BACKGROUND: Knowledge of co-occurring mental disorders (termed 'dual diagnosis') among patients receiving opioid agonist treatment (OAT) is scarce. This study aimed (1) to estimate the prevalence and structure of dual diagnoses in two national cohorts of OAT patients and (2) to compare mental disorders between OAT patients and the general populations stratified on sex and standardized by age. METHODS: A registry-linkage study of OAT patients from Czechia (N = 4,280) and Norway (N = 11,389) during 2010-2019 was conducted. Data on mental disorders (F00-F99; ICD-10) recorded in nationwide health registers were linked to the individuals registered in OAT. Dual diagnoses were defined as any mental disorder excluding substance use disorders (SUDs, F10-F19; ICD-10). Sex-specific age-standardized morbidity ratios (SMR) were calculated for 2019 to compare OAT patients and the general populations. RESULTS: The prevalence of dual diagnosis was 57.3% for Czechia and 78.3% for Norway. In Czechia, anxiety (31.1%) and personality disorders (25.7%) were the most prevalent, whereas anxiety (33.8%) and depression (20.8%) were the most prevalent in Norway. Large country-specific variations were observed, e.g., in ADHD (0.5% in Czechia, 15.8% in Norway), implying differences in screening and diagnostic practices. The SMR estimates for any mental disorders were 3.1 (females) and 5.1 (males) in Czechia and 5.6 (females) and 8.2 (males) in Norway. OAT females had a significantly higher prevalence of co-occurring mental disorders, whereas SMRs were higher in OAT males. In addition to opioid use disorder (OUD), other substance use disorders (SUDs) were frequently recorded in both countries. CONCLUSIONS: Results indicate an excess of mental health problems in OAT patients compared to the general population of the same sex and age in both countries, requiring appropriate clinical attention. Country-specific differences may stem from variations in diagnostics and care, reporting to registers, OAT provision, or substance use patterns.

• MeSH
• diagnóza dvojí (psychiatrie) MeSH
• dospělí MeSH
• duševní poruchy * epidemiologie   farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• opiátová substituční terapie * statistika a číselné údaje   MeSH
• opioidní analgetika terapeutické užití   MeSH
• poruchy osobnosti epidemiologie   MeSH
• poruchy spojené s užíváním opiátů * epidemiologie   farmakoterapie   MeSH
• prevalence MeSH
• registrace * MeSH
• senioři MeSH
• sexuální faktory MeSH
• úzkostné poruchy epidemiologie   farmakoterapie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Norsko MeSH

BACKGROUND: Physical diseases represent a significant burden for opioid agonist treatment (OAT) patients. This study described physical morbidity in two national cohorts of OAT patients focusing on gender differences. METHODS: This population-based cohort study linking multiple health registers investigated physical diseases (ICD-10) in patients receiving OAT in the Czech Republic (N = 4,280) and Norway (N = 11,389) during 2010-2019. Gender-stratified analysis was performed. RESULTS: Overall, we found a large burden of physical morbidity across gender groups in OAT patients. In the Czech Republic and Norway, women in OAT had a significantly higher prevalence of physical diseases across most diagnostic chapters, notably genitourinary diseases and neoplasms. Injuries/external causes and infectious/parasitic diseases were among the most common diseases in both women and men. Viral hepatitis accounted for over half of infectious morbidity in women and men in both cohorts. CONCLUSIONS: Our findings support the need for early screening, detection, and treatment of diseases and conditions across organ systems and the integration of health promotion activities to reduce physical morbidity in OAT patients. The gender differences underline the need for a tailored approach to address specific medical conditions.

• MeSH
• kohortové studie MeSH
• lidé MeSH
• opiátová substituční terapie MeSH
• opioidní analgetika * terapeutické užití   MeSH
• poruchy spojené s užíváním opiátů * farmakoterapie   epidemiologie   MeSH
• prevalence MeSH
• sexuální faktory MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Norsko MeSH

INTRODUCTION: Among people receiving current or previous opioid maintenance treatment (OMT), the leading cause of premature death is an opioid overdose. However, other causes of mortality remain high in this group. An understanding of causes of deaths across multiple settings can be useful in informing more comprehensive prevention responses. The aim of this study was to describe all non-overdose causes of death in three national cohorts (Czechia, Denmark, and Norway) among OMT patients and to explore associations of non-overdose mortality with age and gender. METHODS: This prospective comparative cohort study used national mortality registry databases for OMT patients from Czechia (2000-2019), Denmark (2000-2018), and Norway (2010-2019). Crude mortality rates and age-standardized mortality rates (ASMRs) were calculated as deaths per 1,000 person years for cause-specific mortality. RESULTS: In total, 29,486 patients were included, with 5,322 deaths recorded (18%). We found variations in causes of death among the cohorts and within gender and age groups. The leading non-overdose causes of death were accidents in Czechia and Denmark, and neoplasms in Norway. Cardiovascular deaths were highest in Czechia, particularly for women in OMT (ASMR 3.59 vs. 1.24 in Norway and 1.87 in Denmark). CONCLUSION: This study found high rates of preventable death among both genders and all age groups. Different demographic structures, variations in risk exposure, as well as variations in coding practices can explain the differences. The findings support increased efforts towards screening and preventative health initiatives among OMT patients specific to the demographic characteristics in different settings.

