Country overview: Czech Republic
- Situation summary
- Drug use among the general population and young people
- High-risk drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-induced deaths and mortality among drug users
- Treatment responses
- Harm reduction responses
- Drug markets and drug-law offences
- National drug laws
- National drug strategy
- Coordination mechanism in the field of drugs
- Public expenditure
- Drug-related research
|Year||EU (28 countries)||Source|
|Population||2013||10 516 125 ||505 665 739 ||Eurostat|
|Population by age classes||15–24||2013||11.1 %||11.5 % ||Eurostat|
|25–49||37.3 %||35.0 %|
|50–64||20.0 %||19.7 % |
|GDP per capita in PPS (Purchasing Power Standards) 1||2012||81||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2011||20.4 %||29.0 % p||Eurostat|
|Unemployment rate 3||2013||7.0 %||10.8 %||Eurostat|
|Unemployment rate of population aged under 25 years||2013||18.9 %||23.4 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2012||215.5||:||Council of Europe, SPACE I-2012|
|At risk of poverty rate 5||2012||9.6 %||17.0 % e||SILC |
p Eurostat provisional value.
1 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.
2 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.
3 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.
4 Situation of penal institutions on 1 September, 2012.
5 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold, which is set at 60 % of the national median equivalised disposable income (after social transfers).
In 2012 the National Survey on Substance Use was implemented by the Czech National Monitoring Centre for Drugs and Drug Addiction in association with the SC&C agency. A total of 2 134 respondents aged 15–64 were selected using a representative household sample. A previous general population survey using similar methodology was carried out in 2008. In addition to the general population surveys, two omnibus surveys were carried out in 2012, and five omnibus surveys were reported in the period 2008–11.
According to data from the latest national survey, cannabis continues to be the most frequently used illicit substance in the Czech Republic. Some 27.6 % of respondents indicated ever having used cannabis, while among the young adults (aged 15–34) the lifetime prevalence rate was 46.4 %. Some 9.2 % of respondents had used cannabis in the past 12 months and 4.4 % in the past 30 days. The highest prevalence rates for past 12 months and past 30 days use of cannabis were noted among respondents aged 15–24. Thus 23.3 % of 15- to 24-year-olds had used cannabis at least once in the past 12 months, while 11 % had used it in the past 30 days. Males reported recent use of cannabis more frequently than females, and the difference was particularly significant in younger age groups. The survey confirmed that use of new psychoactive substances was more common in younger adults. About 0.9 % of respondents aged 15–34 indicated they had ever used new synthetic drugs and 1.6 % of respondents indicated they had ever used new herbal drugs.
Results from the European School Survey Project on Alcohol and Other Drugs (ESPAD) are available from 1995, with the most recent survey conducted in 2011. Lifetime experience of an illicit drug other than cannabis among 15- to 16-year-olds increased from 4.3 % in 1995 to 9.0 % in 1999 and 11.2 % in 2003, and decreased to 8.0 % in 2011. Cannabis use (herb or resin) is very prevalent among this age group. In 2011 some 42 % reported that they had tried cannabis substances at least once. Lifetime use of inhalants was reported to be 8 %, hallucinogens (LSD) 5 %, and ecstasy 3 %. A decline was noted for lifetime use of cannabis (45 % in 2007 to 42 % in 2011), amphetamines (from 5 % in 1999 to 2 % in 2011), and ecstasy (from 8 % in 2003 to 3 % in 2011). Last year prevalence of cannabis use was 30 % and last month prevalence was 15 %, indicating a decline compared with 2003, when the highest rates were reported (36 % and 19 % respectively).
The most recent Health Behaviour in School-aged Children (HBSC) study among 15-year-old students, conducted in 2010, reported 31 % lifetime prevalence of cannabis use. While there was a drop in lifetime prevalence rates between 2002 and 2006 (from 31 % to 25 %), an increase was observed between 2006 and 2010 (from 25 % to 31 %). Around one-fifth of the students had used cannabis in the past 12 months.
