natgillin/translations-raw huggingface dataset:
) Most national case definitions are the same as the EMCDDA definition or very similar, although some countries still include cases due to psychoactive medicines or non-overdose deaths, generally as a limited proportion (see the 2007 statistical bulletin methodological note ‘Drug-related deaths summary: definitions and methodological issues’ and ‘DRD Standard Protocol, version 3.1’).)
Večina nacionalnih opredelitev primerov je enaka ali zelo podobna opredelitvi Centra, čeprav nekatere države še vedno vključujejo primere zaradi psihoaktivnih zdravil ali smrtne primere, ki niso posledica prevelikega odmerka, na splošno v omejenem deležu (glej metodološko opombo v Statističnem biltenu 2007 „Povzetek z drogo povezanih smrtnih primerov: opredelitve in metodološka vprašanja“ in „DRD standardni protokol, različica 3.1“). )
See Tables DRD-2 (part i), DRD-3 and DRD-4 in the 2007 statistical bulletin.)
Glej preglednice DRD-2 (del i), DRD-3 in DRD-4 v Statističnem biltenu 2007.)
In France, the rate was 0.9 per million in 2005, which may imply some under-reporting, but it should be noted that it was about 10 times higher in 1994, when overdose deaths started to decline.)
V Franciji je bila ta stopnja v letu 2005 0,9 milijona, kar bi lahko pomenilo, da je bilo poročanje pomanjkljivo, vendar je treba opozoriti, da je bila ta stopnja v letu 1994, ko se je začelo število smrtnih primerov zaradi prevelikega odmerka zniževati, približno desetkrat višja.)
See Table DRD-5 in the 2007 statistical bulletin.)
Glej preglednico DRD-5 v Statističnem biltenu 2007.)
As most cases reported to the EMCDDA are opioid overdoses, general characteristics of acute drug-related deaths are used for description of opioid cases.) The Czech Republic, Denmark, Germany, Latvia, Malta, the Netherlands, Austria, Portugal and the United Kingdom.
Podatek se nanaša na zahodna in osrednja območja SZO v Evropi, ki vključujejo nekatere države nečlanice EU, in skupno število smrtnih primerov za Estonijo, Latvijo in Litvo (vzhodno območje).
Figure 12: Proportion of acute drug-related deaths that show presence of opioids
Prikaz 12: Delež akutnih z drogo povezanih smrtnih primerov, ki kažejo prisotnost opioidov
CzechRepublic (2005) (
Češka (2005) (
Hungary(2005)
Madžarska(2005)
(1) For the Czech Republic, the EMCDDA Selection D definition of acute drug-related death was used instead of the national definition.
(1) Za Češko je bila namesto nacionalne opredelitve uporabljena opredelitev centra EMCDDA za akutni z drogo povezan smrtni primer iz Izbora D.
The national definition includes poisoning by psychoactive medicines, which accounts for most cases (156 cases out of 218). (2) Office of National Statistics definition.NB: In some countries, the ‘National definitions’ of drug-related death include a limited number of cases of deaths indirectly related to drug use.
Nacionalna opredelitev vključuje zastrupitve s psihoaktivnimi zdravili, kar pomeni večino primerov (156 od 218).(2) Opredelitev Urada za nacionalno statistiko.Opomba: V nekaterih državah „nacionalne opredelitve“ z drogo povezanih smrtnih primerov vključujejo omejeno število smrtnih primerov, ki so z uživanjem drog povezani posredno.
Data for 2005 or last year for which information is available.
Podatki za leto 2005 ali za zadnje leto, ko so podatki na razpolago.
For further information, see Table DRD-1 in the 2007 statistical bulletin.Sources: Reitox national reports (2006), taken from national mortality registries or special registries.
Za nadaljnje informacije glej preglednico DRD-1 v Statističnem biltenu 2007. Nacionalna poročila Reitox (2006) na podlagi podatkov nacionalnih registrov smrtnih primerov ali posebnih registrov.
Although research shows that substitution treatment reduces the risk of fatal overdose, each year some deaths are reported associated with the misuse of substitution medicines.
