Hard drug use figures stable but rise in illicit use of heroin substitute

The widespread use of illegal drugs is one of the unwelcome changes brought to the Czech Republic with the fall of communism. The National Monitoring Centre for Drugs and Drug Use is the official government body in this area, and has just brought out its report for 2005. Its findings are in some senses positive, though there has been a worrying rise in the illegal use of one heroin substitute. I discussed the new report with the director of the drug monitoring centre, Viktor Mravcik.

"The main message of the summary of the situation in 2005 is that the situation has stabilised. There are no major adverse trends. For example the number of drug-related deaths remains stable, very similar to the previous year."

How many drug-related deaths are there a year in the Czech Republic?

"Annually we report around 70 drug-related deaths. It concerns mainly meta-amphetamines - called pervitine in the Czech Republic - and volatile substances."

There's been quite a lot in the news recently about a substance called Subutex. What is it, and how is it getting to drug users?

"Subutex is a medical drug used as a substitution substance. It has a similar affect to methadone. The great advantage of Subutex, at least in the Czech Republic, is that it can be prescribed by any medical doctor, any GP. That means it's available for opiate users in every region in the Czech Republic."

Why is it becoming more popular here?

"Substitution treatment has become a standard medical treatment of drug users in the Czech Republic, and the popularity of Subutex is linked to its availability.

"Because methadone is not available across the Czech Republic. We have around ten specialised substitution centres where methadone can be prescribed. And in other parts of the country Subutex is the only substance that can be prescribed. That's the main reason."

But if drug-users are using as a drug, in a sense, not as a substitute, is there any way you can combat that?

"Yeah, you're right, it is misused by drug users. That's a kind of...dark effect of this treatment. But again the Czech Republic is not the only country with this problem.

"Still, Subutex is much safer than, for example, heroin, from the pharmacological point of view. An overdose caused by Subutex is not as probable - these cases are not so frequent.

"The Czech Republic is aware of the fact that is has...shifted to the black market. For next year we have prepared two main measures aimed at preventing it. The first one is a register of patients on a substitute, including Subutex.

"And the second measure is the expected registration of Suboxone, which is a similar drug but with an even better safety profile."