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The preparation and enforcement of the national drug policy is the responsibility of the Government of the Czech Republic. Its main counsellingbody for drug-related issues is the Government Council for Drug Policy Coordination , which met three times in All 14 regions had drawn up their regional drug policystrategies in in the Pilsen region, drug issues are incorporated into the Policy Document on the Prevention of Crime and Socio-pathological Phenomena. At the turn of both national strategic documents were subjected to evaluationand new strategies for the forthcoming period were prepared. The evaluationof the National Strategy was pursued on an internal basis. The results showed that three strategic objectives had been achieved: the number of problem users of illicit drugs had been kept relatively stable, the rate of infectious diseases and other health risks among drug users remained low, and the network of services for drug users had been maintained. On the contrary, the experimental use of drugs continued to rise and efforts to stabilise or reduce drug consumption and the availability of drugs failed. It turned out that the character and potential of activities in individual areas of the action planand also the level of their successful implementation corresponded with the accomplishment of the respective strategic objectives. Shortcomings were identified in inter-agency coordinationand liaison. The evaluation also concluded that the drug policyhad faced a shortage of financial and human resources in the recent past. In May the Government approved the new National Drug Policy Strategy for the Period , which builds upon the previous strategy, but is different from it in being conceived as a long-term vision providing for the next nine years. The National Strategy defines four key objectives: I to reduce the level of experimental and occasional drug use, particularly among young people; II to reduce the level of problem and intensive drug use; III to reduce potential drug-related risks to individuals and society, and IV to reduce drug availability, particularly to young people. The Strategy will be complemented with three-year action plans. A new Penal Code became effective on 1 January It includes significant changes in how to address illegal drugs. In particular, the changes concern drug possessionfor personal use, where drugs are differentiated according to their social and health risks. In comparison to the previous sentencing guidelines, a lower punishment range will apply to the possession of cannabisin a quantity greater than small; other types of drugs will carry stricter sentences. Another significant change is the new provision concerning the illegal cultivation of plants and mushroomscontaining a narcotic or psychotropic substance. This activity will be covered by less strict sentencing guidelines than the production of drugs. In addition, the cultivation of a small quantity of plants or mushrooms for personal use will now be a misdemeanour. By virtue of two of its regulations, the Government determined drug quantities greater than small, as well as greater-than-small quantities of plants or mushrooms containing narcotic or psychotropic substances. This is a crucial change, as until now specific quantities were only accounted for by internal regulations intended for the police and public prosecutors. The Government regulations are generally binding legal rules which are also followed by courts in their decision-making. Labelled public expenditure on drug policyreached a level of CZK This amount included CZK In comparison to , total expenses showed a nominal increase on all three levels by 1. On the regional level, there was a slight increase in aggregate year-on-year expenditure; a significant increase was recorded in the region of South Moravia, while the region of Central Bohemia reported a marked decline. Over one third of regional expenditures, however, was earmarked to finance sobering-up stations. The aggregate of funds expended by municipalities experienced a slight decline. Out of a total amount of CZK Its purpose was to bring attention to the problems concerning the provision of subsidies and underfunding in general which endanger the quality and even the very existence of the services. No school-based studylooking into the issue of drugs was conducted in the Czech Republic in the latest results were provided in the Annual Report. However, a few small-scale surveys and projects focusing on the adult population were carried out. Surveys carried out at dance events and in other nightlifesettings suggest dramatically higher prevalence rates of illicit drug useamong this specific subpopulation of young adults: in addition to cannabis, they tend to use mainly ecstasy, followed by pervitin, cocaine, and hallucinogens. The year saw a significant rise in the mean estimate of the number of problem drug users, which reached the level of approximately Pervitin users approximately The number of injecting drug users also rose to about In addition, there was a slight increase in the number of opiate users to As confidence intervals for the estimates from recent years overlap, the observed increase should be interpreted with caution. Nevertheless, there was a statistically