160) Ker gre v večini primerov, sporočenih Centru, za prevelik odmerek opioidov, so za opis primerov uživanja opioidov uporabljene splošne značilnosti akutnih z drogo povezanih
There are very few reported overdose deaths among people aged less than 15 years, although drug deaths in this age group could be under-reported.
( smrtnih primerov.
Denmark reported that methadone was the cause of poisoning (alone or in combination) in 43 % of drug-related deaths (89 out of 206, in 2005); Germany reported that 255 cases (out of 1 477) were attributed to ‘substitution substances’ (75 alone and 180 with other narcotics) in 2005, compared with 345 cases in 2004; the United Kingdom reported 280 cases (out of 1 972, drug strategy definition) with ‘mention’ of methadone
161) Češka, Danska, Nemčija, Latvija, Malta, Nizozemska, Avstrija, Portugalska in Združeno kraljestvo.
) See Table DRD-1 (part i) in the 2007 statistical bulletin.) See Figure DRD-2 in the 2007 statistical bulletin.)
162) Glej preglednico DRD-1 (del i) v Statističnem biltenu 2007.163) Glej prikaz DRD-2 v Statističnem biltenu 2007.
(2004); and, in Norway, 55 autopsies revealed traces of methadone.
V mnogih državah članicah se starost žrtev prevelikega odmerka povečuje, kar kaže na zniževanje pojavnosti uživanja heroina med mladimi.
Spain reported (Reitox national reports, 2005) that there were few fatal overdoses involving only methadone (2 % of total), but that it was frequently present in combination in opioid deaths (42 %) and cocaine deaths (20 %).
Ta trend je skupen vsem državam članicam EU-15, čeprav so bila v Avstriji in Luksemburgu v zadnjih letih opažena zniževanja.
Other countries did not report methadone deaths or the numbers were very small.
V drugih državah članicah je ta trend bolj nejasen, zaradi nizkega števila primerov pa je številke težko razlagati (164).
Overdose deaths due to cocaine are more difficult to identify than those caused by opioids, and are often considered to be the result of a combination of causes, rather than from cocaine toxicity itself (166).
Smrtni primeri zaradi uživanja metadona in buprenorfina s štirimi v letu 2004). Buprenorfin je glavno nadomestno zdravilo za opioide v teh dveh državah, vendar je ocena, da v Franciji snov prejema od 70 000 do 85 000 oseb, veliko višja od števila zdravljenih na Finskem.
Studies have found that most cocaine deaths are related to chronic use of the drug and are often the result of cardiovascular and neurological problems brought on by the use of cocaine over a long time, particularly in users with predisposing conditions or risk factors.
Poleg Francije in Finske so leta 2004 še tri države poročale o smrtnih primerih, povezanih z buprenorfinom (v vsaki državi dva ali trije primeri).
In Europe, reports of deaths with cocaine involved usually also mention the presence of other substances (including alcohol and opioids), reflecting the use of cocaine in combination with other drugs.
Študija, s katero so v Združenem kraljestvu med letoma 1980 in 2002 iskali izključno smrtne primere, povezane z buprenorfinom, je odkrila samo 43 primerov, pogosto ob hkratnem uživanju benzodiazepinov in drugih opioidov (Schifano et al., 2005).
There is a clear need to investigate further the health consequences and mortality related to cocaine use.
Akutni smrtni primeri, povezani z uživanjem drog, ki niso opioidi
Trends in acute drug-related deaths
Smrtni primeri, povezani z uživanjem ekstazija in amfetaminov
Deaths due to buprenorphine poisoning appear to be rare, which is attributed to the agonist–antagonist pharmacological characteristics of this drug. However, some deaths have been reported by European countries.
Čeprav raziskave kažejo, da nadomestno zdravljenje zmanjšuje tveganje smrtnega prevelikega odmerka, se vsako leto poroča o nekaj smrtnih primerih, povezanih z zlorabo nadomestnih zdravil.
In the 2006 and 2005 national reports, only France and Finland recorded deaths related to this substance. In Finland, buprenorphine was found in 83 cases in 2005 (73 in 2004), generally combined with benzodiazepines, sedatives or alcohol, or injected.
