Methamphetamine in the Czech Republic: epidemiology and last development on drug scene

Transcription

1 Methamphetamine in the Czech Republic: epidemiology and last development on drug scene Michal Miovský, Tomáš Zábranský Crystal-Meth Sektoren und Grenzen-u bergreifender Trialog , Bezirkskrankenhaus Bayreuth Mehrzweckhalle

2 Meth/amphetamines: fairly traditional drugs Amphetamine: 1887 (Lazăr Edeleanu) Methamphetamine: 1919 (Ogata) WW II use: amphetamine (Allies) vs. methamphetamine (Axis) 1940s post-war distribution of the huge war surplus in US, Europe, and Japan 1950s pharmaceutical wave: anorectics and stimulants ( good wife drug ) page 2 Meth/amph trends in Europe

3 Housework on meth

4 History of Czech meth CzechoSlovak drug use no distinct from rest of Europe till WWII Iron curtain after 1948 cut off people, and commodities incl. psychotropic drugs Use of pharmaceuticals with/out alcohol 1960s: dex/phenmetrazine and other stimulants 1970s: simple formula of production of meth (pervitin) reinvented, probably in Prague, and quickly widespread into the Czech part of the federation Self-supporting squads sharing supplying functions and production know-how as typical phenomenon of pervitin production and consumption page 4

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6 History (cont.) 1984: estimated 30,000 non-alcohol addicts in Czechoslovakia; pervitin clearly prevailing 1986: 1890 people arrested because of drug crimes, only 6 because of drug sale 1990s and later: home-made opioids pushed out by heroin and its hierarchically organized suppliers quickly, but not so for meth (so far) page 6

7 Prevalences (for country of 10 mil.) of age, 2004: Lifetime prevalence: 2.5% (22% THC) Last year prevalence: 0.9% (9.3% THC) ESPAD (16agers), 2007: LTP: 3.5% (45.1% cannabinoids) LYP: 3.1% (34.8% cannabinoids) Prevalence of problem use of pervitin, 2007: 21,000 meth PDUs out of all 31,000 PDUs (stable in last 10 years) Immigrant (Russian speaking) drug users in Prague (2007-8): 77% used meth in last month page 7

8 Prevalences in night life / dance culture setting LTP in general population: 2,5% LTP in dance scene: 47,6% LMP between 2003 and 2007 increased only in stimulants (and far less by shrooms). Frequency of use increased in general (except alcohol), and in pervitin in increased most. page 8

9 Blood-borne diseases and Fatal overdoses 35% of injecting methamphetamine users anti-hcv positive (no difference to opioids) HIV (2007): 0.02% prevalence in Czech IDUs, no details about drugs known Overdoses (2007): 11 out of 40 street drugs ODs page 9

10 Deaths with presence of meth in the deceased page 10

11 Czech (and Eastern-European) specifics Historically and up to now, meth use is NOT concentrated into specific social, sexual NOR ethnic minority Result of social levelling of real socialism? BUT more present in criminal environment (drugs are prohibited thus be definition criminal) BUT it increasingly concentrates into night-life / dance culture setting And that is not that usual given pharmacodynamics of the drug page 11

12 Treatment First treatment demand indicator (FTD) and treatment demand indicator (TD): population of meth users during (Studničková & Petrášová, 2009): page

13 Market/s and law enforcement page 13 Estimated annual consumption (2005): 3,150 kg, of which 160 kg consumed in recreational settings, almost 3,000 kg by PDUs Price about 1000 CZK per 1 g stable for last 15 years, as well as purity Seizures: 6,15 kg in 374 seizure cases (0,2 % of consumed) 281 cases < 5 g 168 cases < 1 g 1178 meth arrests in 2007 (59% of all drug arrests) 593 (49% of all drug cases) sentenced in the same year

14 Meth arrests (in %) page 14

15 Situation on the Drug Scene I. (Miovský, 2007) The police have been active, very consistent and systematic in identifying and arresting home pervitin manufactures (so-called cooks ) since midle 90th. It was more difficult to obtain a good-quality drug and the related risks were higher ( ). There was significant uncertainty concerning the distribution chain (which, in the case of the pervitin scene,, could easily be discerned by the police). The manufacturers often ended up in prison, terminated their activities, or started working for large, well-organised, often foreign groups. This (especially) foreign groups could presumably provide them with much better safety and security, including good-quality equipment and a guaranteed supply of material and sales. page 15

16 Situation on the Drug Scene II. (Miovský, 2007) At the end of the 1990s the original hard core of the drug scene had been definitively transformed and all the signs indicated a trend towards its stabilisation. Thus, the drug market had probably once and for all adjusted to the sociopolitical and economic changes in the Czech Republic. Its manufacturing and distribution became fully professionalised, having evolved from the original homelab scene of cooks. A market system similar to that for heroin was developed, and the markets more or less mingled. The period was characterised by a trend towards stabilisation in the range of substances used and the patterns of use, accompanied by a more stabilised market mostly controlled by well-organised international groups. page 16

17 Situation on the Drug Scene III. (Miovský, 2007) Effect no. 1: Despite the fact we have closed last producer of efedrine (Roztoky), there is high quality precursors on scene. Effect no. 2: Big part of our scene is depends on pharmacies (pseudoefedrine) but we have a problem with regulation (wellorganised groups) and after first successful (el. evidence and ID cards) these groups supply the market by medicaments from Poland, Ukraine and other country. page 17

18 Risks and challenges The price makes meth/amphetamines very competitive in times of economic crisis The relative easiness of making the drug/s and wide spectre of possible procedures (and precursors P/E, BMK, P2P, ) makes them fairly available Very quick changes at the market possible Injecting common for both meth/amphetamine BBDs risk Production patterns may facilitate HIV transmission (common jar) Toxic waste as byproduct The whole phenomenon rather underestimated Unintended consequences of regulation measures page 18 Meth/amph trends in Europe

19 Outlook for stimulant markets? Methamphetamine from north-east, cocaine from south-west? Price vs. reputation Economic crisis may favourise the cheaper product not dependent on plant precursor page 19 Meth/amph trends in Europe

20 Conclusions Meth/amphetamines are quite traditional in EU and quick in changing drug use situations and drug markets when entering it Easy production and cheapness may create strong potential for spread in the LARGE stimulant market of EU Technologies, and consumers are here what is the trigger? We need a real-time monitoring, working in much shorter periodicity / time lags. page 20

21 Thank you for your attention strana 21 GPS ČR /11/