Country overview: Slovakia
- Situation summary
- Drug use among the general population and young people
- High-risk drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-induced deaths and mortality among drug users
- 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 (28 countries)||Source|
|Population||2013||5 410 836||505 665 739||Eurostat|
|Population by age classes||15–24||2013||13.0 %||11.5 %
|25–49||38.2 %||35.0 %
|50–64||20.3 %||19.7 %
|GDP per capita in PPS (Purchasing Power Standards) 1||2012||76||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2011||18.2 p||29.0 % p||Eurostat|
|Unemployment rate 3||2013||14.2 %||10.8 %||Eurostat|
|Unemployment rate of population aged under 25 years||2013||33.7 %||23.4 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2012||204.9||:||Council of Europe, SPACE I-2012|
|At risk of poverty rate 5||2012||13.2 %||17.0 % e||SILC
p Eurostat provisional value.
1 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
2 Expenditure on social protection contains: benefits, which consist of transfers, in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.
3 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.
4 Situation of penal institutions on 1 September, 2012.
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).
Seven general population surveys in Slovakia have been conducted in Slovakia so far. The most recent general population survey, among a sample of 4 055 respondents aged 15–64, was carried out by the National Monitoring Centre for Drugs (NMCD) in 2010.
Cannabis remained the most prevalent illicit substance used, with lifetime prevalence at 10.5 % among all 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. Thus 18.8 % of young adults (aged 15–34) reported ever using cannabis, 7.3 % had used it in the last 12 months, and 2.8 % in the last 30 days. The prevalence of cannabis use has almost halved in 2010, compared to the rates reported from a similar study in 2006.
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 most recent 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.
In 2013 a pilot study was carried out on the prevalence of illicit drug use based on testing of wastewaters in Bratislava. The study proved the primacy of cannabis use, which was followed by amphetamines (pervitin).
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 preventive programmes and educational activities; (vi) and improvements in information provision and the quality of support services, especially for risk groups.
Most prevention interventions are now centrally monitored, while evaluations of their effectiveness remain rare. Universal drug prevention programmes in schools focus on alcohol, smoking, illicit drugs and risk behaviour. Several manualised 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 the psychological and social skills that can act as protective factors. Educational and Psychological Counselling and Prevention Centres also provide prevention interventions, the majority of which focus on elementary school pupils. In the school year 2010–11 these centres carried 1 108 prevention programmes for children and young people aged 3–19, as well as programmes for teachers and parents. In 2012 a pilot of the ‘Unplugged’ programme was initiated and will run in 33 schools across the country. 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 offenders (for example, the programme FreD Goes Net). Educational and Psychological Counselling and Prevention Centres provide counselling services to pupils with learning, personality, psychological or behavioural problems. 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.
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. However, in 2012 a new definition of ‘high-risk drug use’ was adopted. The new definition includes ‘problem drug use’, but is broader (mainly in its inclusion of high-risk use of more substances). Details are available here.
In 2008 the estimated number of high-risk opioids users, based on the multiplier method applied to data from harm-reduction agencies, was 4 888 (range: 3 966 to 9 782). This corresponds to a rate of 1.25 per 1 000 inhabitants aged 15–64 (range: 1.01 to 2.49).
In 2008, using the same method, the estimated number of methamphetamine (pervitin) users was 3 263 (range: 2 523 to 9 854), at a rate of 0.83 per 1 000 inhabitants aged 15–64 (range: 0.64 to 2.51).
In 2008 it was estimated that around 10 519 people (range: 8 182 to 33 489) were problem drug users, or 2.7 per 1 000 inhabitants aged 15–64 (range: 2.1 to 8.5).
Treatment demand data are collected by the National Health Information Centre from outpatient and inpatient centres, and treatment centres in prison settings. Additional data on treated clients are collected by the national focal point directly from the therapeutic communities.
In 2012 treatment demand data were gathered from 369 treatment units. A total of 2 193 clients entered treatment at these units, of which 1 036 were new clients entering treatment for the first time.
Among all treatment clients in 2012, the primary drug used was amphetamines (mainly methamphetamine) at 45 %, followed by opioids at 26 % and cannabis at 21 %. Among new treatment clients, amphetamines were reported as the primary drug by 49 %, followed by cannabis at 32 % and opioids at 13 %. The treatment demand data indicate that amphetamines have replaced opioids in the last decade; nevertheless, opioids remain the most frequently injected substance (74 % of all and 70 % of new treatment clients who reported opioids as their primary drug injected it), while injecting of amphetamines was less prevalent (28 % of all and 19 % of new treatment clients who reported amphetamines as their primary drug injected it).
In 2012 some 40 % of all treatment clients were under the age of 25. New treatment clients tended to be younger, with 52 % under 25. With regard to gender distribution, among all clients entering treatment 83 % were male and 17 % were female. A similar distribution was reported among new treatment clients, with 85 % male and 15 % female.
The National Reference Centre for the Prevention of HIV/AIDS collects human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (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 people who inject drugs (PWID) and who are in treatment. Voluntary HIV testing is offered to everyone entering healthcare settings. Long-term data indicate that HIV/AIDS infection among PWID in Slovakia is one of the lowest in the world. In 2012 one HIV positive case among PWID was reported. In 2012 about 0.2 % of HIV testing samples collected from 524 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 remained fairly stable at 40.3 % in 2010–11, while in 2012 some 37.8 % of clients were HCV positive. About 28.1 % of the same group tested positive for hepatitis B virus (HBV — anti-HBc) in 2012. HCV is more common among opioid injectors than among those who inject other substances (mainly pervitin), while HBV indicates an opposite trend — it is less common among opioid injectors than among other subgroups of PWID.