S spremljanjem števila smrtnih primerov, povezanih z metadonom in buprenorfinom, ter okoliščin smrti se lahko pridobijo pomembne informacije za zagotavljanje kakovosti programov nadomestnega zdravljenja in za pobude za preprečevanje in zmanjševanje škode.
In France, only two fatal overdoses involving buprenorphine were reported in 2005 (four in 2004). Buprenorphine is the main opioid substitution drug in these two countries, but the estimated 70 000 to 85 000 people receiving the substance in France is much greater than the numbers treated in Finland.
Smrtni primeri, pri katerih se omenja ekstazi, so redki, vendar pa so povzročili precejšnjo zaskrbljenost, ko so jih začeli pred nekaj leti prijavljati, saj se pogosto zgodijo nepričakovano med socialno vključenimi mladimi osebami.
In addition to France and Finland, in 2004, three other countries reported deaths mentioning buprenorphine (two or three in each case).
Omejeni podatki, ki so na voljo v nacionalnih poročilih Reitox za leto 2006, kažejo, da smrtni primeri zaradi ekstazija ostajajo na podobnih stopnjah kot v preteklih letih.
A study searching exhaustively for deaths with mentions of buprenorphine in the United Kingdom between 1980 and 2002 found only 43 cases, often in combination with benzodiazepines or other opioids (Schifano et al., 2005).
V vsej Evropi je bilo zabeleženih 78 smrtnih primerov, povezanih z ekstazijem (165).
Data available for the EU reveal some general trends in drug-related deaths. From a longer term perspective, the EU-15 Member States and Norway experienced a sharp increase in drug-related deaths during the 1980s and early 1990s, possibly paralleling the expansion of heroin use and injection (167).
Tudi o smrtnih primerih zaradi uživanja amfetaminov se ne poroča pogosto, čeprav je bilo v letu 2004 na Češkem 16 smrtnih primerov pripisanih pervitinu (metamfetaminu), v letu 2005 pa 14, kar ustreza povečanju ugotovljenega števila problematičnih uživalcev pervitina in povpraševanja po zdravljenju.
Drug deaths continued to increase between 1990 and 2000, although less sharply.
S Finske so poročali o 65 smrtnih primerih, povezanih z amfetamini, čeprav vloga te droge v teh primerih ni bila opredeljena.
Acute deaths related to non-opioid drugs
Smrtni primeri, povezani z uživanjem kokaina
Deaths related to ecstasy and amphetamines
Danska je poročala, da je bil metadon vzrok zastrupitve (sam ali z drugimi snovmi) pri 43 % smrtnih primerov, povezanih z drogami (89 od 206 v letu 2005).
Deaths mentioning ecstasy are infrequent, but caused considerable concern when they started to be reported some years ago, as they often occur unexpectedly among socially integrated young people.
Nemčija je poročala, da so v letu 2005 255 primerov (od 1 477) pripisali „nadomestnim snovem“ (pri 75 primerih samo njim, pri 180 primerih pa tem snovem skupaj z drugimi drogami), v primerjavi s 345 primeri leta 2004, iz Združenega kraljestva so poročali o 280 primerih (od 1 972 primerov, opredelitev strategije boja proti drogam), pri katerih je bil „omenjen“ metadon (2004), na Norveškem pa je 55 obdukcij razkrilo sledi metadona.
The limited data available in the 2006 Reitox national reports suggests that ecstasy deaths remain at similar levels to those reported in previous years.
Španija je poročala (nacionalna poročila Reitox, 2005), da so imeli malo smrtnih primerov zaradi prevelikega odmerka, kjer bi bil metadon edina snov (2 % vseh primerov), vendar pa je bil pogosto prisoten pri smrtnih primerih zaradi hkratnega uživanja opioidov (42 %) in kokaina (20 %).
In Europe as a whole, there were references to 78 deaths involving ecstasy (165).
Druge države niso poročale o smrtnih primerih zaradi uživanja metadona ali pa so bile sporočene številke zelo nizke.
Since 2000, many EU countries have reported decreases in the numbers of drug-related deaths, possibly related to increases in treatment availability and harm-reduction initiatives, although possible moves away from injection or a reduction in heroin availability may also be important.
