Country overview: Slovenia
- 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 | Slovenia | EU (27 countries) | Source | ||
|---|---|---|---|---|---|
| Population | 2008 | 2 025 866 | 497 455 033 | Eurostat | |
| Population by age classes | 15–24 | 2008 | 12.4 % | 12.6 % 1 | Eurostat |
| 25–49 | 37.8 % | 36.3 % 1 | |||
| 50–64 | 19.8 % | 18.4 % 1 | |||
| GDP per capita in PPS (Purchasing Power Standards) 2 | 2007 | 89.3 | 100 | Eurostat | |
| Total expenditure on social protection (% of GDP) 3 | 2006 | 22.8 % p | 26.9 % p | Eurostat | |
| Unemployment rate 4 | 2008 | 4.5 % | 7 % | Eurostat | |
| Unemployment rate of population agends under 25 years | 2008 | 11.7 % | 15.5 % | Eurostat | |
| Prison population rate (per 100 000 of national population) 5 | 2006 | 65 | Council of Europe, SPACE 2006.1 | ||
| At risk of poverty rate 6 | 2006 | 12 % | 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
In 2008, the Clinical Institute of Occupational, Traffic and Sports Medicine carried out a general population survey on drug use, but results haven’t been published yet. Irrespective of this survey, it is estimated that cannabis is the most frequently used illegal drug in Slovenia. A public opinion poll survey in 1999 among a representative sample of people aged 18 years old and above, showed that 10.6 % of respondents admitted to having used one or more illegal drugs (marijuana, heroin, cocaine, amphetamines, LSD/hallucinogens, ecstasy, sedatives without a doctor’s prescription, alcohol and pills together, drugs by injection). 8.8 % of respondents answered that they had used marijuana at least once in their lifetime.
The ESPAD school survey was repeated since 1995, and the latest survey was done in 2007, based on a nationwide stratified random sample of high-school students aged 15–16. As in many central and eastern European countries, an increase in lifetime experience with illegal drugs was observed during the 1990s. Whereas in 1995, 3 % reported that they had ever used an illicit drug other than marijuana and hashish, 7 % admitted lifetime experience in 1999. In 2003, the proportion however decreased to 5 % and in 2007 increased again to 7 %. Lifetime experience with marijuana/hashish use increased by nearly 100 % from 13 % in 1995 to 25 % in 1999. In 2007, 22 % reported a lifetime experience with cannabis with respectively 24 % among males and 20 % among females. Last year prevalence of cannabis in 2007 was 18 % and last month prevalence was 9 %. Lifetime prevalence of inhalants was reported by 16 % of the students, ecstasy and cocaine both were reported to have been used at least once by 3 % of the sample. Regarding the other substances, lifetime prevalence was equal to 2 %.
Prevention
The most important prevention activity in Slovenia is a project run by the Slovenian Network of Health Promoting Schools, which has been under way in Slovenia since 1993. The project is carried out on a national level, and covers general prevention activities, which are oriented towards the promotion of a healthy lifestyle and are included in health education programmes.
Preventive programmes in Slovenia are very widespread, yet there are no systematically collected data on prevention available. However, the Regional Institute of Public Health in Ravne na Koroškem, is coordinating a multi-sectional body responsible for development of national guidelines for developing, implementing and evaluating preventive programmes.
The establishment of a national body coordinated by the Ministry of Education was foreseen, which would be in charge of developing standards for preventive programmes carried out in schools and other education institutions, but at the end of 2008, Slovenia is still missing such a body. Consequently, there are various preventive programmes — which differ regarding their quality and content — carried out in schools by numerous performers like health institutions, NGOs, state institutions etc. So far, none of the existing programmes has been implemented nationally.
However, there are some examples of life-skills programmes at regional level.
Problem drug use
In Slovenia, opiates and, in particular, heroin are the most reported substance linked to problem drug use according to various data sources (e.g. treatment demand data). The first problem drug use estimate where the EMCDDA definition was adopted was carried out by the National Institute of Public Health (NIPH) in Slovenia in 2003 for the years 2000 and 2001, using the capture–recapture method and two data sources (police arrests and treatment data). The most recent estimate refers to the 2004 data and amounts to 10 654 problem drug users (9 078–12 593). In terms of rate per 1 000 inhabitants aged 15–64 years, this corresponds to 7.8 (6.6–9.2) per 1 000. Estimates by gender and age are available.
