Country overview: Czech Republic
- Situation summary
- Data sheet
- Barometer
Contents
- Drug use among the general population and young people
- Prevention
- Problem drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-related deaths
- Treatment responses
- Harm reduction responses
- Drug markets and drug-related offences
- National drug laws
- National drug strategy
- Coordination mechanism in the field of drugs
- Drug-related research
| Year | Czech Republic | EU (27 countries) | Source | ||
|---|---|---|---|---|---|
| Population | 2008 | 10 381 130 | 497 455 033 | Eurostat | |
| Population by age classes | 15–24 | 2008 | 13 % | 12.6 % 1 | Eurostat |
| 25–49 | 37 % | 36.3 % 1 | |||
| 50–64 | 21.2 % | 18.4 % 1 | |||
| GDP per capita in PPS (Purchasing Power Standards) 2 | 2007 | 118.2 | 100 | Eurostat | |
| Total expenditure on social protection (% of GDP) 3 | 2006 | 80.2 % | 26.9 % p | Eurostat | |
| Unemployment rate 4 | 2008 | 4.4 % | 7 % | Eurostat | |
| Unemployment rate of population agends under 25 years | 2008 | 10.2 % | 15.5 % | Eurostat | |
| Prison population rate (per 100 000 of national population) 5 | 2006 | 185.6 | Council of Europe, SPACE 2006.1 | ||
| At risk of poverty rate 6 | 2006 | 10 % | 16 % 7 | SILC, 2007 |
|
p Eurostat provisional value.
1 2007 figures.
2 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
3 Expenditure on social protection contains: benefits, which consist of transfers, in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.
4 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.
5 Situation of penal institutions on 1 September, 2006.
6 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold in the current year and in at least two of the preceding three years.
7 EU-25 countries.
Drug use among the general population and young people
One of the most recent general population surveys on drug use was the 2004 General Population Survey on Health Status and Lifestyle of the Population of the Czech Republic, implemented among people aged 18–64 by the Institute for Health Information and Statistics (IHIS). Overall, the latest general population surveys suggest that the increases in lifetime experience of drug uses, observed during the previous decade, have now stopped.
Lifetime prevalence for cannabis use was 20.6 %, followed by ecstasy (7.1 %), and magic mushrooms and other natural hallucinogens (3.5 %).
Results of ESPAD surveys on drug use among young people are available from 1995 and the most recent survey was done in 2007. Lifetime experience with an illicit drug other than marijuana/hashish among 15–16 year olds increased from 4.3 % in 1995 to 9.0 % in 1999 and 11.2 % in 2003 (ESPAD survey). In particular, marijuana (herbal cannabis) or hashish (cannabis resin) use is very prevalent among this age group. In 2007, 45 % of 16-year olds reported that they had tried these substances at least once (compared to 35 % in 1999 and 18 % in 1995). Lifetime use of ecstasy for the same age range was reported to be 5 % in 2007 while it was 8 % in 2003. A decline was noted for lifetime amphetamine use, which decreased from 5 % in 1999, to 3 % in 2007. Last year prevalence of cannabis use was 35 % and last month prevalence was 18 %.
The last HBSC study among 15-year-old students, conducted in 2006, reported 25 % for lifetime prevalence of cannabis, indicating a declining trend compared to 2002 (31 %). Lifetime prevalence of inhalants (9 %) was the second most commonly reported. Last month prevalence of cannabis was reported to be 10 %. Compared to 2002 results, the only increase in lifetime and last year prevalence involved inhalants; for all other substances, a decline in the lifetime prevalence was noticed.
Prevention
Prevention activities in the Czech Republic are coordinated by the Ministry of Education and they are mainly implemented by schools and NGOs that provide services in the field of treatment and help to drug users.