Študije kažejo, da je večina smrtnih primerov zaradi kokaina povezanih s kroničnim uživanjem te droge, smrtni primeri pa so pogosto posledica kardiovaskularnih in nevroloških težav, ki jih povzroči dolgoročno uživanje kokaina, predvsem pri uživalcih, ki so za to bolj dovzetni ali so izpostavljeni dejavnikom tveganja.
At European level, drug-related deaths fell by 6 % in 2001, by 14 % in 2002 and by 5 % in 2003 (Figure 13).
V Evropi so pri smrtnih primerih, povezanih s kokainom, po navadi omenjene tudi druge prisotne snovi (vključno z alkoholom in opioidi), kar kaže na uživanje kokaina hkrati z drugimi drogami.
However, reports for 2004 and provisional data for 2005 indicate that the decrease in drug-related deaths has not continued beyond 2003.
Države, ki so poslale podatke, so v nacionalnih poročilih za leti 2006 in 2005 navedle več kot 400 smrtnih primerov zaradi uživanja kokaina.
A worrying trend has begun to emerge in reports of drug-related deaths in some countries.
Zdi se, da so smrtni primeri zaradi zastrupitve z buprenorfinom redki, kar se pripisuje agonističnoantagonističnim farmakološkim značilnostim tega zdravila.
After marked peaks in drug-related deaths in 1999–2001, followed by a clear decrease for two to three years, an increase in reported deaths has been observed in 2004 and 2005 (168).
Vseeno pa so evropske države poročale o nekaterih smrtnih primerih.
This pattern generally describes the trends in drug-related deaths observed in recent years in Ireland, Greece, Portugal, Finland and Norway and, to a lesser extent, those observed
V nacionalnih poročilih za leti 2006 in 2005 sta le Francija in Finska navedli smrtne primere, povezane s to snovjo.
Amphetamine deaths are also infrequently reported, although in the Czech Republic 16 deaths were attributed to pervitin (methamphetamine) in 2004 and 14 in 2005, correlating with an increase in the estimated number of problem pervitin users and treatment demands.
Na Finskem so buprenorfin leta 2005 našli v 83 primerih (73 leta 2004), na splošno pa je bil zaužit hkrati z benzodiazepini, pomirjevali, alkoholom ali vbrizgan.
In Finland, 65 deaths were reported involving amphetamines, although the role of the drug in these deaths was not specified.
Francija je poročala le o dveh smrtnih primerih zaradi prevelikega odmerka buprenorfina v letu 2005 (v primerjavi
) Depending on country, figures refer to 2004 or 2005, for ecstasy and cocaine.)
Odvisno od države se podatki nanašajo na leto 2004 ali 2005 za ekstazi in kokain.)
See Figure DRD-8 in the 2007 statistical bulletin.) See Table DRD-2 in the 2007 statistical bulletin.
Za podrobnejše poročilo o smrtnih primerih, povezanih s to drogo, glej izbrano vprašanje o kokainu 2007.
Chapter 8: Drug-related infectious diseases and drug-related deaths the Netherlands, although in most countries young drug users
Poglavje 8: Z drogami povezane nalezljive bolezni in smrtni primeri povezano z uživanjem kokaina, je treba podrobneje raziskati.
Figure 13: Overall trend in acute drug-related deaths, 1996–2005 for all Member States with available data account for a decreasing proportion of overdoses (170).
Prikaz 13: Splošni trend akutnih z drogo povezanih smrtnih primerov od leta 1996 do 2005 za vse države članice, za katere so na voljo podatki
Gender differences are also observable in trends in
Trendi pri akutnih smrtnih primerih, povezanih z drogami
(1) For 2005 the figure is provisional, based on comparing 2004 and 2005 only for those countries with data for both years.NB: The indexed change is calculated based on countries with information for the stated year and the preceding.
(1) Podatek za leto 2005 je začasen ter temelji na primerjavi podatkov za leti 2004 in 2005 samo za tiste države, za katere so na voljo informacije za obe leti.Opomba: Indeksirana sprememba je izračunana na podlagi držav, za katere so na voljo informacije za navedeno in prejšnje leto.