The Ministry of Education, Youth and Sports provides methodological guidance and coordinates prevention activities in the Czech Republic within the scope of the National Strategy for the Primary Prevention of Risk Behaviour for 2013–18. The regions play an increasingly important role in these activities and each region established its own prevention plan in 2012, outlining the main priorities, the network of services, coordination and funding of activities. A Committee of Regional School Prevention Coordinators established by the Ministry ensures better coordination of prevention activities in the regions. A great deal of effort has been made in recent years to enhance the quality of primary prevention programmes by standardisation, certification and training, and sharing experience and best practice. The Czech Republic has introduced Europe’s first accreditation system, under which funding is available only to certified programmes. A number of methodological documents setting the professional competency standards for providers of school-based primary prevention, along with their certification rules and on-site inspection guidelines, were finalised in 2012. In 2012 the Ministry of Education, Youth and Sports introduced the new certification system, and the Certification Office of the National Institute for Education was opened in 2013.
Universal prevention activities in school settings are guided by the Minimum Preventive Programme, including recommendations for lessons and class activities and a number of other guidance materials developed in 2011–12. The programme addresses a broad range of risk behaviours, including social problems such as truancy, bullying, racism, xenophobia, hooliganism, crime and the use of addictive substances.
The European Union Drug Abuse Prevention (EU-DAP) pilot project, Unplugged, was piloted in Czech Republic between 2006–10. Following a thorough evaluation, which indicated a statistically significant reduction in recent tobacco use and a reduction in experimentation among its target audience (children aged 12–14), the programme was further scaled up and in 2012 an additional 100 education professionals were trained. In addition, the Unplugged: Parents module was also introduced in selected schools. A number of other methodological materials and pilot programmes addressing the role of families in the prevention of high-risk behaviours were introduced in 2012.
Non-governmental organisations (NGOs) can also receive project-based funding to carry out additional prevention activities in schools and in the out-of-school environment from subsidy proceedings at the national level through the Ministry of Education and the Government Council for Drug Policy Coordination.
A priority target audience for selective prevention activities is that of children and adolescents at risk of substance use, while local projects addressing high-risk families and children with attention and behavioural problems are also available. Selective prevention activities are mainly implemented by pedagogical and psychological counselling centres that carry out special programmes for schools or classes at risk, or are operated by NGOs. In 2012 a new project, Streetwork online, was initiated. It applies the basic principles of low-threshold services such as free-time activities, safe environment, prevention and contact to the internet environment and social media.
Indicated prevention programmes are rare and mainly target adolescents who experiment with psychoactive substances, or their families. Some interventions to reduce the risk of drug use in recreational settings are also implemented, but remain limited.
View ‘Prevention profile’ for additional information.
Up to 2012 the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) defined problem drug use as injecting drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis were not included in this category. However, in 2012 a new definition of ‘high-risk drug use’ was adopted. The new definition includes ‘problem drug use’, but is broader (mainly in its inclusion of high-risk use of more substances). Details are available here.
The multiplier method, based on data from low-threshold centres and outreach programmes, is used to estimate the size of high-risk drug-use populations in the Czech Republic. In 2012 the national estimate suggested that there were 30 700 high-risk stimulant users (mainly using the home-made methamphetamine pervitin), which translates to a rate of 4.25 per 1 000 people aged 15–64 (range: 4.23–4.26).
The estimated number of opioid users in 2012 was 10 600 (range: 10 500–10 700), or 1.47 per 1 000 persons aged 15–64 (range: 1.46–1.48). The data suggests that, of these, around 4 300 were heroin users and around 6 700 were buprenorphine users.
In 2012 the number of injecting drug users (IDUs) was estimated at 38 700 (range: 38 450–38 900), or around 5.35 per 1 000 people aged 15–64 (range: 5.32–5.38).
The prevalence of frequent cannabis users was estimated based on data from 2012 National Survey on Substance Use, which suggest that about 0.3 % of 15- to 64-year-olds use cannabis daily or almost daily.
Data on treatment demand in the Czech Republic are available through several data sources that partly overlap — the National Health Information System (NHIS), the Register of Treatment Demands administered at the national level by the Public Health Service of the City of Prague, and final reports of projects mainly carried out by NGOs. A new Act on Health Services came into force in 2012 and specifies the establishment of a National Drug Treatment Register, which will be launched for data collection in 2014 and will combine NHIS and the Treatment Demand Register.
In 2012 a total of 206 outpatient and inpatient treatment and low-threshold centres out of 268 treatment facilities contributed to the current Register of Treatment Demands .
