INTRODUCTION: Drug-related mortality is a key epidemiological indicator that is collected nationally and internationally. Significant efforts were made in 2006-2007 to improve the quality of data concerning drug-related mortality in the Czech Republic. The aim of this article is to identify the effect of a quality improvement project on the drug-induced mortality data reported in the General Mortality Registry (GMR), and to demonstrate how to identify, quantify and interpret changes in drug-induced mortality based on the example of the Czech Republic. METHODS: We extracted data on illicit drug-induced deaths from the Czech Republic GMR and Special Mortality registry (SMR) for the years between 2004 and 2012, and aggregated monthly and quarterly time series. We applied a new procedure to identify structural breakpoints in time series based on dating structural changes in standard linear regression models. RESULTS: In the GMR, breakpoints were identified in three time series: (i) opioid-related deaths; (ii) other stimulant-related deaths; and (iii) total drug-induced deaths. In the SMR, the structural breaks were identified for opioids, volatile substances and selection D time series. In each of these time series, the analysis identified a decrease in the intercepts in the different segments. DISCUSSION AND CONCLUSIONS: The structural breaks identified and quantified in the GMR time series were plausibly caused by the quality improvement efforts that started in 2006. These results demonstrate that it is critical for the analysis and use of drug mortality data collected in the registries to identify practice changes in the relevant registries, to quantify their influence and to adjust mortality estimates accordingly.

• Klíčová slova
• drug-induced deaths, drug-related mortality, overdose, structural change, time series,
• MeSH
• artefakty MeSH
• časové faktory MeSH
• lidé MeSH
• opioidní analgetika MeSH
• předávkování léky * MeSH
• stimulanty centrálního nervového systému * MeSH
• zakázané drogy * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• opioidní analgetika MeSH
• stimulanty centrálního nervového systému * MeSH
• zakázané drogy * MeSH

Recently, there is a global growing concern over the new (mainly synthetic) psychoactive substances, known as legal highs, research chemicals or bath salts. They are represented by various chemical groups imitating "old" illicit drugs with stimulant, euphoric, hallucinogenic or sedative effects. In the Czech Republic, the peak of their use and supply was observed at the beginning of 2011, when new psychoactive substances were available in smart shops known locally as Amsterdam shops - in that time mainly synthetic cathinones and also synthetic cannabinoids were present. After legislative change that placed tens of new substances under the control of criminal law in April 2011, new psychoactive substances are available at Internet and their use is (after short and media driven boom in early 2011) rather limited and decreasing. Though, the use of new synthetic stimulants was recently reported locally among problem (injecting) drug users; new very potent synthetic opioids represent potential threat of further expansion in this users subgroup.

• Klíčová slova
• new psychoactive substances - legal highs - research chemicals - bath salts - synthetic drugs - drug use - drug supply.,
• MeSH
• internet MeSH
• lidé MeSH
• nové syntetické drogy otrava   MeSH
• poruchy spojené s užíváním psychoaktivních látek epidemiologie   MeSH
• prevalence MeSH
• psychotropní léky otrava   MeSH
• stimulanty centrálního nervového systému otrava   MeSH
• zakázané drogy otrava   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• nové syntetické drogy MeSH
• psychotropní léky MeSH
• stimulanty centrálního nervového systému MeSH
• zakázané drogy MeSH

BACKGROUND: In order to reduce injecting drug use, low-threshold facilities in the Czech Republic have started to distribute empty gelatine capsules as an oral alternative of drug application for those injecting methamphetamine. This report reviews implementation of this intervention and its possible benefits and limitations. METHODS: Between December 2008 and January 2009, 109 low-threshold facilities were asked to complete a questionnaire about the capsule programmes. Two focus groups were conducted, one with professionals involved in distribution and one with peer outreach workers who were interviewed on their experience of using the capsules. RESULTS: A total of 50 facilities (46%) responded to the questionnaire; 16 (32%) distributed the capsules regularly and 19 (38%) were planning to introduce this practice. The main target groups were injecting users of methamphetamine whose veins had been damaged, and methamphetamine users wishing to reduce injecting. The advantages of capsules, as perceived by service staff and peer outreach workers, were their easy use and the satisfactory effect of the oral application; health risks related to the oral use of methamphetamine were considered drawbacks. CONCLUSION: Capsule distribution is a promising harm reduction approach for injectors of methamphetamine or other stimulants; nonetheless its benefits and limitations should be further analysed in an in-depth longitudinal study.

• MeSH
• aplikace orální MeSH
• chemie farmaceutická MeSH
• hodnocení programu MeSH
• injekce intravenózní MeSH
• intravenózní abúzus drog prevence a kontrola   MeSH
• lidé MeSH
• methamfetamin aplikace a dávkování   škodlivé účinky   chemie   MeSH
• pomocné látky chemie   MeSH
• poruchy spojené s užíváním amfetaminu rehabilitace   MeSH
• příprava léků MeSH
• průzkumy a dotazníky MeSH
• snížení rizika poškození * MeSH
• stimulanty centrálního nervového systému aplikace a dávkování   škodlivé účinky   chemie   MeSH
• tobolky MeSH
• želatina chemie   MeSH
• zjišťování skupinových postojů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• methamfetamin MeSH
• pomocné látky MeSH
• stimulanty centrálního nervového systému MeSH
• tobolky MeSH
• želatina MeSH