentation the authors introduce preliminary results of the HCV seroincidence study and possible interpretations that may have impact on evaluation of harm reduction methods.

Marijuana and the "gateway drug" theory

The extent and length of the discussion on marijuana as “gateway drug” can serve as implicit evidence that majority of experts and laypersons is well aware of the fact that other illegal drugs cause much bigger health- and social harms. The presentation defines the “gateway theory” ad review major scientific studies dealing with this topics that were published in peer reviewed journal within last 10 years. Then the main competing explanation of the normal succession in drug initiation is introduced – the theory of “general propensity to use drugs” – together with two significant studies in the general propensity modeling. We shortly mention the relevance of animal studies for “gateway drug” discussions. We conclude that the gateway theory cannot be rejected completely, but the “general propensity” theory fulfills better the Bradford-Hill criteria of causality.