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 | 2010 | 10 506 813 | 501 105 661 p | Eurostat | |
| Population by age classes | 15–24 | 2010 | 12.5 % | 12.1 % p | Eurostat |
| 25–49 | 37.2 % | 35.8 % p | |||
| 50–64 | 20.8 % | 19.1 % p | |||
| GDP per capita in PPS (Purchasing Power Standards) 1 | 2009 | 82 | 100 | Eurostat | |
| Total expenditure on social protection (% of GDP) 2 | 2008 | 18.7 % | 26.4 % p | Eurostat | |
| Unemployment rate 3 | 2010 | 7.3 % | 9.6 % | Eurostat | |
| Unemployment rate of population aged under 25 years | 2010 | 18.3 % | 20.9 % | Eurostat | |
| Prison population rate (per 100 000 of national population) 4 | 2009 | 210.4 | Council of Europe, SPACE I-2009 | ||
| At risk of poverty rate 5 | 2009 | 8.6 % | 16.3 % | 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, 2009.
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).
Drug use among the general population and young people
In 2009, the Survey on Citizens opinions about an attitude to the issue of health and healthy lifestyle was conducted for a sample of 1 486 respondents aged between 15–64 years.
According to the results of the survey, lifetime prevalence of cannabis was 27.6 %, followed by ecstasy (4.6 %), pervitin (methamphetamine) and amphetamines (2.5 %), and cocaine (1.5 %). Other drugs were not surveyed. Cannabis was also most frequently used illegal substance in the past 12 months — at 11.1 % and within the past month — 4.1 %. With respect to gender, the drug use is more prevalent among males, however it should be noted that 15–to–24-year old females reported higher lifetime and last year prevalence rates of amphetamines use than males in the same age group. The lifetime, recent and current drug use rates for population aged 15 to 64 reported by this study were significantly lower than the those found in the 2008 General Population Survey. The differences should be attributed to methodological variations between both studies rather than to be interpreted as an indication for the beginning of a declining trend in drug use.
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, 11.2 % in 2003 and decreased back to 10 % in 2007 (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 22 % 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, Youth and Sports 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.
The Professional Qualification Standards for Providers of Addictive Substance Use in the field of Primary Prevention Programmes was launched in 2006. It defines the content, staff, scope and target group of prevention programmes.
In 2009, the Ministry subsidised 278 projects implemented by schools and education facilities and 18 projects implemented by the NGOs. In addition, the Council of the Government for Drug Policy Coordination supported 11 specialised preventive projects implemented by NGOs. All these programmes were certified according to the Standards. In 2009, a priority target audience for selective prevention activities were children and adolescents from ethnic minorities, however the project called `2009 Safer Party Tour` focusing on drug prevention and harm reduction interventions at large summer and music festivals was also continued. Indicated prevention programmes are almost exclusively oriented towards working with individuals and their families.
A monitoring system gives an overview on existing prevention interventions in the country. 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 2009 using the multiplier method, based on data from low-threshold centres and outreach programmes. In 2009, the national estimate suggests that there are 37 400 problem drug users (95 % CI: 33 300–41 500), which is higher than the estimate for 2008 (32 500, 95 % CI: 30 400 – 34 700). Rise in the estimated number of methamphetamine (pervitin) users from 21 200 in 2008 to 25 300 in 2009 accounts for most of that increase. The data suggests that in 2009 there were 12 100 opiate users of which 7 100 were heroin users and 5 100 Subutex® users. The number of IDUs (injecting drug users) was estimated at 35 300 in 2009 (95 % CI: 34 200–36 400) and is significantly higher than 2008 estimate (31 200, 95 % CI: 30 000–32 400). Cocaine problem 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. Problem cocaine use has not been included to estimation, due to a very low number of cocaine users in treatment or contact with services in the Czech Republic. Ecstasy and cannabis are not included in estimates by definition.
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 2009, a total of 276 outpatient and inpatient treatment and low-threshold centres contributed to the Treatment Demand Register. The register however does not cover the treatment provided by general practitioners, substitution treatment centres and in prisons. At the same time, only data reported from 217 treatment units corresponds to the EMCDDA treatment demand indicator definition (2) and are used to calculate and report on treatment demand in the Czech Republic in the 2011 Statistical bulletin.
In 2009, a total of 8 207 drug users entered in treatment whereas, 4 317 persons sought treatment for the first time. As in 2008, users of amphetamines (mainly methamphetamines) were the most commonly represented among all treatment clients entering treatment, at 60.8 %, as well as among first treatment clients with 63.1%. This was followed by opioids users with 23.5 % among all treatment clients and 19.0 % of cannabis users among first time treatment clients.
In 2009, 45 % of all clients entering treatment were aged less than 25 years. The age distribution for new treatment clients aged less than 25 years was 56 %. In 2009, the male to female ratio for all treatment clients was 67.5 % for male and 32.5 % for female clients. A similar distribution was also reported among new treatment clients, with 67 % being male and 33 % female. This gender distribution male: female-2:1 is also consistent with the estimated gender structure of problem drug users in the country.
(2) The EMCDDA defines TDI as a number of persons who starts treatment for their drug use at a treatment centre during the calendar year 1 January to 31 December. If a person starts treatment more than once during the same year at the same or another centre, then only the last treatment in the year is counted. Treatment is said to start as soon as a client begins formalised face-to-face contact with a treatment centre. Drug treatment centres are defined as outpatient, inpatient, low threshold services, general practitioners and prison treatment units.
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.
HIV seroprevalence rates among injecting drug users (IDU) remained consistently below 1 % in the Czech Republic between 1996 and 2009 (0.1– 0.5 % in 2009). The number of newly-diagnosed HIV cases among the general population is relatively low, although it seems to have been increasing over the last four years. 157 new HIV cases were diagnosed in 2009.
