Country overview: Croatia
- 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 | Croatia | EU (27 countries) | Source | ||
|---|---|---|---|---|---|
| Population | 2010 | 4 425 747 | 501 105 661 p | Eurostat | |
| Population by age classes | 15–24 | 2010 | 12.2 % | 12.1 % p | Eurostat |
| 25–49 | 34.8 % | 35.8 % p | |||
| 50–64 | 20.2 % | 19.1 % p | |||
| GDP per capita in PPS (Purchasing Power Standards) 1 | 2008 | 64 p | 100 | Eurostat | |
| Total expenditure on social protection (% of GDP) 2 | 2008 | 26.4 % p | Eurostat | ||
| Unemployment rate 3 | 2010 | 11.8 % | 9.6 % | Eurostat | |
| Unemployment rate of population aged under 25 years | 2010 | 30.7 % | 20.9 % | Eurostat | |
| Prison population rate (per 100 000 of national population) 4 | 2009 | 110.3 | Council of Europe, SPACE I-2009 | ||
| At risk of poverty rate 5 | 2009 | 17.9 % | 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
To date in Croatia, no general population survey on illicit drug use has been carried out, however a feasibility study was carried out in 2010.
The European School Survey Project on Alcohol and other Drugs (ESPAD) was conducted nationwide regularly, since 1995. Cannabis was reported as the most frequently used substance. In 2007, results of the survey indicated that among 15–16-year-old students lifetime prevalence of cannabis use was 18 %, last year prevalence was 13 % and the last month prevalence was 6 %. Lifetime prevalence of inhalants was reported by 11 % of the sample. Regarding all other substances, percentages for lifetime prevalence were equal or below 2 %.
The Health Behaviour in School-aged Children (HBSC) was conducted twice (2002–06) in Croatia. Only 15-year-old students were interviewed about their herbal cannabis use. In 2002, lifetime prevalence of herbal cannabis was 16 % and 14 % in 2006. More male (17 %) than female students (11 %) reported lifetime herbal cannabis use.
In 2009, Zagreb became the fourth city in the world which conducted a study on measurement of the quantities of illicit drugs in communal wastewaters to determine the population trend of drug use. According to the results of this study, the marijuana was the most widely used drug followed by heroin in Zagreb. The study allowed to determine the weekly fluctuations in drug use habits, which indicated increase in ecstasy and cocaine use during the weekends, while such fluctuations were not characteristic for marijuana levels.
Prevention
In 2010, the first National addiction prevention program for children and youth in educational setting and social welfare system for 2010–14 was adopted. The programme outlines following prevention aspects: (1) main target audience (pre-school children and pupils, university students and children and young people in social care institutions), (2) evaluation criteria for prevention programmes and (3) standards for drug use prevention activities.
Addiction prevention programmes in the Republic of Croatia are being implemented primarily at the local community level of the 21 counties, as multidisciplinary activities with the participation of different sectors such as education, health, social care, non-governmental organisations and media. Universal drug prevention is mostly organised and implemented within the education system and is primarily aimed at reducing the interest of young people in experimenting with addictive substances. On a community level, youth clubs and non-governmental organisations offer educational activities during free time using peer education methods or proposing alternative positive behavioural models for free time activities. Although there are numerous small-scale projects carried out across the counties, systematic monitoring of preventive programmes does not exist in the Republic of Croatia, nor their systematic evaluation. Recently the shift from mainly information-provision and mass media campaigns towards more skills based prevention activities is observed in universal prevention strategies.
Selective and indicated prevention is undertaken in some projects with vulnerable families and within the educational context, aimed at children with special needs. The German programme MOVE (Motivational short intervention for youth at risk) was implemented and adapted to Croatian needs. Training for MOVE targets persons who encounter vulnerable youth in the scope of their work, i.e. counselling at the social care centres, prevention services and outpatient treatment, school services, NGOs and homes for education of children and youth care institutions. It consists of 12 modules/units and is based on experiences from different therapeutic concepts and theories transformed into short advisory dialogues. The basic goal was to include youth who otherwise would not come to counselling and who prefer shorter dialogues that are more efficient for these specific cases than longer conversations.
