Country overview: Slovakia
- Drug use among the general population and young people
- Problem drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-related deaths
- 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 (27 countries)||Source|
|Population||2012||5 404 322||503 663 601 b p||Eurostat|
|Population by age classes||15–24||2012||13.5 %||11.7 % b p||Eurostat|
|25–49||38.2 %||35.4 % b p|
|50–64||20.2 %||19.5 % b p|
|GDP per capita in PPS (Purchasing Power Standards) 1||2011||73||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2010||18.6 p||29.4 % p||Eurostat|
|Unemployment rate 3||2012||14.0 %||10.5 %||Eurostat|
|Unemployment rate of population aged under 25 years||2012||34.0 %||22.8 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2011||198.7||:||Council of Europe, SPACE I-2011|
|At risk of poverty rate 5||2011||13.0 %||16.9 % e||SILC
p Eurostat provisional value.
b Break in series.
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, 2011.
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).
General population surveys in Slovakia have reported a continuous increase in the lifetime prevalence of drug use among the general population in the period 1994–2006, followed by a decrease in the most recent studies.
Surveys conducted in 1994 and 1996 found that lifetime prevalence rates for any illicit drug in the general population increased by two-thirds (from 6.2 % in 1994 to 10.4 % in 1996). Other survey cycles suggested that this sharp increase slowed in 1998, when the lifetime prevalence rate for all illicit drug use was reported at 10.8 %. In 2006 two surveys among the general population were carried out: one by the Public Opinion Research Institute (PORI) and one by the National Monitoring Centre for Drugs (NMCD) focused only on herbal cannabis use. Results of the PORI study indicate that lifetime prevalence of marijuana was 16.1 %, last year prevalence was 6.9 % and last month prevalence was 2 %. These results show an increasing trend in the proportion of cannabis users. Results of the NMCD study indicated a lifetime prevalence of cannabis use of 11.7 %, last year prevalence of 4.1 % and last month prevalence of 1.7 % among people aged 15–64. In the 15–24 age group lifetime prevalence of cannabis use was reported at about 29 %, last year prevalence at 13.1 %, and last month prevalence at around 5 %, suggesting a stable pattern over recent years. Lifetime prevalence of any illicit drug was reported by 26 % of the sample. Ecstasy was the second most prevalent drug among those aged 15–24, with lifetime prevalence at 4.3 %, last year prevalence at 1.6 % and last month prevalence at 0.5 %. Solvents or inhalants were reported with a lifetime prevalence of 1.7 %. In 2010 a general population study among a sample of 4 055 respondents aged 15–64 was carried out by the NMCD. It found that cannabis remained the most prevalent illicit drug used in Slovakia by 10.5 % of respondents, followed by ecstasy at 1.9 % and cocaine at 0.6 %. Around 3.6 % reported last year cannabis use, while 1.4 % reported last month cannabis use. Illicit drug use continued to be more common among young people aged 15–34, and among males.
As in many other central and eastern European countries, European School Survey Project on Alcohol and Other Drugs (ESPAD) studies conducted since 1995 showed an increase in illicit drug consumption among secondary school students aged 15–16. Although lifetime prevalence rates for cannabis more than tripled from 9 % in 1995 to 32 % in 2007, the results of the latest survey (2011) showed a decline to 27 %. In terms of gender, 31 % of males and 23 % of females reported ever having used cannabis. Last year prevalence of cannabis use was 19 % and last month prevalence was 9 %. Lifetime prevalence for ecstasy use was 0 % in 1995, 6 % in 2007 and 4 % in 2011. Lifetime prevalence for amphetamines and LSD remained unchanged from 2007 and 2011 at 2 % for amphetamines and 4 % for LSD, while lifetime prevalence of inhalants fell from 13 % in 2007 to 10 % in 2011.
A national school survey on tobacco, alcohol and drugs among 16-year-old students has been carried out in Slovakia every four years since 1994, with the latest in 2010. Slovakia also participates in the Health Behaviour in School-aged Children (HBSC) project, which covers 11-, 13- and 15-year-olds, for which the latest data collection was performed in 2009/2010.