Since 2007, a ministerial guideline introduces prevention into the school curriculum, describes the individual institutions involved in the system of prevention and the role of the teacher, defines the Minimum Preventive Programme, and recommends specific practices for schools and school facilities if they detect specific risk behaviour among children and young people. It addresses a broad range of social problems like truancy, bullying, racism, xenophobia, hooliganism, crime and the use of addictive substances. Universal, selective and indicated prevention entered officially the vocabulary of the Ministry of Education. Standards now define the content, staff, scope and target group of prevention programmes. A monitoring system gives an overview on existing prevention interventions in the country. A new example of selective prevention programmes is the Safer Party Tour 2008, implemented in recreational settings like dance parties. Indicated prevention programmes are almost exclusively oriented towards working with individuals and their families. Evaluation research about prevention programmes has made significant progress.
Problem drug use
The existing estimates on the number of problem drug users (1) in the Czech Republic were carried out between 1999 and 2007 using the multiplier method, based on data from low-threshold centres. In 2007, the national estimate suggests that there are 30 900 problem drug users. Of these, 20 900 are methamphetamine (pervitin) users; 5 750 heroin users and 4 250 Subutex users. The number of IDUs (injecting drug users) was estimated at 29 500 in 2007. Cocaine use still remains sporadic in the Czech Republic.
The EMCDDA defines problem drug use as intravenous drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis are not included in this category.
(1) The Czech definition of problem drug use is the use of drugs by injection and/or the regular or long-term use of opiates and methamphetamine. Cocaine is not considered as a part of the definition, due to its very low prevalence in the Czech Republic. Ecstasy and cannabis are not included either.
Treatment demand
A nationwide system for reporting treatment demand has been operating in the Czech Republic within the framework of the Hygiene Service since 1995. In 2007, a total of 228 outpatient and inpatient treatment and low-threshold centres contributed to the Treatment Demand Register out of a total of 269 treatment centres in the Czech Republic.
In 2007, a total of 8 121 drug users entered in treatment whereas, 4 346 persons sought treatment for the first time. Users of amphetamines (mainly methamphetamines) were the most commonly represented among all treatment clients entering treatment, at 60.9 %, as well as among first treatment clients with 63.6 %. This was followed by opioids users with 23.2 % among all treatment clients and 18 % of cannabis users among first time treatment clients.
In 2007, 52 % of all clients entering treatment were aged less than 25 years. A similar age distribution was also reported among new treatment clients, with 63 % being under the age of 25 years. In 2007, the male to female ratio for all treatment clients was 68 % for male and 32 % for female clients. A similar distribution was also reported among new treatment clients, with 67 % being male and 33 % female.
Drug-related infectious diseases
The rate of infections (HIV-AIDS, HBV and HCV) among drug users has remained stable in recent years. Data are available from national registers and studies involving different drug user groups in the Czech Republic.
For hepatitis, in 2007, the long-term proportion of injecting drug users in all newly reported cases increased for HBV (103 cases in 2007, 87 in 2006) and decreased for HCV (667 in 2007 and 704 in 2006). HIV seroprevalence rates among IDUs remained consistently below 1 % in the Czech Republic between 1996 and 2007 (0.2 % in 2007). The number of newly-diagnosed HIV cases among the general population is relatively low, although it seems to have been increasing over the last three years. 112 new cases were diagnosed in 2007 (17 % more than in 2006). The HCV infection rate in the population of IDUs has consistently been reported over the last three to four years at between 20 % and 35 %.
Drug-related deaths
An automated system for collection of drug mortality data, which covers all of 13 departments of forensic medicine and forensic toxicology, provides information on overdoses on narcotic and psychotropic substances to the Czech national focal point. According to the drug-related deaths standard (deaths caused by an acute intoxication of drugs) for special registries, 40 deaths were recorded in 2007 (42 were registered in 2006 and 62 in 2005).
The majority were related to opiates, inhalants and pervitin (methamphetamine). When comparing the number of drug overdoses since 1998, a continuous decline can be observed.
For the Czech Republic, the EMCDDA selection D was used instead of the national definition. National definition includes also poisoning by psychoactive medicines, which accounts for most cases (173 cases out of 213).
