• 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
• Public expenditure
• Drug-related research

Drug use among the general population and young people

In Slovakia, general population surveys have reported a continuous increase in lifetime prevalence of drug use among the general population in the period 1994–2006 followed by stabilisation and even a slight decrease in the most recent studies. Surveys conducted in 1994 and 1996 showed 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 the second 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 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 %, 4.1 % for the last year prevalence and 1.7 % for the last month prevalence among people aged 15–64 years. In the 15–24-year-old age group, lifetime prevalence was reported at about 29 %, last-year prevalence at 13.1 %, while last month prevalence, suggesting a stable pattern over recent years, was reported at around 5 %. Lifetime prevalence of any illicit drug was reported by 26 % of the sample. Ecstasy was ranked the second most prevalent drug in the 15–24-year-old age group, 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 to 64 was carried out, the main findings are described in the 2010 national report, while the final results are awaiting further validation.

As in many other central and eastern European countries, the ESPAD national school surveys conducted repeated since 1995, showed an increase in illegal 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 last survey show decline to 27%. In 2011, this prevalence was reported by 31 % of males and 23 % of females. In 2011, last year prevalence of cannabis was reported by 19 % of the sample and 9 % reported a last-month prevalence. The proportion of those who reported having used ecstasy at least once in their lives was 0 % in 1995, raised to 6 % by 2007 and declined to 4 % in 2011. Lifetime prevalence rates for amphetamines and LSD remain unchanged from 2007 and 2011 at 2 % and 4 % respectively, while lifetime prevalence of inhalants dropped from 13 % in 2007 to 10 % in 2011.

In addition, the national school survey on Tobacco-Alcohol-Drugs among 16 years old students is implemented every four years since 1994, and the last was carried out in 2010. Slovakia also participates in ‘Health Behaviours of School Children’ project, which covers 11, 13 and 15 years olds and the last data collection was performed for 2009/2010.

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Prevention

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 national strategy. This policy document within drug demand reduction concentrates on the following issues: (i) innovative approaches in the area of prevention and reduction of drug use or abuse-related damages; (ii) aiming efforts on the support of protective factors and a healthy lifestyle; (iii) reduction of legal and illegal drugs 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. The key idea 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, illegal drugs and risk behaviour. There are several standardised programmes now in place, for example, a long-term national prevention programme intended for pupils aged 12–15 years (the sixth to ninth year of elementary school or the first year of secondary school). It develops and strengthens psychological and social skills which can act as a protective factor (‘The way to emotional maturity’). ‘Pedagogical and psychological counselling centres’ also provide prevention intervention, the majority of which focus to elementary school pupils. In the school year 2009/2010, these centres carried in total 642 prevention programmes for children and young people from the age of three years until the age of 19. Prevention targeting families is limited and focuses mainly on information exchange and discussions. Community prevention programmes are targeted at recreational activities, such as the organisation of 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 NGOs in recreational settings such as festivals, for children and young people residing in disadvantaged communities and marginalised families, and young delinquents (‘FreD goes net’). Furthermore, 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.

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Problem drug use

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 from 15–64. Cocaine is used rarely in Slovakia, and so the definition is practically limited to intravenous drug users and regular users of opioids and/or pervitin (methamphetamine powder). In 2008, around 10 600 persons (8 200–33 500) were estimated to be problem drug users (2.7, 2.1–8.5 per 1 000 inhabitants). Estimates by drug were available: for the same year, users of opioids were estimated in the range of 4 000–9 800 (approximately 46 % of the estimated population of problem drug users) and users of pervitin 2 500–9 900. 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.

The EMCDDA defines problem drug use as injecting drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis are not included in this category.

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Treatment demand

In 2010, the National Health Information Centre collected national treatment demand data from a total of 175 treatment centers comprising of outpatient and inpatient centres, and treatment centres in prison settings. In 2010, a total of 2 266 clients entered treatment, out of which 1 087 were first-time treatment clients.

Among all clients entering treatment in 2010, the primary drug used was opioids, at 38.2 % of all treatment clients, followed by, 35.4 % for amphetamines (mainly methamphetamines) and 19.4 % for cannabis. Among first-time treatment clients, amphetamines were reported as the primary drug at 41 %, followed by 26.8 % for cannabis and 25.7 % for opioids.

