We would like to stress out that there are no uniform national data according to EMCDDA methodology in the Republic of Slovenia. But some data are available, anyway

the ratio 1,2. The ratio for the year 1998 is 1,45. In the year 2000 is also interesting the rise in the number of indirect drug related death

(suicides of addicted people) to the year 1999 for the ratio 9:4=2,25.
The Reports from the toxicological department of the Institute of Forensic

Medicine are based on the number of requests for toxicological analyses in the

cases of drug related deaths.

Data collection on deaths due to illegal drugs use has no uniformly prescribed methodology – direct comparison are difficult.

But we started with activities for preparation data base on mortality according to EMCCDA guidelines.
According to a research, done in the Institute of Public Health some data are available:
Figure 3.2.2. Mortality rate per 100.000 population by age groups and gender (Slovenia 1985 -2000)

Source: Jožica Šelb, Institute of Public Health
Figure 3.2.3. Mortality rate due to drug use population for population aged 15 to 49 by gender (1985 -2000)

Source: Jožica Šelb, Institute of Public Health

Figure 3.2.4. Mortality rate due to drug use by birth cohort (1985 -1999)

Source: Jožica Šelb, Institute of Public Health

3.3. Drug-related infectious diseases

A more detailed insight is provided in Part 4, Chapter 11. Infectious diseases
HIV and AIDS
Slovenia has a low level HIV epidemic. In 2001 the reported newly diagnosed HIV incidence rate was 8.0 per million (one case injecting drug user - IDU) and reported aids rate 2.5 per million (no IDU cases). According to all available HIV surveillance information the prevalence of HIV infection among injecting drug users in Slovenia remains below 1%. Regretfully, all HIV prevalence information is limited to treatment data and no information is available from needle exchange, other lower threshold harm reduction programmes or from community based surveys.
HBV
In 2001 reported acute HBV infection incidence rate in the Slovenian population was 0.9 / 100.000 population, which underestimates the burden of the disease. Since information on transmission route was not available it was impossible to estimate the proportion of injection drug users. During the period from 1996 to 2000 the prevalence of antibodies against hepatitis B virus (HBV) among confidentially tested injection drug users treated in the network of Centres for Prevention and Treatment of Illicit Drug Use ranged between 2.6% to 6.6%. All available HBV prevalence information is limited to treatment data.
HCV
In 2001 reported acute HCV infection incidence rate in the Slovenian population was 0.5 / 100.000 population, which greatly underestimates the burden of the disease. Information on transmission route was available for six cases of the total of 10 reported cases. Four cases were among injection drug users. During the period from 1996 to 2000 the prevalence of antibodies against hepatitis C virus (HCV) among confidentially tested injection drug users treated in the primary health care network of Centres for Prevention and Treatment of Illicit Drug Use ranged between 20.8% to 30.1%. All HCV prevalence information is limited to treatment data.

3.4. Other drug-related morbidity

b) Psychiatric co-morbidity

The first type of patients comprises those who fail to respond favourable to standard protocols (methadone dosages are generally in the 60-80 mg/day range, with the maximum of 100 mg/day). In the PISA-MMTP are no dosage limits and patients are encouraged to accept an increase of their dosage if they continue to show addictive behaviour. They are referred to public services that treat addiction and operate on a territorial basis.

The second type of patients comprise of heroin-addicted psychiatric patients who are resistant to standard psycho-pharmacotherapy. These patients do not remain compliant with pharmacological treatment; once they have left the hospital they usually discontinue the treatment and show psychopathological symptoms and addictive behaviours despite the number of admissions to hospital (at least two in the previous two years). After referral by the hospital division of the Department, they receive methadone maintenance treatment as soon as they leave hospital.
Data emerging from our naturalistic study make it possible to identify another subgroup of heroin addicts who should be started on methadone as a priority.

A third or a half of all opiate addicts may suffer from mental disorders. Enrolment in treatment makes a significant positive impact on their psychological well-being.

Methadone maintenance reduces maladaptive behaviors (likelihood of overdose and law-breaking); it is effective on the risk behaviors of pregnant addicts, with worthwhile benefits for both, the mother and the fetus; it is effective on risk-behaviours in HIV-infected addicts. Our data shows that even those mentally ill heroin addicts who have proved to be resistant to treatments, both for addiction and mental illnesses, and are non-compliant with psycho-pharmacotherapy are likely to develop an adaptive behaviour as long as they are maintained on an adequate methadone programme. Thus both, compliance with the treatment of addiction and the possible treatment of the concomitant mental illness, become achievable aims.

Therefore, even in dually diagnosed patients methadone maintenance confirms its power to reverse maladaptive behaviours.

c) Other important health consequences (e.g. drugs and driving, acute and chronic drug effects...)

According to the article Drugs and traffic safety – slovenian aproach (Majda Zorec Karlovsek, Borut Stefanič)

Table 3.4.1. The number of requests for toxicological analysis in cases of suspicion of drug impaired driving

Average age among drivers in the accident group was 27.5 years for males and 29.3 years for females and in the non-accident group 24.9 years for males and 25.3 years for females.