A total of 8 955 drug users entered treatment in 2012, of which 4 313 were new clients entering treatment. As in previous years, amphetamines (mainly pervitin) were the most commonly reported primary substance used (67 % of all treatment clients and 71 % of new treatment clients). This was followed by opioids, reported by 18 % of all treatment clients. For new treatment clients the second most commonly reported substance was cannabis, at 18 %. Injecting remains the primary mode of drug use, with two-thirds of all treatment clients and more than a half of new treatment clients reporting injecting their primary drug (mainly methamphetamine and opioids).
In 2012 some 35 % of all clients entering treatment were under the age of 25. Among new treatment clients, 44 % were under 25. The male to female ratio is one of the lowest in Europe, with around two males for every female entering treatment (for both categories of all treatment clients and new treatment clients).
The rate of infections (human immunodeficiency virus (HIV)–acquired immune deficiency virus (AIDS), hepatitis B virus (HBV) and hepatitis C virus (HBC)) among drug users has remained stable in recent years. Data are available from national registers and studies involving different drug user groups.
HIV seroprevalence rates among people who inject drugs (PWID) remained consistently below 1 % between 1996 and 2012 (0.0–0.7 % in 2012). The number of newly diagnosed HIV cases among the general population is relatively low and has remained stable. In 2012 the number of new HIV cases reported increased to 212, six of which were reported as related to injecting drug use.
The number of newly reported cases of acute HBV continued a declining trend. In 2012, similar to the previous years, around a third of all newly reported HBV cases with a known transmission route were registered among PWID.
In 2012, similar to the previous years, two-thirds of newly reported HCV cases with a known transmission route were registered among PWID. The available data also indicate a significant decline in the number of new HCV cases with a known transmission route registered among PWID between 2006 and 2012 from 711 to 518 cases respectively (506 cases were reported in 2011). The HCV prevalence in the population of PWID has been relatively stable, and in diagnostic testing of clients in low-threshold services ranged from 16.0 % in 2006 to 22.4 % in 2009. In 2010 the rate fell to 13.6 % among clients of low-threshold services, but subsequently increased slightly to 18.6 % 2012. However, it is possible that the data from diagnostic testing may underestimate the HCV infection rates among PWID. The self-reported data from the Register of Treatment Demands suggest that about a third of PWID in contact with the treatment system are HCV positive, with some indication of a stabilising trend over recent years.
The prevalence rates of HIV, HCV and HBV in general are higher among clients of opioid substitution treatment programmes and prisoners.
Drug–induced deaths in the Czech Republic are routinely monitored by a means of a specialised register (Selection D), which covers 13 departments of forensic medicine and forensic toxicology, providing information on overdoses due to narcotic and psychotropic substances to the national focal point and also to the General Mortality Register (GMR —Selection B). Data extraction and reporting are in line with the EMCDDA definitions and recommendations.
According to the drug-induced deaths standard (deaths caused by an acute intoxication of drugs) for special registries, 28 deaths (of which were 23 males) were recorded in 2011, which is the lowest number since 2005. All death cases were confirmed by toxicology. In 2011 opiates (heroin, codeine, methadone, buprenorphine and opium) alone or in combination with other psychoactive substance were detected in six deaths, while methamphetamine was found to be a principal drug in 16 deaths. In 2011 the number of death cases attributed to inhalant use also dramatically fell when compared to 2009–10 data (8 in 2009; 16 in 2010; 4 in 2011).
Based on these data, the drug-induced mortality rate among adults aged 15–64 was 5.6 deaths per million in 2011, which is below the European average of 17.1 deaths per million.
According to data from the GMR, 32 drug-induced deaths (of which 20 were males) were reported in 2012. More than half (17 cases) were related to opioids and seven were related to stimulants.
A study of the registered clients of opioid substitution treatment was carried out using data from the Substitution Treatment Register. It estimated the mortality rate at 1.3 per 1 000 registered patients. This is an underestimate, as not all physicians report all patient deaths. Several mortality cohort studies among drug users have been published and their results presented and discussed in the National reports to the EMCDDA.
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 for the treatment of drug addiction and reintegration to service providers (mainly NGOs). An independent agency is responsible for the accreditation of drug treatment at medical and inpatient facilities.