Treatment responses
The Council of the Government for Drug Policy Coordination is the main coordinating and initiating body on drug-related issues. The Secretariat of the Council organises the distribution of subsidies to service providers (mainly NGOs) in the sphere of treatment of drug addiction and reintegration. Furthermore, the Secretariat is also responsible for accreditation, monitoring, evaluation and coordination of delivery of drug treatment, medical and inpatient facilities at the regional/local levels.
In the Czech Republic, drug treatment is primarily delivered by public organisations and NGOs. To a lesser extent, private institutions and office-based medical doctors are also involved in treatment delivery. These organisations provide three main treatment services: detoxification, outpatient care and institutional care. Treatment services are also divided into short-term (4–8 weeks); medium-term (3–6 months) and long-term (seven or more months) services. Substitution maintenance treatment, detoxification and inpatient medical drug treatment is mainly financed through health insurance, whereas outpatient and inpatient psychosocial treatment is primarily funded by the public budgets at national level and regional/local levels.
Since 2000, two substitution agents are available: methadone and buprenorphine. In 2008, a composite sublingual preparation which contains buprenorphine and naloxone has been introduced. In 2007, there were 15 specialised substitution treatment centres, out of which two centres were registered in prisons. Furthermore, according to Act No 379/2005 any medical doctor, regardless of his/her specialisation, may initiate high dosage buprenorphine treatment. In 2007, an estimated 4 900 clients were undergoing substitution treatment, 620 of whom were on methadone and approximately 4 300 on buprenorphine.
Harm reduction responses
The Czech network of low-threshold facilities established since 1992 includes low-threshold centres (drop-in) and outreach programmes providing needle exchange. (altogether, 109 programmes). Programmes operate in all regions of the Czech Republic, providing a wide range of services. The Czech NFP estimates that over the past five years, the rate of problem drug users maintaining contact with these agencies has risen from 60 % to about 70 %. It has also been observed that the number of problem drug users has not increased. However, the number of syringes used has been increasing over recent years: in 2007, about 4.5 million syringes were distributed through NSPs in the Czech Republic, representing a 2.5 times increase compared to 2003. The main sources of clean injecting material include exchange programmes (drop-ins and outreach work), but also pharmacy syringe sales.
Drug markets and drug-related offences
Heroin reaches the European market, including the Czech Republic, mainly through the Balkan route. The Balkan route is used for the transit of heroin from Afghanistan and neighbouring countries to Europe, via some of the central and east European countries. Cannabis continues to be the most frequently trafficked drug.
In 2004, Czech authorities observed an increase in pervitin (methamphetamine) exported to neighbouring countries, such as Germany and Austria and also detected clandestine pervitin laboratories. In 2005 and 2006, the quantity of pervitin seized was 5.3 kg; in 2007, the quantity of pervitin seized was 5.9 kg. There are no domestic sources of production of dance drugs in the Czech Republic. Most of the ecstasy tablets on the Czech market come from the Netherlands, Belgium and Poland.
Since 2002, the data provided by the Police National Drug Headquarters on criminal offences related to drugs have proved relevant for monitoring trends. In 2007, a total of 2 031 drug law offences were reported, with 59 % of methamphetamine law offences followed by 28 % of cannabis law offences and 7 % for heroin law offences.
Herbal cannabis was the most commonly seized drug in 2007, with 563 seizures. The number and quantity of cannabis plant seizures remained similar to that reported in 2006. The number of cannabis plant seizures in 2007 (46) was also similar to that in 2006 (44), but the number of cannabis plants seized tripled against 2006, from 2 276 plants to 6 992 plants. Cocaine seizures increased markedly in terms of both number and quantity, with 38 seizures with a total quantity of 37.6 kg reported in 2007, in comparison to 11 seizures with a total of 4.7 kg in 2006. A considerable increase was reported in the number of ecstasy tablets seized, with 30 seizures of 62 226 tablets in total being reported in 2007, compared with 29 seizures of 26 259 tablets in 2006, but the number of seizures remains rather low, given the high prevalence of ecstasy use. The heroin situation was stable with 96 seizures of 20 kg in total reported in 2007. Other substances seized in 2007 included 310 tablets of Subutex®, 1.2 kg of ephedrine, and 35 tablets of Rohypnol.
