Abstract
OBJECTIVES: Problem opioid users (POU) represent about one third of circa 47 thousand problem drug users altogether. While heroin has been gradually disappearing from the drug scene, buprenorphine is currently a primary problem opioid drug.
At the same time use of opioid analgesics is increasing. METHODS: A cross-sectional study was conducted among clients of two drop-in centres in Prague in order to analyse current situation among POU.
The aims of the research were to find out currently used opioids and specifics of their use. A questionnaire administered face-to-face was used to collect the data.
The convenience sample was made of 68 clients who had previously used an opioid drug and visited low-threshold drop-in centres Drop In and Progressive in Prague during December 2016 and February 2017. RESULTS: The most used opioids in the last month were Subutex(R), Suboxone(R) and heroin, to the lesser extent opium and fentanyl.
Czech "braun", methadone, Vendal(R) retard, morphine and Addnok(R) were used only sporadically. Respondents had also experience with use of other opioids, such as Palladone(R), Tramal(R), Ravata(R), and codeine.
Subutex(R), Suboxone(R) and heroin were most often bought at the black market, metadon, fentanyl and Vendal(R) retard were mainly gotten for free, braun and opium were mainly home-made. The most common form of application was injection.
The frequency of daily applications was highest in case of Subutex(R) (on average 2,6times a day). The prize at the black market was found out for heroin (100 CZK for 100 mg), Subutex(R) (75-150 CZK for 2 mg) and Suboxone(R) (50-150 CZK for 2 mg).
CONCLUSIONS: Proportion of injecting use among POU remains high and recently there are emerging risks related to misuse of opioid analgesics. Results also showed limits in settings of opioid substitution treatment programmes and small proportion of POU currently in the substitution treatment.
Therefore, increased capacity of substitution treatment programmes in Prague is necessary as well as their accessibility for clients.