natgillin/translations-raw huggingface dataset:
These are generally aggravated by social marginalisation and additional specific problems, such as the risks associated with injection, including the transmission of infectious diseases and overdoses (EMCDDA, 2007c).
) Agranulocitoza je hematološko stanje, ki lahko povzroči hitro razvijajoče se smrtno nevarne okužbe.) Sporočilo za javnost SAMHSA.
Outpatient cocaine clients have one of the largest male to female ratios (five men for every woman) and one of the highest mean ages (about 32 years) among drug treatment clients.
Med uporabniki kokaina, ki se zdravijo izvenbolnišnično, je delež moških vprimerjavi zženskami eden od največjih (pet moških na eno žensko), njihova povprečna starost pa je ena od najvišjih (približno 32 let) od vseh uporabnikov storitev zdravljenja zaradi drog.
This is particularly the case in some countries with large numbers of primary cocaine clients, especially Italy, where their sex ratio is 6:1 and the mean age is 34¢years.
To velja predvsem za nekatere države zvelikim številom primarnih uporabnikov kokaina, zlasti Italijo, vkateri je razmerje med spoloma 6:1, povprečna starost pa 34 let.
Primary users of cocaine report an older age at first use of their main drug (22.3 years, 87¢%¢before the age of 30) compared to primary users of other drugs, and the average time lag between first cocaine use and first treatment entry is about nine years.
Primarni uporabniki kokaina poročajo, da so bili ob prvi uporabi glavne droge starejši (22,3 leta, 87% pred 30. letom) od primarnih uporabnikov drugih drog, povprečni časovni zamik med prvo uporabo kokaina in prvim zdravljenjem pa je približno devet let.
Most cocaine clients snort (63¢%) or smoke (31¢%) the
Večina uporabnikov storitev zdravljenja zaradi kokaina drogo vdihava (63%) ali jo kadi (31%), samo 3% pa jih
Cocaine, mainly powder cocaine, was cited as the principal reason for entering treatment by about 17¢%¢of all drug treatment clients in 2008, corresponding to about 70¢000 cases in 27 European countries.
Kokain, predvsem kokain vprahu, je kot glavni razlog za začetek zdravljenja leta 2008 navedlo približno 17% vseh uporabnikov storitev zdravljenja zaradi drog, kar pomeni približno 70000 primerov v27 evropskih državah.
Among those entering treatment for the first time in their life, the proportion of primary cocaine users was higher (24¢%).
Med tistimi, ki so se začeli zdraviti prvič vživljenju, je bil delež primarnih uporabnikov kokaina večji (24%).
drug, while only 3¢% report injecting it¢(94).
poroča ovbrizgavanju(94
There are wide differences between countries regarding the proportion and number of primary cocaine clients.
Med državami so velike razlike glede deleža in števila primarnih uporabnikov kokaina.
The highest proportions are reported by Spain (46¢%), the Netherlands (33¢%) and Italy (28¢%).
Onajvečjih deležih poročajo Španija (46%), Nizozemska (33%) in Italija (28%).
Elsewhere in Europe, cocaine accounts for less than 10¢% of drug treatment clients, with eight countries reporting less than 1¢%¢(92).
VBelgiji, na Irskem, Cipru, vLuksemburgu in ozdravljenju iz 14 držav, opravljena leta 2006, je
daily and 25¢% have not used it during that period¢(95). An analysis of treatment data from 14 countries in 2006 revealed that about 63¢% of cocaine clients are polydrug users.
) Glej prikaz TDI-2 in preglednici TDI-5 (del i) in (del ii) ter TDI-24 vstatističnem biltenu 2010; podatki za Španijo se nanašajo na leto 2007.)
Among them, 42¢% also use alcohol, 28¢%¢cannabis and 16¢% heroin.
Glej preglednici TDI-1 in TDI-3 vstatističnem biltenu 2010.)
91) See Table PDU-103 (part ii) in the 2010 statistical bulletin.92) See Figure TDI-2 and Tables TDI-5 (part i) and (part ii) and TDI-24 in the 2010 statistical bulletin; data for Spain refer to 2007.
Glej preglednico TDI-17 (del iv) vstatističnem biltenu 2010.)