The implementation of drug prevention in Slovakia falls under the responsibility of the key ministries concerned: Education, Health, Labour, Social Affairs and Family, and the Ministry of Interior. The main objectives and framework for drug prevention are defined in the National Anti-Drug Strategy for the Period 2009–12, and prevention is one of the major priorities of the strategy. Within the area of drug demand reduction the policy concentrates on: (i) innovative approaches in the area of prevention and reduction of drug use or abuse-related damages; (ii) support of protective factors and a healthy lifestyle; (iii) reduction of licit and illicit drug consumption by children and youth; (iv) creation of conditions for the active and meaningful use of leisure time; (v) preparation of preventative programmes and educational activities; (vi) enhancement of the information level and the improvement of the quality of support services, especially for risk groups.
Most prevention interventions are now centrally monitored, while evaluations of their effectiveness remain rare. The key principle of universal prevention in Slovakia is to support, develop and strengthen children’s life skills and to promote their health. Universal drug prevention programmes in schools focus on alcohol, smoking, illicit drugs and risk behaviour. Several standardised programmes are now in place, including The Way to Emotional Maturity, a long-term national prevention programme for pupils aged 12–15 (the sixth to ninth year of elementary school or the first year of secondary school) that develops and strengthens psychological and social skills that can act as a protective factor. Pedagogical and psychological counselling centres also provide prevention intervention, the majority of which focus on elementary school pupils. In the school year 2010–11 these centres carried 894 prevention programmes for children and young people aged 3–19, as well as programmes for teachers and parents. In 2011 a number of information and education activities in cooperation with the police or public health authorities also took place in educational settings. Primary and secondary schools have a drug prevention coordinator, usually a school psychologist or a teacher, forming a country-wide network, although no integrated training or education programmes are in place for them.
Prevention targeting for families is limited and focuses mainly on information exchange and discussions. Community prevention programmes are targeted at recreational activities, such as organising summer camps and sports activities for young people and children within leisure centres. The website of the National Monitoring Centre for Drugs provides online information and consultation services.
Selective prevention interventions are organised by health services and non-governmental organisations (NGOs) in recreational settings such as festivals, and for children and young people in disadvantaged and Roma communities, marginalised families and young delinquents (for example, the programme FreD Goes Net). Pedagogical and psychological counselling centres provide counselling services to pupils with learning, personality, psychological or behavioural problems. In 2011 several innovative prevention activities for adolescents with substance abuse experience were piloted in Slovakia. For indicated prevention, specialised psychological counselling is also provided for families with drug addiction problems and for disruptive children in school settings.
View ‘Prevention profile’ for additional information.
The latest estimates for the problem drug user (PDU) population were calculated using the multiplier method, with data from users of harm reduction programmes aged 15–64. Cocaine is rarely used in Slovakia, and so the definition is in effect limited to injecting drug users (IDUs) and regular users of opioids and/or pervitin (methamphetamine powder). In 2008 it was estimated that around 10 600 people (range: 8 200–33 500) were problem drug users, or 2.7, 2.1–8.5 per 1 000 inhabitants aged 15–64. For the same year, there were estimated to be 4 000–9 800 opioid users (approximately 46 % of the estimated population of PDUs) and 2 500–9 900 pervitin users. Practically all of the estimated problem drug users were injecting drug users, which may be partially related to the data source used in the study (low-threshold services).
The same method has been used for three consecutive years, yielding stable prevalence estimates.
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. Details are available here.
In 2011, the National Health Information Centre collected national treatment demand data from 438 treatment units comprising outpatient and inpatient centres, and treatment centres in prison settings. It found that 2 313 clients entered treatment, of which 1 037 were new treatment clients.
Among all treatment clients in 2011, the primary drug used was amphetamines (mainly methamphetamine) at 38.2 %, followed by opioids at 33.7 % and cannabis at 19.2 %. Among new treatment clients, amphetamines were reported as the primary drug by 41.9 %, followed by cannabis at 27.3 % and opioids at 22.7 %.
In 2011 some 38 % of all treatment clients were under the age of 25. New treatment clients tend to be younger, with 49 % under 25. With regard to gender distribution, among all clients entering treatment 82 % were male and 18 % were female. A similar distribution was reported among new treatment clients, with 83.7 % male and 16.3 % female.