For hepatitis, in 2009, a quarter of all newly reported HBV cases and two thirds of newly reported HCV cases were registered among IDUs. The HCV prevalence in the population of IDUs has consistently been reported over the last three years, from 16.0 % in 2006 to 22.4 % in 2009 in diagnostic testing of clients in low-threshold services. In 2009, for the first time since 2005, the self-reported HCV prevalence among clients in Treatment Demand Register felt below 30 % thus continuing declining trend observed already in past three years.
Drug-related deaths
An automated system for collection of drug mortality data, which covers 14 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, 49 deaths were recorded in 2009 (44 were registered in 2008, 40 in 2007, 42 in 2006 and 62 in 2005). All death cases were confirmed by toxicology. Less than half of all cases involved heroin (40.8 %), however the number of fatal opiate related overdoses has increased from 15 in 2008 to 20 in 2009. Largest proportion of DRD in the Czech Republic is attributed to pervitin. 79.6 % of all DRD were in males.
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 (176 cases out of 225).
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 inpatient 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, out- 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 2009, there were registered 72 specialised substitution treatment centres, out of which 10 centres were registered in prisons. However, only 34 registered facilities reported administrating opioid substitution treatment in 2009. Furthermore, any medical doctor, regardless of his/her specialisation, may initiate high dosage buprenorphine as well as Suboxone treatment. In 2009, an estimated 3 896 clients were undergoing substitution treatment, 686 of whom were on methadone and approximately 3 210 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, 95 NSPs and one vending machine available in 2009). Programmes operate in all regions of the Czech Republic, providing a wide range of services. The Czech NFP estimates that in the past five years, the rate of problem drug users maintaining contact with these agencies has risen from 60 % to about 70 % (in Prague even about 80 %) of problem drug users. The number of syringes used has been increasing over recent years: in 2009, about 4.9 million syringes were distributed through NSPs in the Czech Republic, representing a 2.6 times increase compared to 2003. The main sources of sterile 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. Although 73 heroin seizures were reported in 2009, which is the lowest number since 2006, the quantity of heroin seized remains stable over the period 2006–09 (between 20–50 kg per year).
Cannabis continues to be the most frequently trafficked drug and the domestic production of marijuana with a higher THC content has been on the rise. It is grown in artificial conditions and, with increasing frequency, on a large scale. In 2009, the volume of the marijuana seized was almost twice less in comparison to that seized in 2008 (393 kg in 2008 to 172 kg in 2009). The number of growing sites detected and cannabis plants seized continued to increase (1 780 seized units in 2005 to 33 427 in 2009). Herbal cannabis was the most commonly seized drug in 2009, with 384 seizures.
In 2009, pervitin was the second most commonly seized drug with 326 seizures; the volume of pervitin seized was almost the same compared with the previous year (around 3.8 kg in 2008 and 3.6 kg in 2009). The amounts smaller than 50 g accounted for 96 % of all pervitin seizures. A restricted sale of pseudoephedrine containing medications introduced in 2009 was followed by significant rise in the illegal import of pseudoephedrine containing medications from neighbouring countries, especially Poland. The Customs Drug Unit reports seizing more than 50 000 tablets of illegally imported pseudoephedrine containing medication in 2009–10. The smaller number of pervitin production facilities were detected in 2009 when compared to 2008 (434 production facilities in 2008 and 342 in 2009).
Slight increase in cocaine seizures is reported compared with the previous year — 26 seizures with a total quantity of 13 kg in 2009, 24 seizures with a total quantity of 8 kg in 2008. While the number of reported ecstasy seizures and tablets seized has dropped significantly in 2009.
In 2009, a total of 2 340 persons arrested for primary drug related crime according to the Czech Penal Code were reported by the National Drug Headquarters. Around 54.7 % of cases were related to methamphetamine followed by 33.7 % related to cannabis and 5.8 % related to heroin. In the Czech Republic, the supply related offences exceeded those related to use. Reported data over the period 2006–09 do show that the proportion of use-related offences is stable and remains between 10–12 % from all reported drug offences.
National drug laws
Until the end of 1999, the Criminal Code stated that possession of narcotic drugs and psychotropic substances in greater than small quantities is a criminal offence, and could 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) were imposed under the Act on Misdemeanours.
In 2010, the new Criminal Code firstly set out a distinction between cannabis and other drugs for personal possession offences, whereby a cannabis offence would attract a sentence of up to one year. The new Code also fixed binding limit quantities with which to determine whether an offence was administrative or criminal — these had previously been set in non-binding prosecutor and police directives.
Penalties for drug trafficking can be up to 10–18 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 category of medicines was created to restrict sales of non-prescription medicines, such as those containing pseudoephedrine (a precursor for producing methamphetamine).
National drug strategy
In May 2010 the new National Drug Policy Strategy for the period 2010–18 was approved. The new strategy builds on the previous Czech national drug policy strategy which covered the period 2005–09, but is different from it in being conceived as a long-term vision for the next nine years. The strategy, similarly as the previous one, 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). The strategy defines four key objectives: (1) to reduce the level of experimental and occasional drug use, particularly among young people; (2) to reduce the level pf problem and intensive drug use; (3) to reduce potential drug-related risks to individuals and society, and (4) to reduce drug availability, particularly to young people. The strategy is complemented by three-year action plans, the first covers the period 2010–12.
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 2010–12 action plan. 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 the 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 2010 Czech National report mainly focused on aspects related to prevalence and incidence of drug use, consequences of drug use and the evaluation of interventions.