Although this figure is higher than the one obtained based on 2000 and 2001 data, it is not clear whether it should be interpreted as an increase, because the previous estimates were preliminary. This question is being discussed on the national level.
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.
Treatment demand
Treatment demand data in Slovenia is collected through the Centre for the Prevention and Treatment of Illicit Drug Addiction (CPTDA), an established network of centres for the prevention and treatment of illegal drug addiction. The CPTDA network offers nationwide coverage, and in 2007 a total of 17 outpatient treatment centres submitted treatment demand data out of 19 treatment centres. In 2007, the total number of reported clients in treatment was 1 566, of whom 276 were first-time treatment clients, 413 in repeated treatment and 877 in continuous treatment. The actual number is higher, but the extent of underreporting is difficult to estimate.
In 2007, 95.8 % of all clients entering treatment reported opioids as their primary drug. This was followed by 3.1 % for cannabis and 0.9 % for cocaine. Among first-time treatment clients 92.8 % reported opioids as their main problem substance, followed by 6.5 % for cannabis and 0.4 % for cocaine. 32 % of all clients entering treatment were aged less than 25. A higher percentage in age distribution was reported among new treatment clients, with 42 % being under the age of 25. As regards gender distribution among all clients entering treatment in 2007, 77 % were male whereas 23 % were female. A slightly different gender distribution was reported in 2007 among new treatment clients entering treatment, at 77 % for males and 23 % for females.
Data for Slovenia includes data for outpatient clients and clients treated in prison, and data for outpatient clients was validated. However, the data collection for prison clients was still in the process of development, thus figures are underestimated. With effect from next year (reporting year: 2007), the process of data validation for prison clients will be implemented.
Drug-related infectious diseases
No prevalence rates are available for drug-related diseases among the whole population of (injecting) drug users. Several studies among sub-populations on HIV prevalence were conducted among tested groups of injecting drug users and those in treatment during the period 2002 to 2007. These indicated HIV prevalence rates of below 1 % among confidentially- and voluntarily-tested IDUs who were treated for the first time in the network of outpatient centres and non-governmental needle and syringe exchange programmes. The prevalence rate of antibodies against the hepatitis B virus (HBV) was 3.6 % in 2007 (compared to 10.4 % in 2003) among the same population. The prevalence rate of antibodies against hepatitis C virus (HCV) was 21.8 % in 2007 (compared to 22.5 % in 2003). However, there is a high risk of underreporting of cases both for HCV and HBV.
Drug-related deaths
Data on drug-related deaths are aggregated using data from the General Mortality Register, the Institute of Forensic Medicine and data from the First Treatment Demand Database. According to all sources combined, there were 39 direct drug-related deaths in 2006 (compared to 44 in 2005). Drug-related deaths were defined as deaths due to accidental poisoning, intentional poisoning and poisoning of undetermined intent. A trend analysis over time cannot yet be undertaken due to continued adjustments of data reporting in line with the EMCDDA’s methodology. Out of the 39 cases, in the majority of the confirmed drug-related deaths, the cause of death was heroin use, followed by the group of other opioids, opium and benzodiazepines, with methadone in third place.
Treatment responses
In Slovenia, on the national level, drug-related treatment is regularly provided by different systems of health, social and civil society organisations (NGOs). Implementation of treatment is carried out on a formal legal basis under two acts: the Health Care and Health Insurance Act (Official Gazette 9/92); and the Prevention of the Use of Illicit Drugs and Dealing with Consumers of Illicit Drugs Act (Official Gazette 98/99).
The main financial actor in funding drug-related treatment in the health sphere is the Health Insurance Institute of Slovenia. Responsibility for implementing treatment lies predominantly at the national level. The public sector is the main actor involved in the delivery of drug-related treatment, mainly medically-assisted treatment. However, drug-related treatment, mainly psychosocial interventions, is also delivered by NGOs, which are supported by public funding.
Drug-related treatment is available within the framework of the public health national service network. Treatment takes place primarily at one of 18 CPTDAs, which are run as a franchise or as a public health service. The legislative basis of the work of CPTDAs, and the provision of drug-related health services, is defined in four laws: the Law on the Prevention of Illicit Drug Use; the Law on Health Care and Health Insurance; the Law on Drugs and Medicine Accessories; and the Law on the Health Service. To provide hospital and treatment at special clinics, the government has established a public health institute — the Centre for the Treatment of Drug Addicts — at the Ljubljana Psychiatric Clinic. Hospital treatment includes hospital detoxification, psychosocial-therapeutic treatment, prolonged treatment and health rehabilitation. Hospital and clinical programmes of treatment, and maintenance with methadone and other substitution medication, are under the supervision of the Health Council.
