1. „ Roma and Drugs in Figures – the Czech Republic“ Budapest, 29-30 October 2004 Czech National Focal Point for Drugs and Drug Addiction Office of the Government of the Czech Rep. tel. +420296153222 fax +420296153264 Pavla Lejckova

2. Content  Roma population in the Czech Republic  Drug use among Roma  Roma population surveys  Pattern of drug use among Roma  HCV seroprevalence study  Roma and treatment  Gravity of drug problem in Roma communities

3. Roma Population in the CR  evidence of Roma population?  11 746 Roma in the CR in 2001 according to Census – based on their own declaration  32 903 according to 1991 Census  145 738 according to municipal authorities in 1989  estimate: 160 – 200 thousand (based on demographic projections)  no evidence of Roma population  civic approach: equal approach to individual with no regard to nationality or ethnicity  protection of personal data (nationality/ethnicity = personal information)  fear of accusation of discrimination  demographic and social characteristics  high fertility, higher number of children in families, less favourable health status (influenced by extent of smoking and alcohol)  lower level of education, low qualification, high level of unemployment (long-term, social support), low quality of housing

4. Roma Population Surveys  Roma Out-Reach and Battery Project, 2003 - 2004  NGO project focusing on extent and pattern of drug use in Roma population with the help of Roma out-reach workers  2003: research model proposed, pilot testing, focus groups  2004: research realization  Specifics of Roma Drug Users Compared to Majority Population Users, 2002 - 2003  NGO in Prague  non-standardized questionnaire in low-threshold centre  sample: 30 Roma respondents (29 aged 15 – 25, 1 older), 30 non- Roma respondents (24 aged 15 – 25, 6 older)  questions on drug used, frequency, age at first use, route of administration, needle sharing, treatment  Out-Reach Programme in Socially Excluded Roma Communities, 1999 -  Council of the Government for Roma Community Affairs  situation analysis in Roma communities: assessment of unemployment, housing, truancy, illiteracy, criminality, prostitution, gambling, drug use – in the beginning and at the end of year  81 Roma communities observed, gravity of the problem assessed

5. Prevalence of Drug Use among Roma  Roma and Drugs, 2004 (school survey realized by A Kluby Society in Brno)  200 respondents (aged 12 – 16); 96 students of Roma community schools  drugs = tobacco, alcohol, illicit drugs Prevalence of drug use First drug used  age at first drug use: non-Roma 88 % at the age of 12 and older Roma 53 % at the age of 11 and younger

6. Pattern of Drug Use among Roma  Specifics of Roma Drug Users in Comparison to Majority Population Users, 2002 - 2003  30 Roma and 30 non-Roma low-threshold centre/out-reach programme clients Primary drugRoma population: - 63 % combine heroin and pervitin - all combine main drug with inhalants and sedatives - 43 % use daily TreatmentLow-threshold centre - Roma 30 % vs. 73 % non-Roma Romanon-Roma Heroin87 %50 % Subutex-43 % Pervitin13 %7 % Romanon-Roma Voluntary34 %56 % Involuntary13 %16 % Never47 %28 %

7. HCV Seroprevalence Study 1  HCV Seroprevalence Study, NMC  September 2002 – December 2003  multi-site cross-sectional study  12 centres involved: low-threshold incl. out-reach programmes  study goals  identify prevalence of HCV antibodies (seroprevalence) among injecting drug users  identify predictive factors influencing the prevalence  evaluate level of knowledge on hepatitis C and the methods of prevention applied among injection drug users  identify sources of instruments for injecting and attitudes to the acquisition of clean instruments and identify factors influencing these practices  760 clients tested, 226 HCV positive results = 29.7 %

8. HCV Seroprevalence Study 2  main findings by ethnic groups  Roma: younger with shorter period of drug injecting  higher M/F ratio (3:1) than in the major population (2:1)  higher frequency of opiates as main drug than in major population (36% vs. 27%)  higher frequency of drug injecting than in major population  lower knowledge and information about drug-related infectious diseases, risk factors, harm reduction measures (e.g. testing)  no significant differences in:  sharing of needles  imprisonment (Roma slightly more frequently)  sex for money or drugs #%# of positive results % Czech65186.019530.0 Roma9212.22426.1 Others141.9642.9 Total757100.022529.7

9. Roma and Treatment  insufficient data in general  according to treatment demand register:  2000: 60 Roma clients out of 9 237 all treatment demands  2002: 54 Roma clients out of 4 148 first treatment demands (1.3 %)  substitution treatment is the only attractive modality for Roma community (high ratio of Roma clients in substitution centres esp. in Usti nad Labem, Ostrava, Brno)  exchange programmes are acceptable  low number in contact with low-threshold centres  very low interest for psychotherapy

10. Drug Problem in Roma Communities  Out-Reach Programme in Socially Excluded Roma Communities, since 1999 (data for 2003)  81 Roma communities observed, gravity of problems assessed Prevalence of drugs in communities  substantial problem in 11 communities (13.6 %)  correlation with the extent of gambling (59), prostitution (28), criminality (67), usury (35), low education #% of all communities % communities with reported drug use Any illicit drug5669.1 Marijuana4555.680.4 Ecstasy67.410.7 Pervitin2935.851.8 Heroin89.914.3 Inhalants4454.378.6 Sedatives2227.239.3

11. Thank you for your attention  Contact: Czech National Focal Point for Drugs and Drug Addiction National Drug Commission Office of the Government of the Czech Republic Nabrezi Edvarda Benese 4 118 01 Prague 1 Pavla Lejckova tel: +420 296 153 349 lejckova.pavla@vlada.cz