93) See Figures TDI-1 and TDI-3 in the 2010 statistical bulletin.94) See Table TDI-17 (part iv) in the 2010 statistical bulletin.95) See Table TDI-18 (part ii) in the 2010 statistical bulletin.
Glej preglednico TDI-18 (del ii) vstatističnem biltenu 2010.
Annual report 2010: the state of the drugs problem in Europe
Letno poročilo 2010: stanje na področju problematike drog v Evropi čustva glede sprememb, izboljšati prepoznavanje in nadzorovanje impulzov in potreb, povezanih zuporabo kokaina, zmanjšati skokainom povezano škodo in preprečiti ponovno uporabo (NTA, 2006).
Overall, two main groups of cocaine clients have been identified in treatment: socially integrated individuals using powder cocaine; and a more marginalised group of clients, using cocaine, often crack cocaine, in combination with opioids.
Na splošno lahko med uporabniki kokaina na zdravljenju opredelimo dve glavni skupini: socialno integrirane posameznike, ki uporabljajo kokain vprahu, in bolj marginalizirano skupino uporabnikov, ki kokain – pogosto crack kokain – uporablja vkombinaciji zopioidi.
The first group typically reports snorting the drug, and sometimes consuming it in conjunction with other substances such as alcohol or cannabis, but not with opioids.
Prva skupina običajno navaja vdihavanje kokaina in občasno uporabo skupaj zdrugimi snovmi, kot sta alkohol ali konoplja, vendar ne zopioidi.
Some members of this group are referred to treatment by the criminal justice system.
Nekatere posameznike iz te skupine napoti na zdravljenje kazenskosodni sistem.
The second group often reports injecting drugs, uses both cocaine and opioids, sometimes smokes crack and presents precarious health and social conditions.
Druga skupina pogosto poroča ovbrizgavanju drog, uporablja kokain in opioide, včasih kadi crack ter živi vslabih zdravstvenih in socialnih razmerah.
In this group, which includes former heroin users re-entering drug treatment for cocaine use, the identification of the primary drug can be difficult (NTA, 2010)¢(97).
Vtej skupini znekdanjimi uporabniki heroina, ki se začnejo znova zdraviti zaradi uporabe kokaina, je določanje primarne droge lahko zapleteno (NTA, 2010)(97).
Treatment and harm reduction
Zdravljenje in zmanjševanje škode
Two recent studies investigated the effectiveness of psychosocial treatment provided to powder cocaine (NTA, 2010) and crack cocaine users (Marsden et al., 2009) in English treatment centres.
V dveh nedavnih študijah se je proučevala učinkovitost psihosocialnega zdravljenja, namenjenega uporabnikom kokaina vprahu (NTA, 2010) in crack kokaina (Marsden idr., 2009) vangleških centrih za zdravljenje.
Both compared changes in drug use before and after six months of treatment (or earlier in case of discharge).
Vobeh študijah so primerjali spremembe vzvezi zuporabo drog pred šestmesečnim zdravljenjem in po njem (ali prej vprimeru odpusta).
In the first study, 61¢% of powder cocaine users (1 864¢out of¢3¢075) had stopped using the drug and a¢further¢11¢%¢had significantly reduced their use.
Vprvi študiji je 61% uporabnikov kokaina vprahu (1864 od 3075) prenehalo uporabljati drogo, nadaljnjih 11% pa jih je uporabo znatno zmanjšalo.
In the second study, 52¢% of crack cocaine users (3¢941 out of 7¢636) were abstinent after six months of treatment.
Vdrugi študiji je 52% uporabnikov crack kokaina (3941 od 7636) po šestih mesecih zdravljenja ostalo abstinentov.
Less positively, it was found that opioid substitution treatment was not as effective with clients using heroin and crack cocaine as with those using only heroin.
Manj pozitivna je bila ugotovitev, da nadomestno zdravljenje zopioidi pri osebah, ki uporabljajo heroin in crack kokain, ni bilo tako učinkovito kot pri osebah, ki uporabljajo samo heroin.
This finding confirms the detrimental effects of concomitant cocaine or crack cocaine use on the outcomes of substitution treatment, and underlines the need to develop new strategies to treat combined heroin and cocaine or crack cocaine dependence.