The Commission for Controlling the Work of the CPTDAs, appointed by the Minister of Health, oversees the treatment centres. This commission checks, amongst other items, the documentation, human resources and equipment of the centres, the scope of work performed, their methadone maintenance programmes and consultation-based treatment.
The treatment system in Slovenia can be classified into four categories: (i) outpatient treatment, (ii) inpatient treatment, (iii) detoxification, and (iv) substitution maintenance treatment. Outpatient treatment involves the majority of treated drug users, and the most frequent treatment is substitution treatment (mostly with methadone). It also includes psychosocial interventions, medically-assisted treatment, individual or group counselling and a socio- or psychotherapy component. Inpatient drug treatment consists mainly of psychosocial interventions, yet may also be pharmacologically-assisted in terms of withdrawal treatment. Detoxification treatment may take place in inpatient or outpatient settings. Inpatient treatment offerings include detoxification and treatment lasting six to eight weeks.
Substitution treatment with methadone, which was introduced in 1990, is provided either by the doctors employed in these outpatient clinics or by general practitioners, who practice at the CPTDAs, although not commonly.
Buprenorphine was registered in 2004 and in 2005 slow-release morphine became also available. These two medications have contributed to the increased diversification of opioid maintenance treatment options. Treatment with naltrexone is also possible in the framework of the CPTDAs network or the CTDA. The buprenorphine/naloxone combination was introduced in 2007.
In 2007, the total number of clients in opioid substitution treatment it was estimated to 1 200. According to data of the coordination of the CPTDA and CTDA, the total number of clients in opioid substitution treatment in 2007 was 2 901.
Harm reduction responses
Slovenia has more than 10 years of experience in the field of harm reduction. Reduction of drug-related harm was also included in the national strategy on drugs 2004–09. Recently, many new programmes have been developed at local level, mainly aimed at injecting drug users and drug users in recreational settings. Programmes of harm reduction for injection drug users (i.e. needle exchange programmes, information, counselling) exist in the capital city of Ljubljana and other regions and cities (i.e. Koper region, city of Celje, city of Ilirska Bistrica, etc.). These programmes are provided mainly through NGOs. Syringes are mainly made available through specialist agencies, outreach and mobile services, but also through pharmacy-based exchange; in 2007, more than 882 000 syringes were distributed nationwide. Funds were provided by the Ministry of Health.
Drug markets and drug-related offences
Slovenia is located on the Balkan route, which is the main pathway for illegal trafficking of heroin from south-east Europe to central and western Europe. In addition, criminal groups engaged in illicit drug trafficking, particularly cannabis from Albania to Central Europe, and cocaine from the Mediterranean to Central Europe are operating in the country.
Data provided by the Ministry of Interior on drug seizures from all law enforcement agencies show that in 2007, cannabis remained the illicit drug most often involved in drug-related offences with 2 622 ( includes cannabis resin, herbal and plant) for cannabis related offences followed by 572 for heroin related offences and 199 for cocaine related offences. In terms of quantity of different types of illicit drugs seized in Slovenia, cannabis leads the list, due to the fact that cannabis is cultivated in Slovenia. The total quantity of seized cannabis plants in 2007 amounted to 9 483 plants and the total amount of cannabis plants seizures amounted to 366 in 2007. Ecstasy is the most widespread synthetic illicit drug in Slovenia, and a significant increase can be observed over the past four years with a total quantity of 874 seized ecstasy tablets in 2004, 1 309 in 2005, 2 950 in 2006 and 1 246 in 2007.
The street price of illicit drugs is estimated by the Slovenian Police Department through their monitoring system at national level based on all seized reports. The average price of cannabis has been increasing in the last few years. The price of cannabis resin was stable in 2004 and 2005 but it increased by 35 % in 2006, reaching an average price of EUR 9/gram in 2007. Furthermore, the average price of an ecstasy tablet in 2007 was between EUR 5 to EUR 7 per tablet.