Problem drug use
Croatia used a mortality multiplier method to estimate the size of injecting drug users population in 2009 (based on benchmark of cases treated in 2009 and multiplier obtained for 2004–09 from the General Mortality Register). The estimated size of IDU population was 3 145. The figure obtained correspond to a rate of 1.6 per 1 000 inhabitants aged 15–64 (1).
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) Calculated by the EMCDDA, using 2 969 981 as the 15–64 population size.
Treatment demand
Since 1978, the Croatian Institute of Public Health has been gathering data on treatment demand clients. In 2009, the Croatian Institute of Public Health gathered data from 33 inpatient and 23 outpatient treatment units.
In 2009, a total of 7 733 clients entered in treatment, out of which 1 463 were first-time treatment clients.
Among all treatment clients 80.8 % reported opioids as their primary drug followed by 10.3 % for cannabis and 1.8 % for cocaine. Among first-time treatment clients, 45.6 % reported opioids as the primary drug, followed by 34.0 % for cannabis and 3.5 % for cocaine.
In 2009, 20 % of all clients entering treatment were aged less than 25 years. A higher percentage in age distribution was reported among new treatment clients, with 42 % being under the age of 25 years. As far as gender distribution is concerned, 83 % of all clients entering treatment were male whereas 17 % were female. A similar distribution in gender distribution was reported among new treatment clients with 80% for male and 20 % for female.
Drug-related infectious diseases
HIV data is the only one checked and compared at national level, it is estimated that the incidence rate of HIV infection among the addict population is low. The incidence of HIV-positive persons has remained stable over the last years. No new HIV cases were detected among injecting drug users in 2009. The latest data from seroprevalence study in 2007-08, indicates very low prevalence of HIV among addicts and it is estimated to be approximately 0 %. What has contributed to the low figure is a permanent education, being well-informed, opioid substitution therapy, counselling centres and widespread needle and syringe exchange.
HBC and HCV are not nationally monitored in Croatia to the same extent as HIV and the number of new cases of drug users being infected with HBV and HCV virus is therefore not known. Nevertheless, the national estimate form the latest seroprevalence study in 2007-08 indicates that the prevalence would be around 24.0 % for HBV (positive aHBc) and 44.0 % for HCV.
Drug-related deaths
There are two sources in Croatia for information on acute deaths: the Central Bureau of Statistics operates a Mortality Register, and collects and evaluates all data on deaths in the entire country; and the Croatian Institute of Public Health (CIPH) encodes the basic causes of death, and compiles overall statistics. The Mortality Register includes, in addition to demographic data, all causes of death and classifies them using a four-digit code, and this is connected to the CIPH database. So as soon as the Mortality Register is changed, the CIPH database is automatically updated.
In the last 15 years the number of deaths is gradually increasing in Croatia, and in the year 2007 the highest number of deaths so far was recorded (115). In the following years some decline in the drug related cases can be noted. The latest drug-related deaths data are for 2009 where a total of 61 cases were registered and 95.1 % of these involved males. A majority of the cases (83.0 %) of deaths were associated with opiates. Some 8.2 % of death cases are registered among those aged 25 and younger.
Treatment responses
Drug-related treatment in Croatia falls under the responsibility of the Ministry of Health and Social Welfare, whereas the implementation of treatment programs falls under the responsibility of outpatient services for mental health and addiction prevention, general practitioners, hospital institutions, non-governmental organisations and therapeutic communities. Treatment services which are under the state’s authority are funded by the Ministry of Health and Social Welfare, the counties and the Croatian Institute for Health Insurance. Non-governmental organisations are funded by the Office for Combating Drugs Abuse of the Government of the Republic of Croatia, the Ministry of Health and Social Welfare and the counties. In all Croatian counties, there are Services for Mental Health and Drug Addiction Prevention, which are organised within the county Institutes of Public Health. These services are obliged to collect and send data on treated persons to the Croatian Institute of Public Health.