See Table DRD-2 in the 2007 statistical bulletin for numbers of deaths in each country and notes on methodology.Sources: Reitox national reports (2006), taken from general mortality registries or special registries (forensic or police).
Za število smrtnih primerov v vsaki državi in opombe o metodologiji glej preglednico DRD-2 v Statističnem biltenu 2007.Viri: Nacionalna poročila Reitox (2006) na podlagi splošnih registrov smrtnih primerov ali posebnih registrov (sodnomedicinskih ali policijskih).
in the Netherlands, Austria and the United Kingdom.
Vendar pa so nedavni trendi v teh državah različni.
In Italy, after several years of decreasing numbers of drug-related deaths, some increase has been recorded in the past two years (169
V novih državah članicah je bilo mogoče do leta 2002 opaziti strmo naraščanje, v letih 2003 in 2004 pa upadanje.
Research studies among opioid users in various European settings have found that mortality among this group is high compared to that of the general population.
V nekaterih državah je iz poročil o smrtnih primerih, povezanih z drogami, postal razviden skrb vzbujajoč trend.
A collaborative study that started within an EMCDDA project found that opioid users recruited in treatment in eight European locations had a very high mortality compared to their peers of the same age (see EMCDDA, 2006).
Po izrazitih vrhuncih z drogami povezanih smrtnih primerov med letoma 1999 in 2001, čemur je dve leti do tri leta sledilo jasno upadanje, je bilo mogoče v letih 2004 in 2005 opaziti povečanje števila prijavljenih smrtnih primerov (168).
A mortality cohort study carried out in the Czech Republic found that the standardised mortality ratio of stimulant users was 4–6 times higher than that of the general population, while that of opioid users was 9–12 times higher (Reitox national reports, 2005).
Ta vzorec na splošno opisuje trende z drogami povezanih smrtnih primerov, zabeleženih v zadnjih letih na Irskem, v Grčiji, na Portugalskem, Finskem in Norveškem, v manjši meri pa trende, ugotovljene na Nizozemskem, v Avstriji in v Združenem kraljestvu.
A French cohort study that followed individuals arrested for heroin, cocaine or crack use found that male mortality was five times higher and female mortality 9.5 times than in the general population, but with a decreasing trend (Reitox national reports, 2005).
V Italiji je bilo po več letih zmanjševanja števila z drogami povezanih smrtnih primerov v zadnjih dveh letih zabeleženo rahlo povečevanje (169).
Further information on mortality among drug users is expected from cohort studies in progress in several European countries (Bulgaria, Spain, Malta, Austria, Poland, Romania, Sweden, the United Kingdom, Norway).
Navedenih je bilo več razlogov za to nedavno povečanje, med drugim ta, da uživalci opioidov uživajo hkrati tudi druge droge, ali pa se je morda povečala razpoložljivost heroina.
suggested to account for this recent increase, among which are polydrug use by opioid users, or a possible increase in the availability of heroin.
Povečevanje deleža z drogami povezanih smrtnih primerov med uživalci drog, mlajšimi od 30 let, je bilo opaženo v Grčiji, med uživalci drog, mlajšimi od 25 let, pa v Estoniji, Luksemburgu in Avstriji, v manjši meri tudi v Latviji in na Nizozemskem, čeprav se v večini držav med mladimi uživalci drog delež smrtnih primerov zaradi prevelikih odmerkov zmanjšuje (170).
Poor living conditions of drug users as well as their mental health problems may also contribute substantially to the high mortality of this group.
Pri trendih z drogami povezanih smrtnih primerov je mogoče
There is a marked discrepancy in trends in drug-related deaths between the EU-15 Member States and those who have joined since 2004.
Med trendi z drogami povezanih smrtnih primerov v državah članicah EU-15 in v tistih, ki so se EU pridružile od leta 2004, je bistvena razlika.
Among the EU-15 Member States, there has been an overall decrease since 1996, very marked between 2000 and 2002, suggesting a long-term decrease in the number of young opioid injectors.
Med državami članicami EU-15 je mogoče od leta 1996 na splošno opaziti upadanje, ki je navedene v izbranem vprašanju o spolu in uživanju drog za leto 2006.