The National Reference Centre for the prevention of HIV/AIDS collects HIV/AIDS notifications nationwide. In addition, a specific sentinel monitoring study at the Centre for Treatment and Drug Dependencies in Bratislava is being carried out, targeting IDUs in treatment. Voluntary HIV testing is offered to everyone entering healthcare settings. Long-term data indicate that HIV/AIDS infection among injecting drug users in Slovakia is one of the lowest in the world. In 2011 one HIV positive case among injection drug users was reported. In 2011 about 0.4 % of HIV testing samples collected from 615 drug users in different care settings were reported as HIV positive.
The percentage of cases reporting with antibodies to the hepatitis C virus (HCV) among new treatment clients at the Centre for the Treatment of Drug Dependency in Bratislava remains fairly stable at 40.3 % in 2010–11. About 21.5 % of the same group tested positive for hepatitis B virus (HBV). HBV and HCV are, however, more common among opioid injectors than among those who inject other substances (mainly amphetamines).
Since 2009 drug-related death cases have been collected through a nationwide database of autopsy protocols, so-called ‘e-autopsies’, under the Healthcare Supervision Authority. In 2011, according to Selection D, the total number of drug-related deaths was 16. Of these, 14 (87.5 %) were male and the mean age at the death was 38.2 years; 12 (75 %) of the cases were linked to opiates. The reported death rates have been stable since 2002, and range in number from 16 in 2011 to 25 in 2008.
Implementation of drug treatment is the responsibility of the national government, and is allocated to the Ministry of Health. Treatment is mainly delivered through five public specialised Centres for Treatment of Drug Dependencies, mental outpatient clinics, psychiatric hospitals, and psychiatric wards at university hospitals and general hospitals. Private providers also deliver drug treatment. The distinctive features of the Slovak drug treatment services are close links to mental health services and integration with treatment services for alcohol addiction, which allows mental health issues among drug users and consequences related to polydrug use to be addressed. In Slovakia drug treatment is funded by public health insurance.
Centres for Treatment of Drug Dependencies are the main providers of all types of specialised drug treatment, while the mental outpatient clinics, available nationwide, offer outpatient diagnostic services, detoxification and long-term opioid substitution treatment. Drug treatment can be divided into four phases: (i) pre-clinical treatment; (ii) detoxification treatment; (iii) psychosocial treatment; and (iv) social reintegration. Physicians and psychologists, nurses and psychotherapists provide outpatient treatment as a systematic therapeutic service. Residential drug treatment is delivered in inpatient departments, at specialised dependency treatment departments of psychiatric hospitals, and in Centres for Treatment of Drug Dependencies, which are specialised psychiatric institutes. Detoxification treatment is available in outpatient and inpatient treatment centres. Aftercare and social reintegration services for people who are drug-dependent are provided by NGOs outside the healthcare sector, in residential facilities or through self-help groups. A legal provision exists in Slovakia to order involuntary drug treatment in a prison environment, and in public healthcare facilities after a sentence is completed; however, the rationale for this and the effectiveness of the measure is currently being widely debated among professionals and several studies on the topic were reported in the 2012 National report.
Specialised drug addiction treatment offices provide substitution maintenance treatment. Methadone maintenance treatment has been available since 1997 and buprenorphine since 1999. In 2008 the buprenorphine/naloxone combination was introduced and it may be prescribed by psychiatrists with an additional licence for treatment of drug dependencies or by psychiatrists working at Centres for the Treatment of Drug Dependencies. Opioid substitution treatment is not available in prisons.
In 2011 a total of 500 clients were in substitution treatment.
View ‘Treatment profile’ for additional information.
Low-threshold services and outreach harm reduction programmes in Slovakia provide access to sterile injecting equipment and information on safer drug use, although coverage is limited: an estimated 21 % of problem drug users could be reached by existing low-threshold services. That is why public pharmacies remain the main source of sterile injecting equipment in Slovakia. In 2011 five organisations ran outreach needle and syringe exchange programmes (NSPs), in six towns. Three towns — Bratislava, Banská Bystrica and Košice — had both mobile/outreach and stationary syringe exchange programmes. According to data from independent exchange programmes provided by field services and treatment institutions, a total of 322 000 syringes were provided in 2011. The majority of harm reduction programme clients are methamphetamine (pervitin) users, while the proportion of those who inject heroin is declining. Testing for infectious diseases among drug users who are not in contact with healthcare units (in treatment) is not regularly available, and most harm reduction organisations provide testing only occasionally.
