BACKGROUND: Problem drug use is associated with increased somatic comorbidity, including infectious diseases. METHODS: A cross-sectional questionnaire study on a sample of problem drug users (PDUs) recruited from low-threshold programmes in Prague was carried out at the end of 2013. The questionnaire focused on drug use, risk behaviour, somatic symptomatology and comorbidity, health seeking behaviour. Descriptive analysis and multivariate linear regression analysis were performed. RESULTS: The sample consisted of 240 PDUs, 188 of whom (78.3%) were male, aged 18–64, mean age of 34.8 ± 8.4 years. Methamphetamine was the primary drug for 48.3% of the sample and opioids for 47.9%. Injecting drug use in the past 12 months and 30 days was reported by 96.7% and 95.0%. The self-reported lifetime prevalence of hepatitis C was 63.7%, of HIV 0.9%. HCV was the most frequent diagnosis received from a medical doctor (59.6%), followed by dental problems (54.6%) and an abscess at an injection site (39.6%). In the past 12 months, 58.8% had sought health care outside low-threshold drug services, and 29.2% had been taken to hospital by an ambulance (half of them repeatedly). The symptoms of somatic problems were more prevalent in users of heroin, in women, and in non-Czech nationals and their frequency increased with the frequency of the injecting and sharing of injecting equipment. CONCLUSIONS: Infectious blood-borne diseases transmitted via needle sharing, infectious lesions at an injection site, other skin disorders, and dental problems represent the most prevalent somatic comorbid disorders in people who inject drugs. The need for health care of somatic comorbidity is significant and the specific characteristics of this patient group need to be addressed when providing care.

National Institute of Mental Health Klecany Czech Republic

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