Known suicides, added together with undetermined intent deaths constituted 30 % of all drug-related deaths reported in Scotland in 2005.
167) Glej prikaz DRD-8 v Statističnem biltenu 2007.168) Glej preglednico DRD-2 v Statističnem biltenu 2007.
) See Figure DRD-11 in the 2007 statistical bulletin.)
169) Glej prikaz DRD-11 v Statističnem biltenu 2007.
See Figure DRD-9 in the 2007 statistical bulletin.) See Figure DRD-6 in the 2007 statistical bulletin.
170) Glej prikaz DRD-9 v Statističnem biltenu 2007.171) Glej prikaz DRD-6 v Statističnem biltenu 2007.
Reducing drug-related deaths
Zmanjševanje števila z drogami povezanih smrtnih primerov
The attention given to overdose prevention measures has grown in recognition of the relative importance of drug overdose as a public health issue. While engagement with treatment and other services may reduce drug-related deaths, there remains considerable potential for developing interventions targeted specifically on overdose risks, and overall, Europe still lacks a comprehensive approach to overdose prevention.
Podatki o splošni umrljivosti (ki je neposredna ali posredna posledica uživanja drog) med problematičnimi uživalci drog se večinoma nanašajo na uživalce opioidov, medtem ko so podatki o umrljivosti, povezani z drugimi oblikami uživanja drog, po navadi pomanjkljivi, vendar bodo postajali vedno pomembnejši za javno zdravstvo, na primer v zvezi z rednimi, vendar socialno vključenimi uživalci kokaina.
Psychiatric disorders are commonly related to problematic drug use.
Odkar se priznava, da so preveliki odmerki drog razmeroma pomembno javnozdravstveno vprašanje, se ukrepom za preprečevanje prevelikih odmerkov namenja vedno več pozornosti.
Although no systematic collection of information on co-morbidity exists at European level, findings from local research conducted in several European countries suggest that between 30 % and 90 % of clients in drug treatment may have co-morbid psychiatric conditions.
Vključenost v zdravljenje in druge storitve lahko zmanjšajo število smrtnih primerov, povezanih z drogami, vendar je možnosti za razvoj intervencij, osredotočenih posebej na tveganje prevelikih odmerkov, še veliko.
The most common disorders diagnosed among those dependent on drugs include personality disorders, depression, antisocial personality, anxiety, and mood and eating disorders.
Na splošno v Evropi še vedno ni celovitega pristopa preprečevanja prevelikih odmerkov.
Schizophrenia and suicidal tendencies are also mentioned.
Raziskovalne študije med uživalci opioidov v različnih evropskih okoljih ugotavljajo, da je v primerjavi s splošnim prebivalstvom umrljivost v tej skupini visoka.
Co-morbidity is reported to be more common among heroin users, especially those who have a long history of drug use and who have experienced several interruptions in methadone treatment and whose social and living conditions have deteriorated.
V sodelovalni študiji, ki se je začela v okviru projekta Centra, je bilo ugotovljeno, da je bila umrljivost med uživalci opioidov, vključenih v zdravljenje na osmih krajih v Evropi, zelo visoka v primerjavi z njihovimi vrstniki (glej EMCDDA, 2006).
Similarly, drug dependence is common among people with serious mental illness.
Kohortna študija umrljivosti, opravljena na Češkem, je ugotovila, da je bil standardizirani delež umrljivosti uživalcev stimulansov od štiri do šestkrat višji kot pri splošni populaciji, pri uživalcih opioidov pa devet do dvanajstkrat višji.
The European project Isadora (‘integrated services aimed at dual diagnosis and optimal recovery from addiction’) was concluded in 2005 after a three-year research period (1).
(Nacionalna poročila Reitox, 2005).
The project, aiming to identify major institutional and individual risk factors for co-morbidity, involved seven sites across Europe and 352 patients recruited from acute psychiatric wards.
Francoska kohortna študija, ki je spremljala posameznike, aretirane zaradi uživanja heroina, kokaina ali crack kokaina, je pokazala, da je bila umrljivost pri moških petkrat, pri ženskah pa 9,5-krat višja kot pri splošni populaciji, vendar z upadajočim trendom (nacionalna poročila Reitox, 2005).