significant year-on-year increase in the numbers of problem pervitinusers and injecting drug users. In seven HIV positive people who may have contracted the virus through injecting drug use were newly identified, which is less than in and Thus, the reported incidenceof HIV among drug users returned to the more favourable levels experienced in the earlier years the total incidence rate of HIV in the Czech Republic is on the rise, however, as a result of the spread of infection among gay men. However, the results need to be interpreted with caution, bearing in mind the possibility of a sampling error. The rate of injecting among pervitinand opiate users in contact with counsellingand treatmentagencies has been decreasing slightly in the long term, but for the majority of these users it is still the most common route of administration. In , for the first time, data on new cases of sexually transmitted infections among injecting drug users are available. A rising trend in the incidenceof syphilis among injecting drug users has been observed in recent years: cases of syphilis among IDUs were reported in i. According to a special register, the year witnessed a slight increase in the number of fatal overdoses on illicit drugs and inhalants 49 cases in total reported by forensic medicine departments, which suggests the continuation of the slightly rising tendency already experienced in the previous year. In particular, the number of fatal opiate overdoses increased on a year-on-year basis, from 15 cases in to 20 in The rates of fatal overdoses on pervitinand inhalants showed almost no changes. Cocaine was present in two deaths classified as pervitin overdoses. From the mid-term perspective, the growing numbers of indirect pervitin- and THC-related deaths i. These data show a rising trend for the past three years. The traffic police records indicate that the number and proportion of accidents caused under the influence of alcoholand drugs, as well as the number of people killed in accidents caused by impaired drivers, continued to grow in There has also been an increase in both the number and proportion of people killed in accidents caused by drivers under the influence of other drugs, although the numbers of these reported by the police still tend to be much lower in comparison to the results of autopsies on individuals killed in road accidents investigated at forensic medicine departments. In the Czech Republic, drug users and addicts may seek help from a network of services providing a wide range of easy-to-access interventions. The network of helping agencies experienced no major changes in There was a decrease in the capacity of sheltered housing provided as part of after-care programmes for drug users. Early assessment and intervention tools aimed especially at childrenand young people have been introduced into treatmentand counsellingpractice at a growing rate in recent years. There was a year-on-year increase in the number of drug users listed in the Register of Treatment Demands maintained by the Public Health Service. A total of 8, drug users sought treatmentservices in , i. In comparison to the previous years, a slightly declining trend has been reversed, and the numbers of treatment demands returned to their and levels. Traditionally, stimulant users predominate as far as treatmentdemands are concerned. In , too, they comprised the largest group among all treatment demands The second most numerous group was made up of opiate users The age structure perspective reveals a slight aging of the treatment demand population. While the year-on-year increase in average age is small, a rising trend is apparent from the mid-term perspective. In , the average age of first treatment demands and all treatment demands was The average age of people seeking treatment for the first time has increased by more than three years over the past decade and that of all the people demanding treatment has risen by 3. Women continue to account for one third of treatment demands. There was also an increase in the number of drug users reported by psychiatric outpatient facilities. As regards the three largest user groups, there were slightly more opiate heroin users and fewer stimulant pervitin users, and polydrug users showed a more significant rise in their numbers. The year also experienced a growing number of illicit drug users admitted to psychiatric inpatient facilities, which resulted from an increase in the number of admissions to psychiatric hospitals. First and foremost, this increase was due to patients being admitted for disorders caused by polydrug use; the numbers of opiate and stimulant users who were hospitalised dropped. The number of patients in substitution treatmenthas also been on the rise. A wide range of counsellingand treatmentservices is available to drug users in prisons. Nine out of a total of 36 prisons provided methadonesubstitution treatmentin The care of drug-using inmates was complemented by additional services delivered by 15 non-governmental organisations in 30 prisons. The number of low-threshold facilitiesfor drug users has oscillated around on a year-on-year basis. In recent years, however, a significant increase in the number of clients engaged with these low-threshold programmes has been observed. Although the low level of