After 1989 Slovakia gradually became a transit point on the routes through which several drugs are illegally transported. Heroin is primarily imported from Afghanistan. However, following the first fentanyl seizure in 2010, fentanyl almost entirely pushed heroin out of the market in the first half of 2011. This was accompanied by a declining number of heroin seizures and a drop in its purity. However, after a clandestine fentanyl laboratory was dismantled in August 2011 heroin regained its market, though only 0.3 kg of the substance was seized. Herbal cannabis is increasingly supplied by domestic growers of Vietnamese ethnic origin, and the most recent trend indicates that it is intended for distribution not only in Slovakia but also in neighbouring countries such as Hungary. Methamphetamine (pervitin) has been increasingly available in the Slovak drug market since 2006, and is produced from ephedrine or medications containing pseudoephedrine. Pervitin is primarily produced in small ‘kitchen laboratories’. However, mobile laboratories and laboratories with a high-production capacity, producing high-quality pervitin, have also been registered. Commonly available pervitin produced in these laboratories reaches an active substance concentration of over 50 %. However, in some cases, the purity of seized pervitin originating from the Czech Republic reached above 70 %. Cocaine is increasingly smuggled into Slovakia via land transport through the Schengen area, due to strict control measures implemented at airports, which has led to the disappearance of Nigerian drug couriers who previously smuggled cocaine into Slovakia mainly by air. Since 2006 mCPP, BZP and FP began to appear in the Slovak market. As a result, and following the overall European trend, ecstasy-containing MDMA almost disappeared from the drug scene, substituted by tablets containing mCPP or piperazines.
The total number of drug seizures increased in 2011 when compared to 2010. Cannabis products were involved in more than two-thirds of all drug seizures and a total of 137 kg of herbal cannabis and 10 045 cannabis plants were seized. Although the number of methamphetamine seizures increased in 2011 compared to 2010, only 2 kg of the substance was seized (3 kg in 2010). Around 35 kg of cocaine was seized in Slovakia during 2011, which is the second largest amount seized since 1997 (379 kg in 2008), but almost the entire amount was captured in a single seizure.
In 2011 Slovakia reported a total of 1 204 offenders convicted according to the criminal code. Around 52 % were use-related convictions. More than a half were related to cannabis, followed by methamphetamine and amphetamine, and heroin-related convictions.
In 2005 Section 171 of the Penal Code criminalised unauthorised possession for personal use, according to the amount of drug possessed: up to three years’ imprisonment may be imposed for personal possession of an amount corresponding to a maximum of three times the usual single dose for personal use; up to five years may be imposed for personal possession of an amount corresponding to a maximum of 10 times the usual single dose for personal use. New penalties such as home imprisonment and community service may apply, though sentences of immediate imprisonment remain available as the ‘ultimum remedium’. Possession of any amount above 10 doses must be charged under Section 172.
Section 172 of the Penal Code lays down a penalty of 4–10 years’ imprisonment for personal possession of an amount of a drug greater than that mentioned in Section 171, as well as for drug trafficking, acquisition or production.
The penalty increases to a range of 10–15 years or 15–20 years, depending on the value involved and aggravating circumstances (repeated offence, involvement of minors) and up to 25 years if the crime was committed in the context of an organised group. Three convictions for certain serious offences may result in automatic imprisonment of 25 years or even life. The lower age limit of criminal liability is now set at 14.
In 2010–11 the Penal Code was amended to include the compulsory forfeiture of property for drug-related criminal offences. Special provisions are specified under Section 61 of the Code for drug-related traffic offences, and under Section 289 for performance of employment or activity that could endanger the life or health of others, under the influence of addictive substances.
View ‘Legal profile’ for additional information.
Slovakia’s National Anti-Drug Strategy for the Period 2009–12 was adopted in April 2009. Its key objectives were to reduce the level of drug use in society and related risks and damage; to reduce the supply of drugs with an emphasis on sanctioning organised crime groups involved in illegal drug trafficking; and enforcement of adherence to the law in connection with the production and distribution of drugs.
The strategy has two pillars covering demand and supply reduction, and three cross-cutting themes of coordination and cooperation; international cooperation; and information, research and evaluation.
The main strategy is complemented by Departmental Action Plans with 23 specific objectives, setting out the tasks formulated in the national programme to be carried out by relevant sectors and authorities.
View ‘National drug strategies’ for additional information.
