Prevalence of drug use before and during imprisonment in seven European countries (2014-2018).

Substance use is a global phenomenon that is particularly affecting the prison population. This study aimed to describe the prevalence of drug use among people in prison before and during incarceration in seven European countries and to compare it with the prevalence in the general population. Individual data collection was carried out between 2014 and 2018 with a model European Questionnaire on Drug Use among people in prison. A total of 12,918 people living in prison filled in the survey. People in prison report higher level of drug use when compared with the general population and the use of drug inside prison exist, although at lower levels when compared with predetention. Prisons can represent a point of access to engage individuals who use drugs in interventions that address drug use and risk factors related to both drug use and imprisonment.

Gambling products and their risk potential for gambling disorder.

Gambling brings excitement, which is a part of entertainment, but also a basis of operant conditioning, which, in conjunction with other biological and psychological factors, leads to the loss of control over the player's behaviour. This gambling disorder (problem gambling) is characterized by a high intensity and episodic character of gambling and a high amount of staked money, with negative consequences to players and their close ones. Problem gamblers have a high rate of psychiatric comorbidity, as well as suicide. Various gambling products pose a different risk of problem gambling. The game's risk is determined by the arousal for players, the social nature of the game, or the degree of skill required for gambling. It is an effect of so-called structural and situational characteristics, such as amount and variability of bets, structure and probability of win, jackpot, game speed, near wins, audio and visual effects, etc. The game risk increases also with its accessibility or with substance use while playing. In the Czech Republic, there is a high availability of electronic gaming machines (EGM) compared to the neighbouring countries; the availability of on-line games has increased dramatically in recent years. There is also an observed increase in participation in on-line gambling, not just odds and live betting, but also technical games or casino games as reported in population surveys. Estimated up to 5.7% of the adult population is at risk of problem gambling (approx. 510 thousand persons), of which 1.2-1.4% are at a high risk (approx. 80-120 thousand persons). EGMs represent the highest risk, but also casino or on-line games including odds betting, especially live betting shows high risk of problem gambling. Most of the problem gamblers are men; especially young men are highly vulnerable. Although the new Gambling Act has introduced a number of new preventive measures since 2017 according to basic types of games, the assessment of the risk potential of particular gambling products is not a part of their licensing. This contributes to increasing availability of high-risk games, especially on-line.

[New psychoactive substances and their prevalence in the Czech Republic]. / Nové psychoaktivní látky a jejich výskyt v Ceské republice.

Recently, there is a global growing concern over the new (mainly synthetic) psychoactive substances, known as legal highs, research chemicals or bath salts. They are represented by various chemical groups imitating "old" illicit drugs with stimulant, euphoric, hallucinogenic or sedative effects. In the Czech Republic, the peak of their use and supply was observed at the beginning of 2011, when new psychoactive substances were available in smart shops known locally as Amsterdam shops - in that time mainly synthetic cathinones and also synthetic cannabinoids were present. After legislative change that placed tens of new substances under the control of criminal law in April 2011, new psychoactive substances are available at Internet and their use is (after short and media driven boom in early 2011) rather limited and decreasing. Though, the use of new synthetic stimulants was recently reported locally among problem (injecting) drug users; new very potent synthetic opioids represent potential threat of further expansion in this users subgroup.

Mortality of cohort of very young injecting drug users in Prague, 1996-2010.

AIM: To determine the mortality in a cohort of very young injecting drug users (IDUs), and the factors associated with it. DESIGN: A database linkage prospective (follow-up) cohort study. SETTING: A convenience sample of clients of 2 low-threshold facilities, 1 drug treatment clinic, and one special facility for children with severe behavioural disorders, who were all younger than 19 and older than 15, was interviewed one or more times in 1996-8 and asked to agree with their being interviewed again after 10 or more years. PARTICIPANTS: 151 (65 male, 86 female) IDUs recruited in October 1996 - December 1998. MEASUREMENT: Database linkage study compared unique identifiers (IDs) of the recruited subjects with the general register of deaths to determine the life status, and the causes of death of those deceased. Where necessary, we examined the death protocols directly. FINDINGS: Altogether, 8 deaths were registered between recruitment and 31st December 2008 (1,660 person-years). All the deceased were male, and all their deaths were "unnatural"--that is, caused by drug overdose or accident. This translates into the crude mortality rates for the whole cohort being 4.8 deaths per 1,000 person-years (PY), and into a specific mortality ratio in the males SMR=14.4 with the peak at the age of 15-20 (SMR=60.1), declining to SMR=8.2 at the age of 25-30. Except gender, we found no "predictors of death" in this high-risk cohort. CONCLUSION: The overall mortality in the cohort was substantially higher than in the general population; in the male part of the cohort of young injecting drug users it was excessively high in the first three years after recruitment, and caused by external causes exclusively; the mortality in the female sub-cohort was zero, i.e. lower than in the general population of the same age range. Our findings suggest a need to develop targeted prevention of overdoses and other unnatural deaths in young male drug injectors.