availability of testing for infectious diseases and the very low degree of tests performed on the population of problem drug users may be seen as an enduring negative trend, the data from the past two years suggest that the negative trend is slowly being reversed. In and the staff of low-thresholdservices, particularly in Prague, repeatedly referred to clashes between street workers and police officers and the complex nature of work with ethnic minorities. There has been a long-term increase in the number of individuals arrested, prosecutedfor, and chargedwith drug-related criminal offences. Specifically, more people were prosecuted for and charged with drug possession Section a , while fewer people were adjudged to have promoted drug use Section a. The most common drug-related charges are associated with pervitin, cannabis, and heroin; currently, the involvement of cannabis in drug offences is on the rise, while that of pervitin has dropped. The highest number of sentences is awarded in relation to drug production and trafficking Section and in connection with pervitin. Since misdemeanours involving drug possessionfor personal use and since also misdemeanours involving the cultivation of plants or mushroomscontaining a narcotic and psychotropic substance for personal use have been dealt with by the local authorities of municipalities with extended competences instead of the Police of the Czech Republic. The relevant data were not available at the time of writing of this report. According to expert estimates, drug users are annually responsible for approximately thousand criminal offences, which accounts for approximately one fifth of all the offences detected in the Czech Republic about thousand per year. Their most common crime is vehicle burglary. The police records show that The largest number of criminal offences on the part of non-alcohol drug users was committed under the influence of pervitinand cannabis. Cannabis is the most widely available drug in the Czech Republic. In this country, cannabisis frequently grown in artificial conditions which contribute to its higher THCcontent. The number of large-scale indoor cannabis growing sites detected is increasing 84 in Pervitin remains the second most frequently seized drug, although the year experienced the detection of the smallest number of pervitin-cooking laboratories in the past three years From May pharmacies were restricted in terms of their supply of medicines containing pseudoephedrine, which is used as the main precursor in the production of pervitin. Although this measure led to a reduction in the sale of these pharmaceuticals in the Czech Republic, an increase in illegal imports of the products from abroad, mainly from Poland, was recorded. For this reason, measures intended to control the availability of medicines containing pseudoephedrine at the European level have been recommended. Cocaine has become a well-established stimulant drug, particularly in the nightlifesetting. Twenty-six cocaineseizures were recorded. The total quantity of The number and the total volume of heroinseizures have remained relatively stable. The fewest seizures and the smallest quantity of the drug seized in the past four years were recorded for ecstasyin ; tablets containing mCPP as the active ingredient have a significantly larger share of the Czech market than those containing MDMA. On the dance scene, in particular, growing interest in mephedrone was observed in The emerging popularity of this stimulant substance may be partly explained by the lack of ecstasy tablets containing MDMA and by mephedrone, like a number of other new synthetic drugs, not being controlled, or banned, in many countries. This also applies to the Czech Republic, where the handling of mephedrone and other new synthetic drugs may, under specific circumstances, be prosecutedas the offence of promotion of drug use, but it cannot be classified as drug production and trafficking. According to the drug marketestimates, almost 19 tonnes of cannabis, 4. The prices of most common drugs remained stable in , although a slight increase in both the average and most frequent prices for cannabiscould be observed at the retail level. The Report concludes with three chapters on selected issues, including treatmentguidelines, drug use-related mortality, and the cost of drug-related treatment. The first chapter addresses the treatmentguidelines standards covering the area of the treatment of drug users in the Czech Republic. These standards are tools guiding the process of the maintenance and assurance of the quality of services, which makes it possible to assess whether, and to what extent, a specific service is provided in good quality. There are several types of guidelines: training guidelines, guidelines for centres, facilities, and programmes, case- and diagnosis-based procedural guidelines, methodological guidelines, and ethical guidelines. The Czech Republic has elaborated the type of guidelines standards governing the operation of centres, facilities, and programmes. Such guidelines are primarily represented by the so-called Certification Standards of the Government Council for Drug Policy Coordination. Compliance with these standards is tested as part of the certificationprocess. Conceived as an inter-agency instrument, these