In 2010, 42 % of all clients entering treatment were aged less than 25 years. A higher age distribution was reported among new treatment clients, with 55 % under the age of 25 years. With regards to gender distribution among all clients entering treatment, 82 % were male, whereas 18 % were female. A similar gender distribution was reported among new clients entering treatment at 83.1 % for male clients and 16.9 % for female clients.

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Drug-related infectious diseases

No national estimates on drug-related infectious diseases are available for Slovakia. The National Reference Centre for prevention of HIV/AIDS collects HIV/AIDS notifications nationwide, including from a sentinel monitoring study at the Centre for Treatment and Drug Dependencies in Bratislava. Long-term HIV/AIDS infection among injecting drug users is one of the lowest in the world. In 2010, two HIV positive case among injection drug users was reported. In 2010, about 0.3 % of HIV testing samples collected from 371 drug users in different care settings is reported as HIV positive.

The percentages of cases reporting with antibodies to the hepatitis C virus (HCV) and hepatitis B virus (HBV) among patients entering treatment for the first time at a Centre for the Treatment of Drug Dependency in Bratislava were 40.3  % for HCV and 28.3 % for HBV in 2009.

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Drug-related deaths

Since 2009, the drug related death cases in Slovakia are collected through a nationwide database of autopsy protocols , so called ‘e-autopsies’ under the Healthcare Supervision Authority.  In 2010, according to the Selection D, the total number of drug related death was 20; 80.0 % of death cases occurred among men and the mean age at the death was 33.4 years and 60 % of the death cases were linked to opiates. The reported death rates are rather stable, the lowest number of 17 drug-related death cases is reported in 2005 and 2007, while the highest at 25 cases is reported for 2008.

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Treatment responses

The implementation of drug treatment is the responsibility of the Slovakian Government, and falls under the responsibility of the Ministry of Health. Treatment is mainly delivered through public specialised Centres for Treatment of Drug Dependencies, psychiatric hospitals, and psychiatric wards at university hospitals and general hospitals. Drug treatment is also provided by private providers. In Slovakia, drug treatment is funded by public health insurance.

Specialised health services tailored to the emerging need for drug dependence treatment have been established in Slovakia since 1989. During the second half of the 1990s, private facilities also began to operate. Centres for treatment of drug dependencies are the main provider of all types of drug treatment. Drug treatment can be divided into four phases: (i) pre-clinical treatment (ii) detoxification treatment (iii) psychosocial treatment and (iv) social reintegration. Outpatient treatment, as a systematic therapeutic service, is provided by physicians and psychologists, nurses and psychotherapists. Residential drug treatment is delivered in inpatient departments, at specialised dependency treatment departments of psychiatric hospitals, and in specialised psychiatric institutes, known as Centres for Treatment of Drug Dependencies. Detoxification treatment is available in outpatient and inpatient treatment centres. Services concerning aftercare and social reintegration for drug-dependent persons are provided by non-governmental organisations outside the healthcare sector, in residential facilities or as self-help groups.

Substitution maintenance treatment is provided by specialised drug addiction treatment offices. Methadone maintenance treatment is 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.

In 2010, a total of 610 clients were in substitution treatment, 460 of whom were on methadone.

View ‘Treatment profile’ for additional information.

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Harm reduction responses

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. In 2010, there were five organisations running outreach needle and syringe exchange programmes (NSPs) in four towns. In three towns — Bratislava, Banská Bystrica and Košice — there were both types of outlets: mobile/outreach and stationary syringe exchange programmes. According to data available from independent exchange programmes provided by field services, treatment institutions, a total of  317 000 syringes were provided in 2010. Around 40 % of all harm reduction programme clients were Pervitin users, while 31 % inject heroin. Testing for infectious diseases of 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.

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Drug markets and drug-related offences

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, in the market it is available in mixed form or full substituted with fentanyl. In 2010, the first seizures of fentanyl are reported and the police reports indicate an existing production site in the country. Furthermore, a new trend in cocaine trafficking was detected in recent years, when predominately Nigerian citizens act as couriers for the substance and Bratislava airport is mainly used as a transit point from other European cities to Austria. Since 2006, mCPP, BZP and FP began to appear in the Slovak market. As a result and following the overall European trend, the ecstasy containing MDMA almost disappeared from the drug scene, and is substituted by tablets containing mCPP or piperazines. In 2009, mephedrone first appeared in the market. The likely origin of the seized mephedrone is China and it is sold through the Internet in powder or crystalline forms, or as powder-filled capsules.

