BACKGROUND: Within the fifth phase of the Central Asia Drug Action Programme (CADAP) covering five post-Soviet Central Asian countries, an analysis of the mortality of drug users was performed. The results for Kazakhstan and Uzbekistan are presented in detail in this paper since results from Kyrgyzstan and Tajikistan are not considered valid and Turkmenistan did not provide data at all. METHODS: A system of registration of all users of illegal drugs known to the health and/or law enforcement authorities ("narcological registers") exists in Central Asian countries inherited from the system of Soviet "narcology". According to the legal norms, the death of a registered person should be recorded. We conducted indirect standardisation of crude mortality rates and computed the standardised mortality ratio (SMR) comparing observed number of deaths with expected number of deaths according to age and gender specific mortality rates in the general population of the same country. RESULTS: The results show excess mortality in registered drug users, particularly in registered females, in Uzbekistan (the latest available SMR for all those registered is 7.4; the SMR in females is 16.3) and Kazakhstan (4.0 and 12.9). The excess mortality is highest among young adults (18-34) in all the studies. CONCLUSION: Taking into account the limited quality and reliability of the data - first of all, the likely under-reporting of deaths in the narcological registers - the crude mortality rate among registered drug users is quite high when compared to EU countries. The SMR in total is comparably lower as a result of the high background mortality in the general population. This excess mortality is preventable and should be targeted by the national drug policies. Specifically, the programmes should target registered and unregistered female drug users.

• Klíčová slova
• Central Asia, Drug users, Heroin, Mortality, Narcological register, Standardised mortality ratio,
• MeSH
• lidé MeSH
• poruchy spojené s užíváním psychoaktivních látek mortalita   MeSH
• registrace statistika a číselné údaje   MeSH
• sexuální faktory MeSH
• uživatelé drog statistika a číselné údaje   MeSH
• věkové rozložení MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Kazachstán epidemiologie   MeSH
• Uzbekistán epidemiologie   MeSH

BACKGROUND: Intensive use of illicit drugs in general and drug injecting in particular are associated with higher somatic co-morbidity, especially of infectious aetiology. The treatment participation of drug users is complicated by a number of barriers. MATERIAL AND METHODS: At the end of 2013, a cross-sectional questionnaire study was conducted on a non-random sample of 240 drug users (188 men and 52 women) recruited in low-threshold drug services in Prague based on their willingness to participate in the study. Drug injecting sometimes in their lifetime was reported by 237 respondents (98.8%), injecting drug use in the last 12 months by 232 (96.7%), and injecting drug use in the last 30 days by 228 (95.0%). The questionnaire included 38 of the 59 original items from the Barriers to Treatment Inventory (BTI). Factor analysis of these items was performed. In addition to the questionnaire survey, two focus groups with a total of 14 clients were carried out. RESULTS: The factor analysis resulted in a 5-factor model that was fed with 23 BTI items. The factors identified can be interpreted as: (1) difficulty entering treatment due to additional responsibilities (e.g. children, family, work, etc.), (2) previous poor treatment experience, fear and concerns about the treatment or negative attitudes of staff, (3) financial difficulties and formal barriers (health insurance debts, problems with the law, etc.), (4) concerns that entering treatment will be too complicated and difficult, (5) distrust of the treatment's ability to improve the client's life situation. The results of the focus groups have shown that drug users face stigmatization and discrimination in healthcare facilities. CONCLUSION: The access to treatment of infectious and other somatic co-morbidity in drug users is complicated by a number of barriers, which largely arise from the lifestyle and socio-economic situation associated with drug use and from negative experiences with the attitude of medical staff. Healthcare professionals should actively identify and respond to barriers to care among drug users by taking appropriate measures in the context of a multidisciplinary approach and cooperation.

• Klíčová slova
• barriers to care, drug use, infectious diseases, injecting drug use, somatic comorbidity,
• MeSH
• infekční nemoci * MeSH
• komorbidita MeSH
• lidé MeSH
• poruchy spojené s užíváním psychoaktivních látek * MeSH
• průřezové studie MeSH
• uživatelé drog * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The objectives were to: (i) estimate the extent of the injecting equipment (IE) provided by needle exchange programs (NEPs) to injecting drug users (IDUs) in the Czech Republic in 2010; (ii) subsequently validate the recent methodology used for data collection by the Czech National Monitoring Centre for Drugs and Drug Addiction (CMC), and (iii) estimate the number of syringes provided to Czech IDUs. A simple document analysis was performed in order to collect data on the production, sale, and consumption of injecting equipment in the Czech Republic in combination with questionnaire screening in the NEPs and 21 brief interviews with key informants. Ten types of IE most commonly used for drug injecting by the Czech drug users were identified. Approximately 5,038,000 pieces of sterile IE were marketed in the Czech Republic in 2010. According to four manufacturers (with a market share of 96%) and with reference to the year 2010, 5,430,694 pieces of sterile IE were provided to Czech injecting drug users (487,694 pieces of IE were sold to IDUs in pharmacies and 5,038,000 pieces of IE were distributed by NEPs in 2010). We compared the amount of IE provided to IDUs as reported to the CMC National registry by NEPs (4,943,000) with that of IE distributed by manufacturers and distributors (5,038,000) in the country in 2010 and found a difference of less than two percent using two different methodologies. This study confirms the accuracy of the data on the amount of IE exchanged as collected by the CMC monitoring system. This study opens up important public health practice and policy-making issues. The methodology of this study may be used in regions where no data collection system is present or where confirmation of the data related to IE is needed.