Drug treatment is delivered through general practitioners, low-threshold programmes, inpatient and outpatient drug treatment centres, detoxification units, opioid substitution treatment (OST) units, therapeutic communities and aftercare programmes. Addiction treatment is primarily delivered by public organisations, and also by NGOs. It is also delivered, to a lesser extent, by private institutions, which provide three main treatment services: detoxification, outpatient care and institutional care. Inpatient services are divided into short-term (four to eight weeks), medium-term (three to six months) and long-term (seven or more months) services. NGOs mainly provide outpatient care and OST, and some of these programmes are accredited as healthcare facilities, and 15 NGO-based therapeutic communities also provide long-term residential care for drug users. Opioid substitution treatment and outpatient and inpatient medical drug treatment are mainly financed through health insurance, whereas outpatient and inpatient psychosocial treatment is primarily funded by the public budget at national and regional/local levels.
A discussion on a psychiatric care reform strategy 2014–20, led by the Ministry of Health, is ongoing in the Czech Republic. The reform is based on a new concept of a network of specialised addiction treatment services adopted by the Committee of the Society for Addictive Diseases of the Czech Medical Association and aims to further shift the Czech treatment system towards community-type care and introduce flexibility for service provision based on regional needs and priorities. In 2012–13 discussions on the revised standards of professional competency for drug services continued at the national level.
OST with methadone was introduced in the Czech Republic in 1998. In 2012 five substitution agents were available: methadone, three buprenorphine medications and a composite sublingual preparation that contains buprenorphine and naloxone. OST is delivered in specialised psychiatric facilities, and is also available in prisons. In addition, any medical doctor, regardless of his/her speciality, may initiate high-dosage buprenorphine as well as Suboxone treatment. According to newly implemented aggregated reports and a survey on substitution treatment among physicians in the Czech republic, 390 general practitioners and 67 outpatient psychiatric facilities provided substitution treatment for approximately 4 092 clients in 2012. Around 2 298 clients were reported in the substitution register, of which 657 were on methadone and 1 641 on buprenorphine. Since there is an overlap between the two sources it is estimated that in total 4 000 clients received opioid substitution treatment, of which about 3 343 received buprenorphine-based medication and 657 methadone.
View ‘Treatment profile’ for additional information.
The National Drug Policy Strategy for 2010–18 endorses harm reduction as one of its four pillars, and defines the following priority areas: (i) development of new interventions; (ii) increase in the uptake of testing among injecting drug users; and (iii) definition of harm reduction guidelines for nightlife settings. The current (2013–15) Action Plan introduced a number of new tasks, including scaling-up harm reduction programmes for hard-to reach and socially excluded communities and issuing guidelines for infectious diseases testing by service providers. The 2013–17 National Programme for HIV/AIDS reiterates the focus on providing services to high-risk groups.
The Czech network of low-threshold facilities, established since 1992, includes low-threshold centres (drop-in) and outreach programmes providing needle exchange in 103 units (51 stationary units also provide outreach services). Two vending machines and one mobile needle and syringe programme also operate in the country. These programmes operate in all regions, providing a wide range of services: clean needles and syringes, condoms, voluntary counselling and testing for infectious diseases, risk-reduction information, aluminium foil for heroin smoking, gelatine capsules for per-oral use of stimulants and other services. The number of drug users in contact with these services has been increasing over the past 10 years, and it is estimated that in 2012 these centres reached about 34 200 individual drug users, mainly those who inject opiates and methamphetamine, while an increase in the number of buprenorphine (diverted) and cannabis users seeking help from low-threshold services has also been noticed in recent years. The number of syringes distributed through needle and syringe programmes continues to increase and reached more than 5.3 million syringes in 2012. Besides needle and syringe programmes (drop-ins and outreach work), pharmacy syringe sales are the main sources of sterile injecting material for people who inject drugs. Taking into account the high proportion of pervitin users among the problem drug use population, 27 programmes also distribute gelatine capsules as an oral alternative to the injecting of pervitin. Around 47 000 capsules were distributed in 2012.
Treatment for HCV is available to PWID in 38 clinics across the Czech Republic, including those in prisons; however, its costs remain high.
Cannabis continues to be the most frequently seized drug, and domestic production of marijuana has been on the increase. It is grown in natural and artificial conditions and, with increasing frequency, on a large scale and also for export, predominantly to Germany. Quantities of seized marijuana have continued to increase, and a record quantity of 563 kg of marijuana was seized by the Czech law enforcement agencies in 2012. In addition, 218 cannabis cultivation sites were detected. The number of cannabis plants seized increased as well when compared to 2010–11 (90 091 plants in 2012; 62 817 in 2011; 64 904 in 2010). In recent years large-scale cannabis cultivation and distribution has become more specialised and contributed to the establishment of highly organised criminal groups, which are sometimes involved in sale of pervitin.