Treatment services in Croatia can be classified into three main areas: inpatient treatment; outpatient treatment; and rehabilitation therapeutic communities. Across Croatia, there are 33 inpatient treatment centres and 23 outpatient treatment centres. Drug treatment services are provided by national agencies and NGOs. In Croatia, methadone substitution treatment was introduced in the early 1990s and is currently used within three types of treatment: short-term outpatient detoxification; extended outpatient detoxification; and long-term maintenance treatment. The substitution with Buprenoprhine was introduced in 2004 and since 2006, when the Croatian Institute of Public Health started to cover the costs of such treatment, a steadily increase in proportion of clients receiving Buprenorphine is observed. Specialised medical doctors and treatment centres order substitution treatment. However, treatment itself is predominantly provided by general practitioners. In 2006, ‘Guidelines for the use of methadone in the substitution therapy of opiate drug users’ were adopted by the Croatian government. Furthermore, in December 2006 ‘Guidelines for the use of buprenorphine in the substitution therapy of opiate drug users’ were also approved by the Commission for Combating Drug Abuse of the Government of the Republic of Croatia. In 2009 a decision was taken to introduce suboxone as an alternative substitution substance.
In 2009, the total number of clients in substitution treatment was 4 684, of whom 2 333 were on methadone and 2 292 on buprenorphine.
Harm reduction responses
Harm reduction programmes, primarily needles and syringes exchange programmes, are conducted in cooperation with the Croatian Red Cross by the NGOs ‘Terra’, ‘Let’, ‘Help’ and Institut along the coastline: Dubrovnik, Makarska, Split, Šibenik, Zadar, Rijeka, Opatija, Lovran, Pula, Labin, Porec; inland cities Delnice, Ogulin, Karlovac, Zagreb, Nova Gradiška, Dakovo, Vinkovici, Vukovar, and locations on islands. In Croatia, the first harm reduction programmes focusing on problem drug users were introduced immediately after the Croatian Parliament in 1996 recognised this approach as an important element of the national drugs strategy. The NGO ‘Help’ initiated their first project in 1996 in Split, while the Croatian Red Cross started its projects in Zagreb, Zadar and Pula in 1998, followed by activities in Rijeka by the NGO ‘Terra’ in 1999. Needles and syringe exchange programmes are aimed at injecting drug users in order to prevent the spread of blood-borne diseases, especially hepatitis C and HIV. In 2008, around 290 000 syringes were distributed, which is almost doubled in comparison with 2006 data.
In Croatia, there are 69 locations where harm reduction programmes (including drop-in centres) are regularly conducted. Services include voluntary, anonymous and free-of-charge counselling and testing, as well as cooperation in research related to behaviour among the intravenous drug users population. Programmes also print and distribute information about drug use. In last years these programs contributed also to overdose prevention and reduction of other health related risk among their clients. Risk reduction in recreational settings is also promoted through various NGOs.
Drug markets and drug-related offences
The Republic of Croatia is a transit route through which illicit drugs are smuggled on the way from the production countries to consumer countries. Significant and large scale cocaine seizures in Croatia are mostly connected with sea transport and take place mostly in Rijeka, the container terminal and the port of Plomin.
In 2009, the total number of reported drug related offences was 7 063. The majority of the reported drug-related offences were related to cannabis, followed by heroin, amphetamine and cocaine.
With regards to drug seizures, in 2009, there was a total of 2 821 herbal cannabis seizures, a total of 423 cannabis resin seizures, 512 of heroin, 151 of cocaine, 45 of ecstasy and 341 of amphetamine seizures. The number of seizures decreases for all drugs when compared to previous years. In 2009, the lowest number of heroin seizures is documented since 2001.
