Country overview: Slovakia
- 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 | Slovakia | EU (27 countries) | Source | ||
|---|---|---|---|---|---|
| Population | 2008 | 5 400 998 | 497 455 033 | Eurostat | |
| Population by age classes | 15–24 | 2008 | 15.3 % | 12.6 % 1 | Eurostat |
| 25–49 | 38.1 % | 36.3 % 1 | |||
| 50–64 | 18.8 % | 18.4 % 1 | |||
| GDP per capita in PPS (Purchasing Power Standards) 2 | 2007 | 67 | 100 | Eurostat | |
| Total expenditure on social protection (% of GDP) 3 | 2006 | 15.9 % p | 26.9 % p | Eurostat | |
| Unemployment rate 4 | 2008 | 9.6 % | 7 % | Eurostat | |
| Unemployment rate of population agends under 25 years | 2008 | 19.8 % | 15.5 % | Eurostat | |
| Prison population rate (per 100 000 of national population) 5 | 2006 | 160.7 | 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 Slovakia, general population surveys have reported a continuous increase in lifetime prevalence of drug use among the general population. 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 marihuana 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 %.
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. Lifetime experience with any illegal drug other than marijuana increased from 2 % in 1995 to 5 % in 1999 and 6 % in 2003. Lifetime prevalence rates for cannabis more than tripled from 9 % in 1995 to 19 % in 1999, 27 % in 2003 and 32 % in 2007. In 2007, this prevalence was reported by 37 % of males and 28 % of females. In 2007, last year prevalence of cannabis was reported by 24 % of the sample and 11% reported a last month prevalence. The proportion of those who reported having used ecstasy at least once in their lives was 0 % in 1995, 2 % in 1999, 3 % in 2003 and 6 % in 2007. Lifetime prevalence rates for amphetamines remain unchanged in 1995 and 1999 (1 %) and increased to 2 % in 2007. Lifetime prevalence of inhalants increased from 9 % in 2003 to 13 % in 2007; lifetime prevalence of LSD was 2 % in 2003 and 4 % in 2007.
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 programme for the fight against drugs 2004–08’, and prevention is one of the four pillars of the national strategy. This policy document concentrates on the following objectives: (i) upbringing and education at pre-school age within the school system, as well as extracurricular and leisure activities; (ii) active protection of children against socially pathological phenomena; (iii) specialised psychological care and counselling; (iv) cooperation with families; (v) re-education and social reintegration.
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’). Another example is (as in Germany), the national Smoke Free Class competition where 5 484 pupils in 230 classes in 66 schools took part during school year 2006/2007. Over a six month period, 149 classes (64 %) in 41 schools all over Slovakia did not break any of the basic rules of the competition. Counselling services are provided within the education sector, thus providing the possibility to build a counselling and prevention system in all district centres for children and young people from the age of three until the end of their education. Community prevention programmes are targeted at recreation activities, such as the organisation of summer camps and sports activities for children within the centres of leisure.
Occasional selective prevention interventions are organised by health services and NGOs in recreational settings such as festivals. Furthermore, for indicated prevention, specialised psychological counselling is also provided for families with drug addiction problems and for disruptive children in school settings.
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 2007, 17 884 persons (12 794 – 34 828) were estimated to be problem drug users (4.7, 3.4–9.2 per 1 000 inhabitants). Estimates by drug were available: For the same year, users of opioids were estimated in the range 7 597–18 999 (approximately 55 % of the estimated population of problem drug users) and users of pervitin 5 783–15 742. 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 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
In 2007, the Institute of Health Information and Statistics collected national treatment demand data from a total of 101 treatment centers comprising of outpatient and inpatient centers, and treatment centers in prison settings. In 2007, a total of 1 985 clients entered treatment, out of which 890 were first-time treatment clients.
Among all clients entering treatment in 2007, the primary drug use was opioids, at 45.8 % of all treatment clients, followed by, 26.3 % for amphetamines (mainly methamphetamines) and 17.9 % for cannabis. Among first-time treatment clients, amphetamines were reported as the primary drug, at 33.2 %, followed by 29.7 % for opioids and 27.1 % for cannabis.
In 2007, 48 % of all clients entering treatment were aged less than 25 years. A higher age distribution was reported among new treatment clients, with 61 % under the age of 25 years. As regards gender distribution among all clients entering treatment, 80 % were male whereas 20 % were female. A slightly similar gender distribution was reported among new clients entering treatment at 81 % for male clients and 19 % for female clients.
Drug-related infectious diseases
No national estimates on drug-related infectious diseases are available for Slovakia. Long-term HIV/AIDS infection among injecting drug users is one of the lowest in the world. In 2007,4 persons reporting HIV transmitted by injection drug use was identified.
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 40.6 % in 2006 and 6.3 % for HBV in 2002.
Drug-related deaths
The total number of drug-related deaths reported in 2007 was 17 cases (compared with 20 in 2006). Benzodiazepines were the main medicines involved in overdoses. They were implicated in 12 cases (42.9 %) either individually or in combination with other substances). Other substances excluding opioids were identified in eight cases. As regards the distribution by age and gender, we may say that the majority of them were men (88.2 %) and the mean age 29.3 years.