The coordination of drug policy in Slovakia is currently undergoing a number of structural changes. Based on Act No 575/2001 regarding the organisation of government ministries and bodies, adjustments were made to the existing mechanisms for coordination. Further changes are envisaged over the coming years.
At an inter-ministerial level, Resolution No 135 of 2 March 2011 decommissioned the Board of Ministers for Drug Addiction and Drug Control. The Board’s functions were transferred to a newly established inter-ministerial body, the Ministerial Council. Drug issues form one part of the Ministerial Council’s overall work, which covers a range of policy areas due to its role as the general inter-ministerial policy structure. In drug policy matters, the Council’s role is to act as the main policy development and advisory body for the government, tasked with the coordination of drug policy at the national level and managing the Slovak Republic’s responsibilities under international drug control conventions. Headed by the Prime Minister, the Council includes representatives from all government ministries.
The operational or day-to-day coordination of drug policy in the Slovak Republic is carried out by the Anti-drug Strategy Coordination Department, which became part of the Foreign Cooperation Section of the Government Office of the Slovak Republic on 1 July 2011. The Coordination Department took over this role from the former General Secretariat of the Board of Ministers for Drug Addiction and Drug Control. Headed by a director who functions as the National Drug Coordinator, the Coordination Department is responsible for the implementation of the National Anti-Drug Strategy. It is comprised of three different divisions:
- The National Anti-drug Strategy Division is responsible for coordinating the implementation of the drug strategy at the national level, working with both regional and local state administrative authorities.
- The Foreign Relations Division liaises with international bodies and facilitates information exchange between national ministries and sectors in the drugs area.
- The National Monitoring Centre for Drugs functions as the Slovak Republic’s national focal point in the EMCDDA’s Reitox network. It monitors the use of controlled drugs and plays a coordinating role in the national drug information system.
Changes were made to the system of coordination at the regional and local levels in the Slovak Republic in late 2007, following the decommissioning of the Regional Offices, which were coordinated by the Ministry of Interior. As a result, both the local level coordinators and regional committees for the prevention of drug addiction ceased operations. The regional coordinators for the prevention of criminality were retained, however, following the passing of the 2008 Act on the Prevention of Criminality and other Anti-Social Activity. As of 1 March 2010 the coordinators were based in district offices at the regional level.
In Slovakia, drug policy documents still have no associated budgets and there is no review of executed expenditures. A study estimating total drug-related expenditure in 2006 has been published. (1) Recently, the government created an inter-ministerial programme to set drug-related budgets, as requested in the National Anti-Drug Strategy for the Period 2009–12. New developments are anticipated for 2013–14.
In 2006 total drug-related public expenditure (2) represented 0.05 % of GDP, of which 63.3 % was for public order and safety, 14.8 % for treatment, 7.6 % for prevention, 1.8 % for coordination, 1.3 % for education, 0.9 % for harm reduction and 10.3 % for other areas.
The available information does not allow trends in drug-related public expenditures in Slovakia to be reported.
A new inter-ministerial programme was created in 2010, which aimed to develop the budgeting of drug-related activities and the monitoring of its execution within the central government.
(1) C. Fazey (2006), ‘Sociálne a ekonomické náklady užívania drog v SR’ [Social and economic costs of illicit drugs used in the Slovak Republic], Final report, ECO, January 2006 (not published).
(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.
View ‘Public expenditure profile’ for additional information.
The role of drug-related research and the use of research findings and best practices in the formulation and implementation of interventions are formally defined in the current National Anti-Drug Strategy. Funding is provided from the state budget, through the Ministry of Education, in the form of grants that may be intended for a specific research track, or may be provided to the research institution itself. Drug-related research is conducted mainly by governmental agencies, university departments and hospitals, and also by the Slovak Academy of Sciences. The national focal point has organised a database on research, including bibliographic references, which is available on its website. National scientific journals also play an important role in disseminating drug-related research findings. Recent drug-related studies mentioned in the 2012 Slovakian National report mainly focused on aspects related to interventions, consequences of drug use, prevalence of drug use and supply and markets. Current drug research in Slovakia is influenced by the very little sources allocated to it in a regular way, which is a consequence of general restrictions on public expenditures. Human resources in the drugs field are being continuously reduced, either as a consequence of weak economic conditions or due to a reduction in interest in the drugs field.
View ‘Drug-related research’ for additional information.