guidelines cover a wide range of health, social health, and social services. The Standards for Quality in Social Services of the Ministry of Labour and Social Affairs and the standards for primary drug preventionprogrammes developed by the Ministry of Education, Youth, and Sports also fall under this category. Czech examples of guidelines for case- and diagnosis-based procedures include the Recommended Treatment Procedures for Addiction Disorders and Pathological Gambling developed by the Psychiatric Society of the J. The purpose of the second selected issue is to provide information about mortalityrelated to drug useand its significance in terms of public health. This chapter presents an overview of the mortality cohort studies among drug users carried out hitherto in the Czech Republic and summarises their results. Drug users in the Czech Republic show a higher mortality rate in comparison to their peers in the general population. The available studies suggest that their relative risk of death is at least 10 times higher than is the case for the comparable general population age group. Women and very young adults show the highest risk, given the respective low mortality rates for these demographic groups in the general population. In proportion, the highest risk of death occurs shortly after the onset of problem drug use, which is usually at a very early age. The third chapter on a selected issue provides an overview of the cost of drug-related treatmentin the Czech Republic, which is addressed in the context of primary preventionand harm reductionand structured according to types of treatment interventions. It covers the costsincurred in relation to addiction and drug usecounselling, treatment, and after-care, not those of the treatment of health consequences and complications, such as infectious diseases and injuries, brought about by drug use. The data reflect the situation, as more recent data concerning the expenses of the General Health Insurance Company spent on drug-related treatment were not available for analysis. The identified costs of prevention, harm reduction, and drug use treatment and aftercarein the Czech Republic in amounted to CZK The most resources to fund treatment and aftercare, CZK Treatment and aftercare receives less financial support from the budgetof the Government Council for Drug Policy Coordination than harm reduction programmes, but significantly more than primary prevention. When different types of programmes covering the domain of treatment and aftercare are compared, the greatest proportion of all the resources is earmarked for institutional treatment. The resources spent on abstinence-oriented outpatient treatmentrank second, followed by substitution treatmentin third place. The smallest amount of resources is dedicated to treatment in therapeutic communities and aftercare. An additional comparison of treatment interventions indicates that therapeutic communities and aftercare programmes, which are not covered by health insurance, as they do not have the status of a healthcare facility, have the relatively smallest amount of financial resources to use. When the cost is calculated in relation to the number of clients, therapeutic communities turn out to be the most expensive, although the average period of treatment in a community is much longer than in an institutional setting. Use of Psych. Medicines in Czechia Report on Illicit Drugs in Czechia Our publications Focused bulletin Reports on the situation in the field of addiction. Back to top. Map of Aid.

2008 Annual Report: The Czech Republic Drug Situation

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MDAI 5,6-Methylenedioxyaminoindane has a reputation as a non-neurotoxic ecstasy replacement amongst recreational users, however the drug has been implicated in some severe and lethal intoxications. Pharmacokinetics of MDAI was rapid, maximum median concentration in serum and brain was attained 30min and almost returned to zero 6h after subcutaneous sc. MDAI particularly accumulated in lung tissue. All doses of MDAI significantly disrupted PPI and the effect was present during the onset of its action as well as 60min after treatment. Disseminated intravascular coagulopathy DIC with brain oedema was concluded as a direct cause of death in sc. In conclusion, the drug had fast pharmacokinetics and accumulated in lipohilic tissues. Behavioural findings were consistent with mild, transient stimulation with anxiolysis and disruption of sensorimotor processing. Together with hyperthermia, the drug had a similar profile to related entactogens, especially 3,4-metyhlenedioxymethamphetamine MDMA, ecstasy and paramethoxymethamphetamine PMMA. Surprisingly subcutaneous MDAI appears to be more lethal than previously thought and its serotonergic toxicity is likely exacerbated by group housing conditions. MDAI therefore poses greater risks to physical and mental health than recognised hitherto. Abstract MDAI 5,6-Methylenedioxyaminoindane has a reputation as a non-neurotoxic ecstasy replacement amongst recreational users, however the drug has been implicated in some severe and lethal intoxications. Publication types Research Support, Non-U. Substances Indans Psychotropic Drugs 5,6-methylenedioxyaminoindane.

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