In 2009, the quantities of herbal cannabis and herbal resin seized increase when compared to 2008 amounts. However, the quantities of seized heroin, cocaine, amphetamine and ecstasy have decreased when compared to a previous year. In 2009, the quantity of seized heroin was 59 kg, which is at around 40 % from the amount seized in 2008 (153 kg). The quantity of seized cocaine has dropped four times, but the quantity of seized ecstasy tablets almost tree times when compared with 2008 amounts. In 2009, cannabis plants seized were 5 336 as compared to 272 in 2008, herbal cannabis seized 255 kg as compared to 221 kg in 2008, cocaine seized 7 kg as compared to 29 kg in 2008 and 2 455 ecstasy tablets as compared to 6 855 tablets in 2008.
National drug laws
In Croatia, drug control is mainly covered by two legal acts: the Law on Combating Narcotic Drugs Abuse, and the Penal Code.
The Law on Combating Drugs Abuse passed in November 2001 and since updated, regulates conditions for the manufacture, possession of and trade in drugs and substances and precursors. It outlines a system for the prevention of drug addiction and assistance to addicts and sporadic narcotic drug users, including a protective measure of mandatory substance abuse treatment of three months to one year. It prohibits unauthorised drug consumption, cultivation, possession and trafficking, and provides for fines for legal entities in breach of drug trading regulations, and for natural persons who cross the border without declaring psychoactive medicines. Discarding syringes and failure to notify the police of suspicious events are also specific offences.
In Chapter 13 of the Penal Code, Article 173 addresses narcotic drugs abuse and trafficking, with penalties updated in 2006 to align with the Council Framework Decision 2004/757/JHA of 25 October 2004. Under the Penal Code, unlawful possession without the aim to sell is punishable by up to a year in prison. The basic penalty for possession with the aim to sell is a prison sentence from 1–12 years. Any form of actual supply (production, sale, distribution) is punished by 3–15 years imprisonment. When the offender is part of a group or criminal organisation, the maximum punishment rises to life.
Precursor trafficking carries a penalty of three months to five years in prison.
In 2009, the new Criminal Procedure Code was adopted and the system of criminal procedure was strengthened in the country mainly to address more effectively organised crime activities, significant part of which is also related to drugs.
National drug strategy
Croatia’s new ‘National strategy on combating narcotic drugs abuse in the Republic of Croatia 2006–12’ replaced a former strategy which was first implemented in 1996 and ended in 2005. The new strategy is comprehensive, focusing on illegal drugs and covers the same five pillars as in the EU strategy: coordination, supply reduction, demand reduction, international cooperation, and information/research/evaluation. Its two main goals are: (i) a measurable reduction in drug use, drug addiction and related health and social risks and (ii) the measurable promotion of a successful, efficient, scientifically-based application of the law regarding the production and trafficking of drugs and precursors. The strategy is complemented by three year long action plans and the second ‘Action plan on combating narcotic drugs abuse 2009–12’ was adopted in February 2009. There are also annual implementing programmes of the action plan which describe in detail specific aims and methods for achieving the goals, as well as specific tasks of particular executors for each budget period.
Coordination mechanism in the field of drugs
The Commission for Combating Drugs is composed of higher members of all relevant ministries and is chaired by the Deputy Prime Minister in charge of social issues and human rights. The Commission coordinates the activities of the ministries and other actors involved in the implementation of the national drug strategy. It also adopts annual programmes of actions in this field.
The Office for Combating Drugs Abuse is a specialised government service which deals with the day-to-day implementation of the national drug programme and its monitoring. There are also County Commissions for Combating Drug Abuse, which coordinate the implementation of the drug strategy at the local level. Members of these commissions are experts and representatives of local administrations.
Drug-related research
Drug-related research in Croatia has been increasing significantly in recent years. Research is mainly funded by the Ministry of Science, Education and Sport (MZOS) and is implemented by governmental agencies. Libraries and websites from funding and research agencies are the main channels for disseminating drug-related research findings. Recent drug-related studies mentioned in the 2010 Croatian National report cover many aspects related to drug use which include prevalence surveys, wastewater analysis, drug markets and risk factors.