Ta ugotovitev potrjuje škodljive učinke hkratne uporabe kokaina ali crack kokaina na rezultate nadomestnega zdravljenja in kaže, da je treba razviti nove strategije za zdravljenje hkratne odvisnosti od heroina in kokaina ali crack kokaina.
Recent studies for the treatment of cocaine dependence
Novejše študije o¨zdravljenju odvisnosti od kokaina
Over 50 different drugs have been evaluated for treating cocaine dependence.
Ocenjenih je bilo več kot 50 različnih zdravil za zdravljenje odvisnosti od kokaina.
Not one has yet been found to be clearly effective, and neither the European Medicines Agency nor the American Food and Drug Administration has approved any drug for the treatment of cocaine dependence (Kleber et al., 2007).
Za niti eno od njih učinkovitost še ni bila jasno dokazana niti nista Evropska agencija za zdravila in Ameriški urad za živila in zdravila odobrila nobenega zdravila za zdravljenje odvisnosti od kokaina (Kleber idr., 2007).
The use of disulfiram, a substance that interferes with the metabolism of alcohol, was associated with
Vendar se trenutno opravlja več kot 100 nadzorovanih študij znaključnim vzorcem,
In Europe, treatment for dependence on cocaine and crack cocaine is generally provided in specialist outpatient treatment services.
V Evropi zdravljenje zaradi odvisnosti od kokaina in crack kokaina navadno zagotavljajo specialistične službe za izvenbolnišnično zdravljenje.
With no effective pharmacotherapy currently available, cocaine clients are provided with psychosocial treatment such as counselling and cognitivebehavioural therapies.
Ker učinkovite farmakoterapije zaenkrat ni, se uporabnikom kokaina zagotavlja psihosocialno zdravljenje, na primer svetovanje in kognitivno-behavioristične terapije.
Some countries provide guidelines for the treatment of cocaine problems (e.g. Germany, United Kingdom).
Nekatere države so pripravile smernice za zdravljenje težav zaradi kokaina (na primer Nemčija in Združeno kraljestvo).
Guidelines in the United Kingdom recommend, depending on the client’s needs, three to 20¢treatment sessions that aim at resolving ambivalence about change, improving recognition of and controlling cocaine-use cues and urges, reducing cocainerelated harm and preventing relapse (NTA, 2006).
Vsmernicah iz Združenega kraljestva se glede na potrebe uporabnika zdravstvenih storitev priporoča od tri do dvajset terapevtskih sestankov, katerih cilj je razrešiti protislovna
Pharmacotherapy is generally used in Europe to provide relief for symptoms of cocaine dependence, particularly anxiety.
) Od leta 2008 se na Nizozemskem uporabniki kokaina na zdravljenju, ki kot način uporabe navajajo „kajenje“, obravnavajo kot uporabniki cracka.
The first randomised controlled trial of the vaccine was conducted in the United States, and involved 115 subjects undergoing opioid substitution treatment.
Zaradi tega se je precej povečalo število, okaterem se je poročalo vpreteklih letih.
However, only about four in 10 (38¢%) vaccinated opioid users reached a level of antibodies that provided a¢two-month cocaine blockade (Martell et al., 2009).
Neustrezna opredelitev uporabnikov cracka na zdravljenju je mogoča tudi vdrugih državah.)
Denmark, Ireland, Italy and Austria have therefore developed specific programmes for this population.
Glej preglednice TDI-10, TDI-11 (del iii), TDI-21 in TDI-103 (del ii) vstatističnem biltenu 2010.
Chapter 5: Cocaine and crack cocaine
Poglavje 5: Kokain in crack kokain vkaterih preskušajo nove snovi, včasih vpovezavi spsihološkimi ukrepi.
Harm reduction a¢reduction in cocaine use among patients also suffering from alcoholism.
Uporaba disulfirama – snovi, ki ovira presnovo alkohola – je bila povezana zzmanjšanjem uporabe kokaina med pacienti, ki imajo tudi težave zalkoholizmom.
The reduction was attributed to the diminution of alcohol-related disinhibition and impaired judgement.
To zmanjšanje se je pripisalo zmanjšanju zalkoholom povezane disinhibicije in slabše presoje.
Recent studies have also found a direct impact of disulfiram on the metabolism of cocaine.
Vnedavnih študijah je bil ugotovljen tudi neposreden učinek disulfirama na presnovo kokaina.