• MeSH
• lidé MeSH
• programy výměny jehel a stříkaček statistika a číselné údaje   MeSH
• uživatelé drog * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Injecting drug users (IDUs) represent a major subpopulation of hepatitis C virus (HCV)-infected people in developed countries. Yet their uptake to treatment is generally low despite well-documented effectiveness of HCV treatment among former and active IDUs. The present study represents the first attempt to describe the HCV treatment coverage among IDUs and identify factors that affect treatment uptake in the Czech Republic. METHODS: From January to March 2011, a questionnaire survey was conducted among viral hepatitis treatment centres in the Czech Republic. RESULTS: From a total of 76 identified hepatitis treatment centres existing in the country, 39 provided HCV treatment to (mainly former or abstaining) IDUs in 2010. Most clinicians reported being cautious in initiating HCV treatment in IDUs. Abstinence, a screening phase before treatment initiation, opioid substitution treatment and an external evaluation by a specialist were often prerequisites for skrting treatment. However, HCV treatment centres rarely provided drug-use specific services. Financial constraints were also reported, further limiting the inclusion of IDUs into treatment, as non-users are widely preferred to active drug users. Clinicians reported no difference in treatment uptake and adherence between drug users and non-users, nor between opioid and methamphetamine users. CONCLUSION: A number of system- and provider-related factors limit HCV treatment in IDUs in the Czech Republic, despite permissive national clinical guidelines. Targeting these factors is crucial to reduce HCV prevalence at population level.

• MeSH
• adherence pacienta * MeSH
• antivirové látky terapeutické užití   MeSH
• hepatitida C farmakoterapie   epidemiologie   etiologie   psychologie   MeSH
• intravenózní abúzus drog komplikace   MeSH
• lidé MeSH
• pacienti psychologie   MeSH
• prevalence MeSH
• průzkumy a dotazníky MeSH
• uživatelé drog statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• antivirové látky MeSH

The aim of this study was to define the typical groups of users of psychedelics and alike psychoactive substances in Czechia regarding various variables such as demographics, their patterns of use, or motivation for use. Data from 890 Czech respondents were collected through an online questionnaire as a part of The National Psychedelic Research Project. Subjects reported experience with the use of 29 selected substances by answering 133 questions of the questionnaire. Cluster analysis based on answers on last year use was performed, and descriptive statistics was used for 18 questions from the questionnaire. Six groups of users were identified with distinguished users and demographic characteristics, namely, The most experienced; Pure smokers; Highly educated mild users; Past-time users with families; Responsible (party) students and Deep meaning natural substance users. Groups differ mainly in the type of substances used, frequency of use last year, and demographics. Our findings highlight several patterns typical for psychedelics and alike psychoactive substances use in Czechia in each of the groups and the need for targeted drug prevention services, the raise of public awareness regarding this topic, and a possible reevaluation of the legal status of some substances. Results can be useful for health-care providers, social workers, and policy-makers.

• Klíčová slova
• Drug use, online questionnaire, patterns of use, psychedelics, psychoactive substances, typology,
• MeSH
• halucinogeny * MeSH
• lidé MeSH
• poruchy spojené s užíváním psychoaktivních látek * epidemiologie   MeSH
• průzkumy a dotazníky MeSH
• uživatelé drog * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• halucinogeny * MeSH

Kratom (Mitragyna speciosa) is a medicinal plant in Southeast Asia. While studies continue to highlight kratom's utility among poly-drug users, its context of use and therapeutic relevance appears opaque. This review evaluated studies reporting the therapeutic benefits of kratom use among poly-drug users in Southeast Asia, as perceived by the users. A literature search was conducted and only articles that narrated kratom use in poly-drug users in Southeast Asia were selected. A total of nine articles were reviewed. All the surveys were designed as cross-sectional studies and most (n = 7/9) originated from Malaysia. There were no significant differences in the context and motives of kratom use among poly-drug users in Southeast Asia. Kratom was reportedly ingested for a variety of purposes, but largely as an affordable substitute to opiates and amphetamine-type stimulants. Poly-drug users commonly use kratom to self-manage substance use disorder or drug dependence, decrease drug intake, alleviate withdrawal, and for its rejuvenating effects. Co-consumption was not associated with health issues. While these preliminary studies provided important empirical insights, the limitations in their design, sample selection, and focus underscore the need for further studies, including clinical studies, to establish the safety and claimed therapeutic value of kratom in poly-drug users.