In 2012 methamphetamine (pervitin) was involved in 355 seizures. It is primarily produced for the domestic market. The quantity of pervitin seized increased from around 4 kg in 2008 to a record 32 kg seized in 2012. Restrictions on the sale of pseudoephedrine-containing medication were introduced in 2009, which was followed by a significant rise in the illegal import of such medication from neighbouring countries. In 2012 most illegally imported medicines came from Poland, Germany and Hungary. Production of pervitin predominantly takes place in low-volume home-based laboratories, which allows them to be easily relocated to avoid detection, while an increase in the proportion of high-volume laboratories has been noted. In 2012 a total of 235 pervitin laboratories were detected, a decline when compared with 338 laboratories seized in 2011.
Heroin reaches the Czech Republic mainly through the Balkan route, and is imported in small shipments. In 2012 a total of 41 heroin seizures were reported, which is below the numbers reported before 2010. The reduction in the number of heroin seizures was accompanied by a sharp decline in the quantity seized, which fell to 5 kg in 2011 and 8 kg in 2012, while for the period 2006–10 the quantity of heroin seized ranged between 20–50 kg per year. In 2012 Subutex and fentanyl patches were also seized from the illicit market.
In 2011 and 2012 a total of 44 of cocaine seizures were reported each year, while in 2012 only 8 kg of cocaine was seized, in comparison with 16 kg reported in 2011. Cocaine mostly enters the Czech Republic through Italy, Spain, the Netherlands and Austria, by couriers, in postal consignments, in shipping containers and on luxury yachts. Ecstasy is not produced domestically, and is mainly imported from the Netherlands, Poland and Slovakia, and in 2012 the amount seized reduced almost tenfold when compared to 2011.
Synthetic cathinones and cannabinoids represent the largest proportion of new psychoactive substances seized in the Czech Republic.
In 2012 a total of 5 317 drug-law offences were reported, including criminal offences and misdemeanours. Around 53.4 % were arrested for a drug-related crime in connection with methamphetamine, followed by 40.7 % arrested in connection with cannabis and 2.3 % with heroin. Although supply-related offences exceed those related to use, data from 2004–11 show that the share of use-related offences (both criminal offences and misdemeanours) is increasing, from 30 % in 2004 to 36 % in 2012.
The Penal Code, valid since 2010 (Act No. 40/2009), is the major act concerning drug-related offences. The Penal Code regulates several aspects of drug-related offences, such as drug trafficking, unauthorised possession of drugs, conditions of prosecution, diversion of prosecution, types of penalties, etc. Licit handling of narcotic drugs and psychotropic substances and precursors is subject to regulation according to the Addictive Substances Act (Act No. 167/1998).
Drug use is not an offence in the Czech Republic, and possession of small quantities for personal use is a non-criminal offence under the Act of Violations, punishable by a fine of up to CZK 15 000 (EUR 597). A new Penal Code has been effective since 2010 (Act No. 40/2009). For the first time it set out a distinction between cannabis and other drugs for criminal personal possession offences, whereby possession of a quantity ‘greater than small’ of cannabis would attract a sentence of up to one year, but for other substances sentences of up to two years’ imprisonment were possible (or up to 2–8 years if the quantity of drugs is ‘significant’). Also, two governmental regulations fixed threshold quantities with which to determine whether an offence was administrative or criminal — these had previously been set in non-binding prosecutor and police directives. However, in 2013 these governmental regulations were annulled by the Constitutional Court, which reiterated that only the Parliament may ‘define’ a criminal offence. Further changes may be expected.
Penalties for drug supply are from 1–5 years to 10–18 years of imprisonment, depending on various specified 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). Security detention with compulsory treatment is a possible response to addicts who are deemed to be socially dangerous, and is also an option for juvenile delinquents.
In 2009 a new category of medicines was created to restrict sales of non-prescription medicines, such as those containing pseudoephedrine (a precursor for producing methamphetamine).
Following the amendments of several Government Acts (on pharmaceuticals, on addictive substances and on administrative fees), use of cannabis for therapeutic purposes has been allowed in the Czech Republic since 1 April 2013, while provision allowing cultivation and supply of medicinal cannabis (through licencing procedure) came into force from 1 March 2014.
Thirty-three new psychoactive substances or pharmacological agents were put under control in 2011 when the Act on Addictive Substances was amended.
View the European Legal Database on Drugs (ELDD) for additional information.
