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Substitution treatment badly accessible to drug addicts

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Prague, Oct 4 (CTK) – The substitution treatment for drug addicts, in which they receive a “substitute” substance, is badly accessible in the Czech Republic, and there are also problems to finance the therapy that helps people return to everyday life, addictology experts told a press conference on Wednesday.

A total of 2,266 patients underwent a substitution therapy last year, fewer than one third of all problem users of heroin and other opiates, doctors from the addictology clinic at Prague’s General Teaching Hospital (VFN) said.

“The patient must meet a lot of conditions to join the programme…, which enables them to live a normal life, including car driving. Our patients work, care for their families,” the clinic’s director Michal Miovsky said.

Substitution treatment has been available in the Czech Republic for 20 years now, with Prague’s Apolinar clinic being the first to start providing it in 1997.

The VFN addictology centre provides out-patient treatment for 69 patients, who receive substitute preparations and also psychosocial aid and advice.

The therapy lasts several years. In the first two months, the patients turn up in the centre every day. If they meet all conditions, their visits become less frequent and the substitute doses get reduced.

A total of 63 health facilities provided substitute therapy last year.

Miovsky and Petr Popov, the addictology clinic’s head physician, said substitution treatment is very effective, also lowering the risk of the spread of diseases such as jaundice and AIDS and helping reduce the crime rate.

About 30 percent of the patients treated in the VFN centre receive methadone and 70 percent buprenorphine, the former being subsidised and the latter covered by patients.

According to the latest annual report on drug use in the Czech Republic, most patients must buy buprenorphine for the full price worth up to several thousand crowns a month.

Under the law, at least one medicine for each diagnosis should be available for free and covered from health insurance. However, in fact only three addictology centres see the costs of substitute substances covered from health insurers. If centres fail to gain subsidies or grants, they cannot offer any substances to patients.

According to the annual report, the number of patients on substitution treatment stagnated in the past years and has been slightly falling of late, probably due to its bad accessibility and problems with financing.

In 2015, about 12,700 people had problems with using opiates and addictology centres registered 2,248 patients. In 2014, the number of patients was 2,314.

In 2015, the Health Ministry spent 23.1 million crowns on anti-drug programmes, including 19.2 million on treatment and street programmes and 2.1 million on building the Prague addictology clinic.

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