In 2006, pervitin began to be produced in east Slovakia, and ephedrine for the production of pervitin was trafficked from Turkey, Hungary or Poland by various organized groups. The production of pervitin was primarily carried out in small ‘kitchen laboratories’. However, in 2009, occurrences of laboratories with high-production capacity and also high quality of produced pervitin were registered. Commonly available pervitin produced in these laboratories reach an active substance concentration of over 50 %. However, recently in some cases, purity of seized pervitin reached above 80 %. Despite a domestic production, in 2010, some seizures indicate that pervitin is also imported from the Czech Republic.

Herbal cannabis is mainly supplied by domestic growers of Vietnamese ethnic groups, however, the most recent trend indicates that it is intended to be distributed not only in Slovakia but also in neighbouring countries, e.g. Hungary.

The total number of drug seizures dropped in 2009 when compared to 2009 and 2008. In 2010, more than half of all drug seizures involved cannabis products and a total of 0.2 kg of cannabis resin, 171 kg of herbal cannabis and the record amount of 1 986 kg of cannabis plants were seized. A total of 545 methamphetamine (pervitin) seizures resulted in 3 kg of substance seized, which is the highest seized amount since the beginning of the century. The number of seized ecstasy tablets increased in comparison to 2009, while it remains significantly below the record amounts seized in 2008. Following an increase in the amount of heroin seized in 2009, a significant drop in seized amounts of the substance is registered in 2010 (1 kg in 2010, 14 kg in 2009, 13 kg in 2008). The quantities of seized cocaine also followed the declining trend registered already in 2009. 

In 2010, Slovakia reported a total of 1 135 offenders convicted according to new criminal code. Around 55.4 % were use-related convictions. Two thirds were related to cannabis, followed by methamphetamine and amphetamines, and heroin-related convictions.

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National drug laws

Since 2005, Section 171 of the Penal Code criminalises 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 services may apply, though sentences of immediate imprisonment remain available as the ‘ultimum remedium’. Possession of any amount more than 10 doses must be charged under Section 172.

Section 172 of the Penal Code lays down the penalty of 4–10 years’ imprisonment for personal possession of an amount of a drug larger than that mentioned in Section 171, as well as for drug trafficking, acquisition or production of drugs.

The penalty rises 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 limit of criminal liability is now set at 14 years of age.

In 2010, the Penal code was amended to foresee a compulsory forfeiture of property for drug-related criminal offences. Special provisions are provided under Section 61 of the Code for drug-related traffic offences.

View ‘Legal profile’ for additional information.

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National drug strategy

Slovakia’s National Anti-drug Strategy for the period 2009–12 was adopted in April 2009. Its key objectives are 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 the 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, as well as three corss-cutting themes spanning the domains of coordination and cooperation; international cooperation; information, research and evaluation.

The main strategy is complemented by Departmental Action Plans that have 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.

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Coordination mechanism in the field of drugs

The coordination of drug policy in Slovakia is currently undergoing a set 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. A further set of changes are envisaged as taking place 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 as a result of its being designed as 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 national-level coordination of drug policy and the Slovak Republic’s responsibilities under the 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:

1. 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;
2. The Foreign Relations Division liaises with international bodies and facilitates information exchange between national Ministries and sectors in the drugs area;
3. 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 to the system of coordination at the regional and local levels in the Slovak Republic arose 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 are based in District Offices at the regional level.

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Public expenditure

In Slovakia, drug policy documents have no associated budgets and there is no review of executed expenditures. However, a study estimating total drug-related expenditure in 2006 has been published (¹).

In 2006, total drug-related public expenditure (²) represented 0.05 % of GDP, with 63.3 % 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 reporting on trends in drug-related public expenditures in Slovakia.

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) Fazey, C. (2006), Sociálne a ekonomické náklady užívania drog v SR [Social and economic costs of illicit drugs used in 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.

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Drug-related research

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 drug strategy. Funding is provided from the state budget, through the Ministry of Education, in the form of grants which 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 2011 Slovakian National report mainly focused on aspects related to prevalence of drug use and consequences of drug use. 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. Furthermore, human resources are continuously decreasing in the field, either as a consequence of related weak economic conditions or of loss of the issue’s attractiveness.

View ‘Drug-related research’ for additional information.

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