In May 2010 the National Drug Policy Strategy for 2010–18 was approved. The strategy is comprehensive and is based on four pillars: prevention; treatment and re-socialisation; risk reduction; and supply reduction. It is complemented by three supporting domains: coordination and funding; monitoring, research and evaluation; and international cooperation. Focusing mainly on illegal drugs, but with some scope to address other drugs (alcohol, prescription drug misuse), the strategy defines four key objectives: (i) to reduce the level of experimental and occasional drug use, particularly among young people; (ii) to reduce the level of problem and intensive drug use; (iii) to reduce potential drug-related risks to individuals and society; and (iv) to reduce drug availability, particularly to young people. The implementation of the strategy is supported by a series of consecutive three-year action plans, the first of which covered the period 2010–12.
Building on the results of the interim evaluation of the national drugs strategy, the current action plan covers the period 2013–15. It identifies four priorities:
- Reduce excessive alcohol use and heavy cannabis use among young people.
- Address the high levels of problem pervitin (methamphetamine) and opiates use.
- Improve the effectiveness of drug policy funding.
- Achieve an integrated drug policy.
View ‘National drug strategies’ for additional information.
The Government Council for Drug Policy Coordination is responsible at the political level for the overall implementation of the national drug strategy. It is the main initiating, counselling and coordinating body of the government for drug issues. Presided over by the Prime Minister, the Council includes all Ministries involved in the delivery of the national drug policy and three representatives of civil society and a representative of regions (the Association for Addictive Diseases of the Czech Medical Association; an association of NGOs dealing with drug prevention and treatment; and the Association of the Regions). In addition, its Secretariat ensures 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 (national focal point), which is responsible for the collection, analysis and distribution of drug-related data.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 the collection, analysis and distribution of drug-related data.
A network of 14 regional coordinators manages drug-related 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 also draws up and implements their own strategies and plans on drug-related measures, and the extent of such plans and strategies also varies between regions. Dedicated Drug Policy Commissions exist in eight regions, with drug issues addressed by commissions with a broader remit in three other regions, while three further regions use working groups to manage drug policy. At the local level, drug coordinators have been installed in 185 municipalities (so-called ‘municipalities with extended competency’) and the 22 districts of Prague city.
In the Czech Republic, the government has presented annual drug-related budgets, announcing planned labelled expenditures (1,2), since 2002. Additionally, it provides an estimate of the money effectively spent. Estimates are based on a well-defined methodology, but data completeness has changed over time. Between 2007 and 2010, unlabelled expenditures were also estimated, applying a comparable methodology (3).
In 2010 total drug-related public expenditures represented 0.06 % of gross domestic product (GDP). About 72.1 % were unlabelled expenditures, of which about 71.6 % were for supply reduction activities and the remaining for demand reduction (inpatient healthcare and medication received the largest shares). The analysis of labelled expenditures, which represented about 27.9 % of the total expenditures, had a different distribution: 76.2 % were for demand reduction and 23.8 % for supply reduction activities.
Trend analysis can only be based on labelled expenditures, and over the 2005–12 period these expenditures remained stable as a percentage of GDP (range: 0.015–0.017 % of GDP), but grew in nominal terms. The exceptions were 2009 and 2011, when total labelled expenditure declined, probably due to public austerity measures associated with the 2008 economic recession. However, in 2012 total labelled expenditure reached a level identical to that of 2008, in nominal terms.
(1) This budget is not directly linked to national policy documents.
(2) Some of the funds allocated by governments for expenditure on tasks related to drugs are identified as such in the budget (‘labelled’). Often, however, the bulk of drug-related expenditure is not identified (‘unlabelled’) and must be estimated by modelling approaches. The total budget is the sum of labelled and unlabelled drug-related expenditures
(3) Vopravil, J. and Rossi, C. (2013), ‘Illicit drug market and its economic impact’, Universitalia, Universitá di Roma, Roma, February 2013.
View ‘Public expenditure profile’ for additional information.
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 Action Plan 2013–15 underlines the principle of integrating legal and illegal drugs into one policy, and support for research in the field of drugs is mentioned explicitly as one of the tasks. 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 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 the collaboration and 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 2013 Czech National report focused mainly on aspects related to responses to the drug situation, prevalence, incidence and patterns of drug use, and the consequences of drug use. Determinants of drug use, and supply and markets were also mentioned.
View ‘Drug-related research’ for additional information.