However, given the limited quality of the evidence, it was suggested that clinicians should balance possible benefits against the potential adverse effects of disulfiram (Pani et al., 2010).
Vendar se zaradi omejene kakovosti dokazov priporoča, naj klinični zdravniki morebitne koristi presojajo glede na morebitne škodljive učinke disulfirama (Pani idr., 2010).
Harm-reduction interventions targeting problem crack and cocaine users are a new area of work in many Member States.
Ukrepi za zmanjševanje škode, namenjeni problematičnim uporabnikom cracka in kokaina, so vštevilnih državah članicah novo področje dela.
One reason for the limited provision of interventions in this field, in particular for crack users, might be a lack of knowledge among key workers about the drug, the target group and their needs.
Eden od razlogov za omejeno ponudbo ukrepov na tem področju, zlasti za uporabnike cracka, je lahko nezadostno znanje ključnih delavcev otej drogi, ciljni skupini in njenih potrebah.
A recent review of harm-reduction interventions for stimulant users concluded that more attention had been given to specifying cocainerelated harms than to developing interventions to reduce them (Grund et al., 2010).
Vnedavnem pregledu ukrepov za zmanjševanje škode med uporabniki poživil se je izkazalo, da je bilo več pozornosti namenjene opredeljevanju škode, povezane skokainom, kot razvoju ukrepov za njeno zmanjševanje (Grund idr., 2010).
The use of a number of anticonvulsant agents was assessed in 15 studies covering 1 066 patients (Minozzi et al., 2009).
Uporaba več antikonvulzivov je bila ocenjena v15 študijah, vkatere je bilo vključenih 1066 pacientov (Minozzi idr., 2009).
The drugs were not significantly better than the placebo in keeping patients in treatment, reducing the number and type of side effects or reducing cocaine use.
Ta zdravila niso bila bistveno boljša od placeba, kar zadeva ohranjanje pacientov na zdravljenju, zmanjševanje števila in vrste stranskih učinkov ali manjšo uporabo kokaina.
Antipsychotic agents were assessed in seven studies covering 293 patients (Amato et al., 2009).
Antipsihotiki so bili ocenjeni vsedmih študijah, vkatere je bilo vključenih 293 pacientov (Amato idr., 2009).
The studies were generally too small to confirm possible effects, but the available results do not support the use of these drugs in the treatment of cocaine dependence.
Te študije so bile na splošno preveč omejene, da bi lahko potrdile morebitne učinke, vendar razpoložljivi rezultati ne podpirajo uporabe teh zdravil pri zdravljenju odvisnosti od kokaina.
Among patients undergoing opioid substitution treatment, it was found that the use of bupropion, dextroamphetamine and modafinil are associated with higher rates of sustained cocaine abstinence than are achieved with a placebo (Castells et al., 2010).
Pri pacientih na nadomestnem zdravljenju zopioidi je bilo ugotovljeno, da je bila uporaba bupropiona, dekstroamfetamina in modafinila povezana zvišjimi stopnjami neprekinjene abstinence od kokaina vprimerjavi splacebom (Castells idr., 2010).
Member States usually provide cocaine injectors with the same services and facilities as are provided to opioid users, including recommendations for safer use, training for safer injecting and needle and syringe programmes.
V državah članicah so uporabnikom, ki si kokain vbrizgavajo, običajno na voljo enake storitve in zmogljivosti kot uporabnikom opioidov, vključno spriporočili za varnejšo uporabo, usposabljanjem za varno vbrizgavanje ter programi zamenjave injekcijskih igel in brizg.
However, cocaine injecting is associated with increased risks of equipment sharing and with frequent injection, which can lead to vein collapse and to injecting in higher-risk parts of the body (e.g. legs, hands, feet and groin).
Vendar je vbrizgavanje kokaina povezano zvečjim tveganjem souporabe opreme za vbrizgavanje in spogostejšim vbrizgavanjem, kar lahko povzroči oslabitev žil in vbrizgavanje vbolj tvegane dele telesa (na primer vnoge, dlani, stopala in dimlje).
Therefore, safer use recommendations should be adapted to these specific risks and one-for-one syringe exchange policies should be avoided.