• MeSH
• kohortové studie MeSH
• lidé MeSH
• poruchy spojené s užíváním opiátů * MeSH
• předávkování léky * MeSH
• příčina smrti MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Licit and illicit substance use is one of the major public health issues with severe negative health consequences for individuals and society. Health literacy is essential for improving one's health and navigation in the healthcare system. However, the evidence of health literacy in people with substance use disorders is limited. This study aims to examine health literacy and its socio-demographic, health-related, and substance use-related correlates in young people with alcohol (AUD) and substance use disorders (SUD). In this study, cross-sectional data of young people undergoing addiction treatment for AUD (N = 201, mean age 37.6) and SUD (N = 165, mean age 31.1) were used. Health literacy was assessed using the HLS-EU-Q47. Simple and multiple linear regression was performed to estimate the correlates of health literacy. In total, 37.8% of participants with AUD and 41.8% of SUD had limited health literacy. In participants with AUD, living condition factors, self-perceived health indicators, and frequency of alcohol use showed a significant effect on health literacy. In participants with SUD, financial factors, self-perceived health indicators, and injection sharing showed a significant effect. Increasing health literacy might contribute to improved health outcomes and decreased high-risk substance use-related behavior in people undergoing addiction treatment.

• MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• pití alkoholu MeSH
• poruchy spojené s užíváním psychoaktivních látek * epidemiologie   MeSH
• průřezové studie MeSH
• zdravotní gramotnost * MeSH
• zdravotní stav MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

This mixed methods research paper explores health literacy (HL) in individuals with alcohol addiction by using the 47-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and semi-structured interviews concerning health-related competencies (access, understand, appraise, and apply health information), and determines the limitations of the HLS-EU-Q47 when used under specific conditions of clinical practice. The questionnaire survey and the interviews were conducted with individuals of different health literacy levels who were undergoing inpatient alcohol addiction treatment. The findings indicate that individuals with alcohol addiction might require different types of health information according to their health literacy level in terms of quantity and quality of information to recover from alcohol addiction and improve their overall health. The implications for the clinical practice of addiction treatment as well as recommendations for national and regional policy are also discussed.

• MeSH
• alkoholismus * MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• reprodukovatelnost výsledků MeSH
• zdravotní gramotnost * MeSH
• zdravotnické přehledy MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

INTRODUCTION: Health literacy (HL) has increasingly been recognized as an important determinant of individual and population health. We have only limited evidence of health literacy and its predictors in people with substance use disorders or addictive behaviours. Our aim is to assess the level of health literacy and its relationship with socio-demographic characteristics, self-perceived health indicators, and substance use behaviour in this group of population. METHODS AND ANALYSIS: The conceptual model of health literacy proposed by the European Health Literacy Consortium (HLS-EU Consortium) was followed in this study. We performed a cross-sectional survey to assess health literacy in people undergoing residential addiction treatment programs in the Czech Republic. Respondents were selected from multiple facilities offering medical detoxification, long-term institutional treatment, or socio-therapeutic care in therapeutic communities. The respondents’ level of health literacy was assessed using the 47-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47). The association between health literacy and socio-demographic, health-related, and substance use-related factors will be analyzed using linear regression analysis. DISCUSSION: We will determine the level of health literacy in people undergoing addiction treatment using the current comprehensive approach to health literacy. Our study investigates the potential risk factors of limited health literacy in this group of population.

Publikace se zaměřuje na současnou situaci konzumace alkoholu v Česku a předkádá doporučení WHO. Určeno odborné veřejnosti.

• MeSH
• pití alkoholu MeSH
• poruchy způsobené alkoholem MeSH
• primární prevence MeSH
• programy národního zdraví MeSH
• Publikační typ
• směrnice MeSH
• Geografické názvy
• Česká republika MeSH

• Konspekt
• Veřejné zdraví a hygiena
• NLK Obory
• veřejné zdravotnictví
• adiktologie
• politologie, politika, zdravotní politika
• NLK Publikační typ
• publikace WHO

This publication focuses on the current situation in alcohol consumption in Czechia and presents recommendations created by the WHO. Intended for professionals and policy makers.

• MeSH
• pití alkoholu MeSH
• poruchy způsobené alkoholem MeSH
• primární prevence MeSH
• programy národního zdraví MeSH
• Publikační typ
• směrnice MeSH
• Geografické názvy
• Česká republika MeSH

• Konspekt
• Veřejné zdraví a hygiena
• NLK Obory
• veřejné zdravotnictví
• adiktologie
• politologie, politika, zdravotní politika
• NLK Publikační typ
• publikace WHO