National drug laws
In Slovenia, purchasing drugs for one’s own use and consumption is not considered a criminal offence. Consumption itself is not defined as criminal conduct. Slovenia’s Production and Trade in Illicit Drugs Act defines separately the possession of illegal drugs, the possession of a small quantity for individual use, and the possession of a small quantity for individual use for a person who opts for medical treatment or treatment in health or social programmes. Possession of an illegal drug is only considered a minor offence under the Production and Trade in Illicit Drugs Act (Article 33), and is subject to a fine or imprisonment.
The nature and length of imprisonment depends on the quantity of drugs found in possession. For example, possession of small quantities of illicit drugs for one-off personal use might lead to a monetary fine of between EUR 42 and EUR 209, or a prison sentence of up to five days. Persons may be subject to more lenient punishment if they voluntarily enter treatment for illicit drug use, or social security programmes approved by the Health Council at the Ministry of Health or by the Council for Drugs at the Ministry of Labour. The new Penal Code of the Republic of Slovenia, adopted by National Assembly in 2008, defines two criminal offences: the manufacture and trafficking of illicit drugs (Article 186) and facilitating the consumption of illicit drugs (Article 187). Article 186 includes the sale of illicit drugs, the manufacture of illicit drugs, the purchase of illicit drugs with the intention for sale, possession with the intent to sale etc., punishable by 1–5 years’ prison.
Article 187 of the Penal Code includes the offer of illicit drugs for consumption, offers of premises for consumption of illicit drugs to minors etc as offences punishable by prison from six months to eight years. If the offences are committed towards vulnerable people or abusing the position of the offender, they are punishable by 1–12 years’ imprisonment.
National drug strategy
Slovenia’s ‘Resolution on the national programme on drugs 2004–09’ was adopted by the National Assembly in February 2004. This strategic document was discussed at inter-ministerial and governmental levels in 2003. It was also discussed and adopted in 2003 by the Government Commission for Drugs. Public debate about the national strategy was organised by the National Assembly’s Committee on Health, Labour, the Family, Social Policy and the Disabled in January 2004.
Slovenia’s ‘Resolution on the national programme on drugs 2004–09’ is a comprehensive strategy focusing on illicit drugs. Its aim is to encourage preventive action in the area of drugs, and includes various programmes for reducing the demand for drugs. It aims include reducing the number of new drug users among the younger generation; preventing first contact with drugs and raising the age of onset. The programme’s objectives are classified by time and content into three groups, with its main priorities being: (i) to develop the information system in the field of drugs; (ii) to increase the share of drug users included in different programmes; (iii) to support NGOs; (iv) to define standards for financing programmes over several years and for evaluating these programmes; (v) to establish a coordination system in cooperation with faculties and research institutes; and (vi) to improve programmes in prisons to prevent drug use; and to establish a network of local action groups (LAGs).
Coordination mechanism in the field of drugs
Coordination for the drug policy is within the Governmental Commission for Drugs of the Republic of Slovenia. The Commission promotes and coordinates governmental policy and programmes, proposes certain measures, and monitors implementation of the provisions of international conventions. The Commission operates at the inter-ministerial level and is composed of representatives of ministries of health; finance; defence; education and sport; justice; labour, family and social affairs; interior and experts in the field of drugs.
The Governmental Office for Drugs (GOD) was moved from the governmental level to within the organisational structure of the Ministry of Health (MH) as a result of the reform of the public administration. A law on the transfer of the tasks of several government offices to ministries was adopted by the national assembly in December 2003, coming into operation in April 2004. GOD has thus been part of the MH since this time, and, today, drug-related services are under the responsibility of the Directorate for Public Health.
At the local level, the responsible coordination units are local action groups (LAGs), which act as an expert advisory body for mayors and municipal/urban councils responsible for preparing coordinated measures in local communities in the area of drugs. Ten regional coordinators were appointed in 2005. LAGs are not professional units, with a scope of activities that is wider than drug-related actions alone.
Drug-related research
ESPAD and the HBSC survey have been regularly implemented in Slovenia. The national focal point is the one of agencies involved in drug-related research in Slovenia, and also plays an important role in collecting and disseminating research findings at national level. The main focus of drug-related research is population surveys, although applied research in the treatment area and pharmacological research projects are also undertaken. Recent drug-related studies mentioned in the 2008 Slovenian National report mainly focused on aspects related to responses to the drug situation.