Zato je treba priporočila za varnejšo uporabo prilagoditi tem posebnim tveganjem in se izogibati politikam zamenjave brizg po načelu „ena za ena“.
Due to the potential high frequency of injecting, the supply of sterile equipment to injectors should not be restricted (van Beek et al., 2001).
Zaradi možnega pogostega vbrizgavanja za osebe, ki si kokain vbrizgavajo, oskrba ssterilno opremo ne bi smela biti omejena (van Beek idr., 2001). Vnekaterih državah (npr.
Clean crack pipes are also provided in some countries by lowthreshold agencies (Spain, France).
Španiji in Franciji) so vnekaterih nizkopražnih agencijah na voljo tudi čiste pipe za crack.
Harm-reduction interventions targeting powder cocaine users in recreational settings focus mainly on raising awareness.
Prva nadzorovana študija znaključnim vzorcem je bila opravljena vZdruženih državah, vanjo pa je bilo vključenih 115 oseb na nadomestnem zdravljenju zopioidi.
Programmes offer advice and information to young people on the risks associated with alcohol and drug use in general, usually including material on the risks of cocaine use.
Vštudiji je bilo ugotovljeno, da osebe, ki so bile cepljene in so razvile ustrezno raven protiteles, niso več uporabljale kokaina.
Apart from awareness raising, harm-reduction options for this target group, which constitutes the vast majority of cocaine users in Europe, are almost non-existent.
Podobne rezultate je potrdila tudi poznejša študija, vkatero je bilo vključenih deset moških uporabnikov kokaina, ki so drogo kadili, bili od nje odvisni in se niso želeli vključiti vzdravljenje zaradi drog.
Among non-pharmacological interventions, some psychosocial interventions provided positive results in reducing drop-out rates, reducing cocaine use and improving attendance, in particular when provided along with contingency management with vouchers (Knapp.¢et al., 2007).
Ukrepi za zmanjševanje škode, namenjeni uporabnikom kokaina vprahu vsprostitvenih okoljih, so osredotočeni predvsem na ozaveščanje.
Several ongoing studies are further investigating the effects of incentives-based interventions, in some cases in association with behavioural therapy and pharmacological interventions.
Programi za mlade vsebujejo nasvete in informacije otveganjih, povezanih zuživanjem alkohola in uporabo drog na splošno, navadno pa vsebujejo tudi gradivo otveganjih pri uporabi kokaina.
Finally, treatment with auricular acupuncture did not provide significant results (Gates et al., 2006).
Poleg ozaveščanja drugih možnosti za zmanjševanje škode pri tej ciljni skupini, vkateri je velika večina uporabnikov kokaina vEvropi, skorajda ni.
Chapter 6Opioid use and drug injection
Poglavje 6Uporaba opioidov in vbrizgavanje drog
Introduction estimated levels of about 750 tonnes in 2007 and 2008 (UNODC, 2010b).
Uvod proizvodnji heroina je 657 ton, kar je manj od ocenjenih ravni vletih 2007 in 2008, ki sta znašali približno 750 ton (UNODC, 2010b).
Heroin arrives in Europe mainly by two trafficking routes.
Uporaba heroina, zlasti vbrizgavanje te droge, je vEvropi tesno povezana zjavnozdravstveno in socialno problematiko od sedemdesetih let prejšnjega stoletja.
The historically important Balkan route brings heroin produced in Afghanistan through Pakistan, Iran and Turkey, and then through other transit or destination countries (Albania, Hungary, Bulgaria, Czech Republic, the former Yugoslav republics, Romania, Slovakia, Austria, Italy).
Ta droga je vEvropski uniji tudi danes še vedno vzrok za največji delež obolevnosti in umrljivosti, povezan zuporabo drog.
Heroin also enters Europe by the ‘silk route’ via central Asia and Russia, and then through Belarus, Poland and Ukraine to, among others, Scandinavian countries via Lithuania (INCB, 2010b).
Ob koncu 90-ih let prejšnjega in vprvih letih novega stoletja je bilo ugotovljeno zmanjšanje uporabe heroina in znjim povezanih težav, čeprav novejši podatki kažejo, da se je ta trend vnekaterih državah morda obrnil.
Within the European Union, the Netherlands and, to a lesser extent, Belgium play an important role as secondary distribution hubs.