• Klíčová slova
• Heroin, Malaysia, kratom, methamphetamine, poly-drug users,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• dostupnost zdravotnických služeb normy   MeSH
• HIV infekce farmakoterapie   prevence a kontrola   MeSH
• intravenózní abúzus drog * komplikace   mikrobiologie   MeSH
• kooperační chování MeSH
• lidé MeSH
• Organizace spojených národů MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• tuberkulóza farmakoterapie   prevence a kontrola   MeSH
• uživatelé drog * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• zprávy MeSH

BACKGROUND: The availability of various oral contraceptive (OC) pill formulations with different hormone compositions suggests that there is potential to align a particular product with an individual user's needs and preferences. To explore this concept further, a survey was conducted of current users of OCs to define and confirm areas of specific needs, and to gain insight into their views and preferences for OC formulations. METHODS: During November and December 2015, women users (n=615) of OCs in five Central and Eastern European countries were surveyed in face-to-face interviews conducted by experienced interviewers. The survey questionnaire comprised 34 questions about the use of and specific needs for OCs. RESULTS: Four basic needs of women taking OCs were identified: reliable contraception, reversibility of contraception, no effect on body weight and safety. Overall, 85% of surveyed women indicated that prevention of pregnancy was the main reason for taking OCs. Weight gain was the side effect of greatest concern with OC use (46% spontaneous answer; 65% aided answer). Independent behavioural segmentation analysis identified four groups - Solved Cycle Problems (46% of participants), Low Hormone Content (22%), Lifestyle (17%) and Beauty (14%) - which characterised the women according to needs and preferences beyond the basic needs of OCs. Each group had unique features and distinct preferences for different formulations of OCs. CONCLUSIONS: Aligning product advantages with specific individual needs may enhance users' overall experience with OCs as a contraceptive option.

• Klíčová slova
• Eastern and Central Europe, needs and preferences, oral contraceptives, survey, women users,
• Publikační typ
• časopisecké články MeSH

AIM: Local prevalence estimates of problem drug use (PDU) are crucial in the process of assessment of drug situation and trends and for the planning of evidence-based policy responses. The aims of our study are twofold: to estimate the number of problem drug users (PDUs) in the Czech capital city in 2011, and to examine the usability of the capture-recapture method (CRM) modified for data from low-threshold programmes (LTPs) for drug users. METHOD: Six independent LTPs provided data for analysis (SANANIM, Drop-in and Progressive, each of these providing one drop-in centre and one outreach programme). After adjustment of the standard CRM formula for cases without an individual identifier, the overlaps between programmes were calculated and the size of hidden population was estimated. RESULTS: In total, it was estimated that there were 10,754 PDUs in Prague in 2011. The current estimate is in line with estimates obtained previously using another indirect standard approach - the multiplier method. CONCLUSION: The modified version of CRM thus proved a reliable method for local PDU estimates.

• Klíčová slova
• capture-recapture, drug use, estimate, low-threshold programmes, population,
• MeSH
• lidé MeSH
• poruchy spojené s užíváním psychoaktivních látek epidemiologie   MeSH
• prevalence MeSH
• statistické modely * MeSH
• surveillance populace MeSH
• uživatelé drog statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

The use of online communities and websites for health information has proliferated along with the use of mobile apps for managing health behaviors such as diet and exercise. The scarce evidence available to date suggests that users of these websites and apps differ in significant ways from non-users but most data come from US- and UK-based populations. In this study, we recruited users of nutrition, weight management, and fitness-oriented websites in the Czech Republic to better understand who uses mobile apps and who does not, including user sociodemographic and psychological profiles. Respondents aged 13-39 provided information on app use through an online survey (n = 669; M age = 24.06, SD = 5.23; 84% female). Among users interested in health topics, respondents using apps for managing nutrition, weight, and fitness (n = 403, 60%) were more often female, reported more frequent smartphone use, and more expert phone skills. In logistic regression models, controlling for sociodemographics, web, and phone activity, mHealth app use was predicted by levels of excessive exercise (OR 1.346, 95% CI 1.061-1.707, p < .01). Among app users, we found differences in types of apps used by gender, age, and weight status. Controlling for sociodemographics and web and phone use, drive for thinness predicted the frequency of use of apps for healthy eating (β = 0.14, p < .05), keeping a diet (β = 0.27, p < .001), and losing weight (β = 0.33, p < .001), whereas excessive exercise predicted the use of apps for keeping a diet (β = 0.18, p < .01), losing weight (β = 0.12, p < .05), and managing sport/exercise (β = 0.28, p < .001). Sensation seeking was negatively associated with the frequency of use of apps for maintaining weight (β = - 0.13, p < .05). These data unveil the user characteristics of mHealth app users from nutrition, weight management, and fitness websites, helping inform subsequent design of mHealth apps and mobile intervention strategies.

• Klíčová slova
• Healthy lifestyle websites, Individual differences, Mobile app users, Smartphones,
• MeSH
• cvičení MeSH
• dospělí MeSH
• index tělesné hmotnosti MeSH
• internet * MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mobilní aplikace * MeSH
• osobnost MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• telemedicína * metody   MeSH
• tělesná hmotnost MeSH
• věkové faktory MeSH
• zdravý životní styl * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH