The prevalence of illicit drug use in Czechia has been relatively stable in recent years, with cannabis being the most commonly used substance. Illicit drug use is primarily concentrated among young adults aged 15-34 years and among males. The most recent data, from 2017, indicate that almost one in five young adults had used cannabis in the past year, which is slightly below the levels reported in studies from 2013-14. The use of other illicit substances was significantly less common than the use of cannabis.
MDMA/ecstasy was the most common stimulant used among the general population, and its use was also concentrated primarily among young adults. The use of methamphetamine (known locally as ‘pervitin’) is less common among the general population but is the main substance linked to problem drug use in Czechia. The latest study indicates that 1 in 100 adults have tried new psychoactive substances (NPS) in their lifetime. As with other substances, the use of NPS is higher among males and young adults aged 15-34 years.
The cities of Brno and Ceske Budejovice participate in the Europe-wide annual wastewater campaigns undertaken by the Sewage Analysis Core Group Europe (SCORE). This study provides data on drug use at municipal level, based on the levels of illicit drugs and their metabolites found in wastewater. The results indicate that levels of cocaine and MDMA residues in Ceske Budejovice wastewater are generally low; however, an increase was registered between 2011 and 2018. Despite a decrease in the observed levels of methamphetamine residues, they remain among the highest in Europe.
The most recent data on drug use among students are reported by the 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD). Drug use prevalence among Czech students was similar to the European average in the case of lifetime use of illicit drugs other than cannabis and lifetime use of inhalants, while average lifetime NPS use was higher. For all remaining substances, the Czech results were well above the ESPAD average. Most notable is the fact that the lifetime use of cannabis and tranquillisers or sedatives without prescription was more than twice the European average (37 % vs. 16 % and 16 % vs. 6 %, respectively). In addition, levels of last 30-day alcohol use and heavy episodic drinking were clearly above average, as was the level of last 30-day cigarette use. The long-term analysis found a decline in cannabis use from its peak in 2007 and a reduction in alcohol consumption between 2011 and 2015. An ESPAD validation study carried out in 2016 on a comparable sample of students indicates that the declining trends seen in ESPAD 2015 in regular smoking, risky forms of alcohol consumption and cannabis use continued in 2016.
Studies reporting estimates of high-risk drug use can help to identify the extent of the more entrenched drug use problems, while data on first-time entrants to specialised drug treatment services, when considered alongside other indicators, can inform an understanding of the nature of and trends in high-risk drug use.
In Czechia, high-risk drug use is mainly linked to the use of home-made methamphetamine (pervitin), which is predominantly injected. It is estimated that there are 34 700 primary methamphetamine users and approximately 13 100 primary users of heroin or other opioids. Methamphetamine is often used in the context of polydrug use with opioids. Although buprenorphine remains the main drug of choice among high-risk opioid users, in recent years concerns have been raised about the increased misuse of opioid-based pain medications. In 2017, an estimated 43 700 people injected their primary drug. Based on a 2016 survey, around 2 in 10 adults who reported cannabis use in the past 12 months were identified as high-risk users based on the Cannabis Abuse Screening Test scale.
Amphetamines (methamphetamine) are the most commonly reported primary substance for new clients entering treatment, followed by cannabis. Data from 2017 are not comparable with trend data up to 2014. Data from specialised treatment centres up to 2014 are inclusive of a substantial proportion of low-threshold services. Since then, a new treatment register has been launched, with new data now reporting predominantly on treatment services.