Poleg tega je iz poročil ouporabi sintetičnih opioidov, kot je fentanil, in vbrizgavanju poživil, na primer kokaina ali amfetaminov, razvidna vse večja raznovrstnost problematične uporabe drog vEvropi.
Heroin use, particularly injecting the drug, has been closely associated with public health and social problems in Europe since the 1970s.
Heroin prihaja vEvropo predvsem po dveh trgovskih poteh.
Today, this drug still accounts for the greatest share of morbidity and mortality related to drug use in the European Union.
Ena je zgodovinsko pomembna balkanska pot, po kateri vAfganistanu proizvedeni heroin potuje skozi Pakistan, Iran in Turčijo, nato pa vdruge tranzitne ali ciljne države (Albanijo, Madžarsko, Bolgarijo, Češko republiko, nekdanje jugoslovanske republike, Romunijo, Slovaško, Avstrijo in Italijo).
A decline in heroin use and associated problems has been observed during the late 1990s and the early years of the present century, though more recent data suggest that, in some countries, the trend may have changed direction.
Heroin prihaja vEvropo tudi po „svileni cesti“ prek osrednje Azije in Rusije, nato pa čez Belorusijo, Poljsko in Ukrajino prek Litve vskandinavske in druge države (INCB, 2010b).
In addition, reports of the use of synthetic opioids, such as fentanyl, and the injection of stimulant drugs, such as cocaine or amphetamines, reflect the increasingly multifaceted nature of problem drug use in Europe.
VEvropski uniji imata Nizozemska in nekoliko manj tudi Belgija pomembno vlogo kot središči sekundarne distribucije.
Table 9: Production, seizures, price and purity of heroin
Preglednica 9: Proizvodnja, zasegi, cena in čistost heroina
Global quantity seized (tonnes)Heroin Morphine
Svetovne zasežene količine (v tonah) Heroin Morfin
Quantity seized (tonnes)EU and Norway (Including Croatia and Turkey)
Zasežene količine (v tonah) v EU in na Norveškem (skupaj s¨Hrvaško in Turčijo)
Mean retail price (EUR per gram)
Povprečna maloprodajna cena (EUR za gram)Razpon
Mean purity (%)Range
Povprečna čistost (%)Razpon
Since few countries report the retail price and the purity of white heroin, the data are not presented in the table.
Ker le malo držav poroča omaloprodajni ceni in čistosti belega heroina, ti podatki vpreglednici niso predstavljeni.
They can be consulted in Tables PPP-2 and PPP-6 in the 2010 statistical bulletin.Range of the middle half of the reported mean price or purity.Data are for 2008 except the global production estimate (2009).UNODC (2010b) for global values, Reitox national focal points for European data.
Navedeni so vpreglednicah PPP-2 in PPP-6 vstatističnem biltenu 2010.Razpon srednje polovice sporočenih povprečnih cen ali čistosti.Podatki so za leto 2008, razen ocene svetovne proizvodnje (2009).UNODC (2010b) za svetovne vrednosti, nacionalne kontaktne točke Reitox za evropske podatke.
Heroin consumed in Europe originates predominantly in Afghanistan, which accounts for most of the global illicit opium output.
Večina heroina, ki se uporablja vEvropi, je proizvedena vAfganistanu, ki je vodilni proizvajalec prepovedanega opija na svetu.
The other producing countries are Myanmar, which mainly supplies markets in east and south-east Asia, Pakistan and Laos, followed by Mexico and Colombia, which are considered the largest suppliers of heroin to the United States (UNODC, 2009).
Druge države proizvajalke so Mjanmar, ki oskrbuje predvsem trge vvzhodni in jugovzhodni Aziji, ter Pakistan in Laos, sledita pa Mehika in Kolumbija, ki veljata za največji dobaviteljici heroina Združenim državam Amerike (UNODC, 2009).
Global opium production is estimated to have decreased from a peak in 2007, mainly due to a decline in Afghan production, which has fallen from 8¢200 tonnes to 6¢900¢tonnes in 2009.
Ocenjuje se, da se je svetovna proizvodnja opija od vrhunca leta 2007 zmanjšala – predvsem zaradi padca proizvodnje vAfganistanu, ki se je zmanjšala z8200 ton na približno 6900 ton vletu 2009.