National drug laws
Since 1999, the Criminal Code and the Act on Misdemeanours state that possession of narcotic drugs and psychotropic substances in greater than small quantities is a criminal offence, and can attract sentences of up to 2 years’ imprisonment (or 1–5 years in case of aggravating circumstances in the offence). In case of possession of small quantities without intention to supply, administrative sanctions (e.g. a fine or warning) are imposed.
Penalties for drug trafficking can be up to 10–15 years of imprisonment, depending on aggravating circumstances. In the case of addicts committing a drug-related crime, a range of alternatives to imprisonment is available to the court (e.g. suspended sentences, community service and probation with treatment; since January 2009, security detention with compulsory treatment are possible responses to dangerous addicts.). In 2009, a new Penal Code was adopted. This new Penal Code includes major changes, such as a differentiation of sanctions for possession of different drugs, and will come into effect in January 2010. Also in 2009, a new category of medicines was created to restrict sales of non-prescription medicines that are widely abused, such as those containing pseudoephedrine (a precursor for producing methamphetamine).
National drug strategy
The Czech national drug policy strategy covers the period 2005–09. It was first complemented by 2005–06 and 2007–09 action plans. The strategy is comprehensive and is based on four pillars: prevention, treatment and resocialisation, risk reduction and supply reduction. The focus is mainly on illegal drugs but with some scope to address other drugs (alcohol, prescription drug misuse), if necessary. The strategy has two main goals: (1) to combat organised crime associated with the unauthorised handling of drugs and to enforce the observance of laws in connection with the distribution of licit drugs; and (2) to reduce the use of all types of drugs and potential risks and damage that may affect individuals and society as a consequence of drug use. The 2007–09 action plan covers seven policy fields (primary prevention, treatment and aftercare, harm reduction, drug supply reduction and law enforcement, information/research/evaluation, coordination and funding, international collaboration) and contains 172 different objectives.
Coordination mechanism in the field of drugs
The authority responsible at the political level for the overall implementation of the national drug strategy is the Council of the Government for Drug Policy Coordination. This Council is the main initiating, counselling and coordinating body of the government for drug issues. It is presided over by the Prime Minister and includes all ministries involved in the delivery of the national drug policy and three representatives of civil society respective regions (Czech Medical Association — Association for Addictive Diseases, Association of NGOs dealing with drug prevention and treatment, and Association of the Regions). In addition, its Secretariat ensures on a permanent basis the day-to-day implementation of the strategy and the coordination of the respective ministries’ activities. The Secretariat is part of the Office of the Government of the Czech Republic and also includes the Czech National Monitoring Centre for Drugs and Drug Addiction (Czech national focal point) which is responsible for collection, analysis and distribution of drug-related data.
At the local level, a network of 14 regional coordinators provide coordination of activities (including the implementation of the national drug policy) at the regional and local levels. However, their competencies vary from region to region. Each region draws up and implements also their own strategies and plans on drug-related measures and the extent of such plans and strategies also varies between regions. At the local level, local drug coordinators are installed in 205 municipalities (so-called ‘municipalities with extended competency’).
Drug-related research
The current national drug strategy emphasises the role of research, evidence and evaluation of the measures taken in the drug policy field in the Czech Republic. The support of research in the field of drugs is mentioned explicitly as one of the tasks of the 2007–09 action plan, which also contains several specific research activities. The evidence-based approach is currently applied in the certification process of addiction services and in the provision and development of services. Several public administration bodies and several grant agencies fund research in the field of drugs which is mainly conducted by academic centres. The National Monitoring Centre for Drugs and Drug Addiction coordinates collaboration and the exchange of information between research institutions, service providers, and public administration bodies. It publishes an Annual report on the state of the drugs problem in the Czech Republic, which summarises available data about drug use and its consequences. National scientific journals are also an important dissemination channel for drug-related research findings. Recent drug-related studies mentioned in the 2008 Czech National report mainly focused on aspects related to responses to the drug situation.