Problem Opioid Use in the Czech Republic from a Historical Perspective: Times are Changing but Opioid Pharmaceuticals Remain
Abstract
SUMMARY: The prevalence of problem opioid use (POU) in the Czech Republic was estimated at 26.7% of 46,800 problem drug users in 2016, with buprenorphine being the most frequently used opioid. Although POU is not dominant in the Czech Republic because of the prevalent methamphetamine use, it still represents apublic health issue, also because of the high level of intravenous use.
This article reviews the literature on the development of POU on the territory of the Czech Republic and describes several phases of this development: the use of opioid analgesics and domestic production before 1989, aheroin epidemic in the 1990s, and the decline in the use of heroin, which was replaced by diverted substitution medications (buprenorphine), and the recent return of the misuse of opioid analgesics as aconsequence of users looking for asubstance with an optimal cost/benefit ratio. Opioid analgesics are adesirable alternative to illicit opioids in various historical and socio-political contexts as they represent acheap and effective opioid drug.
In conclusion, appropriate regulatory, preventive, and treatment measures, such as opioid maintenance treatment, are needed to alleviate the health and social harms associated with POU.