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 and Drug Dependencies, psychiatric hospitals, and psychiatric wards at university hospitals and general hospitals. Drug treatment is also provided by private. In Slovakia drug treatment is funded by public health insurance companies.
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 the 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) drug-free 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 addiction treatment departments of psychiatric hospitals, and in specialised psychiatric institutes, known as Centres for Treatment and Drug Dependencies. Detoxification treatment is available in outpatient and inpatient treatment centres, and is mainly provided by general psychiatric services.
Substitution maintenance treatment is provided by specialised drug addiction treatment offices. Methadone maintenance treatment is available since 1997 and buprenorphine since 1999. Since October 2005, naltrexone has been officially registered as well as slow-release morphine. Buprenorphine may be prescribed by psychiatrists with an additional licence for treatment of drug addictions or by psychiatrists working at Centres for the Treatment of Drug Dependencies.
In 2007, a total of 500 clients were in substitution treatment, 450 of whom were on methadone.
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 2007, there were 10 organisations running outreach needle and syringe exchange programmes (NSPs) in ten towns and operating at a total of sixteen fixed and mobile syringe provision points. 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 12 points, a total of 420 672 syringes was provided in 2007. Testing for infectious diseases of drug users who are not in contact with health care units (in treatment) is not regularly available, and most harm reduction organisations provide testing only occasionally.
Drug markets and drug-related offences
After 1989, Slovakia gradually became a transit point on the routes through which drugs are illegally transported. Herbal cannabis, the consumption of which is increasing in all regions of Slovakia, is mainly supplied by domestic growers. In 2006, a laboratory for hydroponic herbal cannabis cultivation was found, containing approximately 460 kg of marijuana at various stages of growth and processing, representing one of the largest seizures in the last 10 years. The cultivated herbal cannabis seized was to be distributed not only in Slovakia but also in neighboring countries. In 2006, production of pervitin began to be produced in east Slovakia, and ephedrine for the production of pervitin was trafficked from Turkey via Hungary by various organised groups. Heroin is imported from Afghanistan, and importation and distribution is organised predominantly by the Albanian-speaking community. Furthermore, cocaine trafficking is mainly in the hands of Albanian-speaking criminal organizations. Ecstasy is imported mainly from the Netherlands and Hungary and is available both in tablet or powder form. In 2006, mCPP began to appear in the Slovak market.
In 2007, Slovakia reported a total of 644 drug related offences out of which 59 % were cannabis related offences, followed by 17.4 % for heroin related offences and 5.1 % for amphetamine offences. The largest seizures in 2007 were related to herbal cannabis with a total of 1 269 seizures and methamphetamines with a total of 690 seizures, an amount of which have been increasing since 2002. Information on drug prices is acquired by the National Anti-Drug Unit of the Organised Crime Office in the Presidium (Central Headquarters) of the Police Force. In general, there were no significant changes in drug prices in 2007 when compared to 2006, except for the prices of ecstasy. Ecstasy decreased from EUR 10.70–EUR 16.00/tablet reported in 2006 to EUR 5–EUR 13.00/tablet in 2007.
National drug laws
A new Penal Code was adopted in 2005 and extended the use of alternative sentences. Meanwhile, unconditional sentences remain available as the ‘ultimum remedium’. In case of possession of drugs for personal use, home imprisonment penalty and community services may then apply.
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 ten times the usual single dose for personal use. Possession of any amount more than this 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.
National drug strategy
Slovakia’s third ‘National programme for the fight against drugs (2004–08)’ was adopted in June 2005. Its key objective is to prevent further deterioration with regard to the country’s drug use and drug addiction, with an emphasis on children and young people. The programme’s specific objectives include: decreasing drug use among young people under 18; increasing the age of first exposure to drugs; increasing availability of treatment; involving first contact physicians in the process of prevention and treatment. The programme, which focuses on illicit drugs, covers prevention, treatment, social reintegration, law enforcement, science and research and international cooperation. It is complemented by the 2005–08 action plans (12 ministerial and eight regional action plans) which set out the tasks formulated in the national programme to be carried out by relevant sectors and authorities.
Coordination mechanism in the field of drugs
The Board of Ministers for Drug Dependencies and Drug Control (BMDDDC) is the Government’s coordination, advisory, initiative-taking and control body for drug policy and drug control issues. It is chaired by the Deputy Prime Minister for knowledge-based society, European affairs, human rights and minorities, and includes 12 Ministers and the Public Prosecutor. The BMDDDC has also a permanent advisory body — the Inter-ministerial Drug Action Group — which was set up to deal with urgent problems, emergency situations and to ensure operational and practical cooperation. The General Secretariat (GS) of the BMDDDC acts as its executive arm, and the Director of the GS of the BMDDCC is the National Drugs Coordinator.
Until October 2006, coordination at the regional level, between local state administrations and local self-governing bodies, was carried out by the Regional Coordination Commission on Drugs, which acts as an advisory body to the head of the regional authority. There are also drug coordinators who work within regional authorities (local state administration bodies) and are coordinated via the General Secretariat of the BMDDDC.
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 will be made 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 2008 Slovakian National report mainly focused on aspects related to prevalence of drug use.