Since 2009 data on drug-related death cases have been collected through a nationwide database of autopsy protocols, so-called ‘e-autopsies’, under the Healthcare Supervision Authority. Data extraction and reporting is in line with the EMCDDA definitions and recommendations for Selection D.
In 2012 the total number of drug-related deaths was 26. Of these, 20 were male. The mean age of victims was 40.5 years, with female victims being on average much older than males (53.8 and 36.5 years respectively). All cases were toxicologically confirmed and 17 of them were linked to opiates (all deaths among females were linked to opiates).
The drug-induced mortality rate among adults (aged 15–64) was 6.2 deaths per million in 2012, lower than the European average of 17.1 deaths per million.
Implementation of drug treatment is the responsibility of the Ministry of Health, while the Ministry of Justice plays a role in the provision of treatment in prisons.
Within the health sector, treatment is delivered through five public specialised Centres for the 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. Drug treatment is funded by public health insurance, while residential care is funded through local or regional budgets, with variable degree of clients’ co-financing.
Centres for the Treatment of Drug Dependencies are the main providers of all types of specialised drug treatment, while mental outpatient clinics, available nationwide, offer outpatient diagnostic services, detoxification and long-term opioid substitution treatment (OST). Drug-free treatment can be divided into two stages: detoxification and relapse prevention. Physicians and psychologists, nurses and psychotherapists provide outpatient treatment as a systematic therapeutic service. Detoxification treatment is available in outpatient and inpatient treatment centres. Residential drug treatment is delivered in inpatient departments, at specialised dependency treatment departments of psychiatric hospitals, and in Centres for the Treatment of Drug Dependencies, which are specialised psychiatric institutes. 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 compulsory 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 are 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 OST. Methadone maintenance treatment (MMT) has been available since 1997 and buprenorphine since 1999. In 2008 the buprenorphine/naloxone combination was introduced; it can be prescribed by psychiatrists who hold an additional licence to treat drug dependencies or by psychiatrists working at Centres for the Treatment of Drug Dependencies. Opioid substitution treatment is not available in prisons.
In 2012 a total of 465 clients were in OST, 98 % of whom received methadone.
View ‘Treatment profile’ for additional information.
Low-threshold services and outreach harm reduction programmes in Slovakia provide access to clean needles and syringes (mainly through exchange) 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. Because of this, public pharmacies remain the main source of clean needles and syringes in Slovakia. In 2012 five organisations ran outreach needle, and 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 293 100 syringes were provided in 2012. The majority of harm reduction programme clients were methamphetamine (pervitin) users, while the proportion of those who inject heroin was 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 by Albanian criminal groups. In 2010–11 there were indications that fentanyl replaced heroin in the market; however, after a clandestine fentanyl laboratory was dismantled in August 2011 the trend did not continue in 2012. 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. An increase in smuggling herbal cannabis from the Czech Republic was also noted. Methamphetamine (pervitin) has been increasingly available in the Slovak drug market since 2006, originating from domestic production. It is produced primarily in small ‘kitchen laboratories’ from ephedrine or from over-the-counter medications containing pseudoephedrine. 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 65 %. Some cases of pervitin smuggling from the Czech Republic have been registered. The purity of seized pervitin originating from the Czech Republic may in some cases be above 70 %. Cocaine is increasingly smuggled into Slovakia via land transport through the Schengen area by Albanian criminal groups. Ecstasy is mainly imported from the Czech Republic, Hungary, Poland, Austria or the Netherlands; however, tablets containing MDMA have almost completely disappeared from the drug scene, and have been substituted by tablets containing mCPP.
The total number of drug seizures decreased in 2012 when compared to 2011, with the overwhelming majority of seizures involving cannabis and methamphetamine. A total of 177 kg of herbal cannabis was seized, more than the 137 kg reported in 2011. The quantities of cannabis resin seized remained small, while the number of cannabis plants seized dropped almost three times in comparison to 2011. Although the number of methamphetamine seizures decreased in 2012 compared to 2011, a record amount of 11 kg of the substance was seized (2 kg in 2011; 3 kg in 2010). The number of seized ecstasy tablets also increased, from 27 in 2011 to 529 in 2012. Around 2 kg of cocaine was seized in Slovakia during 2012. Heroin seizures increased from 33 in 2011 to 82 in 2012, while the amounts seized remained relatively low, and at same level as previous year (0.3 kg).
In 2012 Slovakia reported a total of 1 214 offenders convicted according to the criminal code. Around 52 % were use-related convictions. More than half of all convictions were related to cannabis, followed by methamphetamine and amphetamine, and heroin.
In 2005 Section 171 of the Penal Code changed the offence of 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; and 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 3–10 years’ imprisonment for drug trafficking, supply or production. The minimum was reduced from four to three years in 2013 to enable alternatives to prison to be given. 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 the performance of employment or activity that could endanger the life or health of others, while under the influence of addictive substances.
View the European Legal Database on Drugs for additional information.
The National Drug Strategy of the Slovak Republic for the Period 2013–20, was established through resolution No. 380 of 10 July 2013 by the Slovak Government. The country’s fifth drug strategy takes a comprehensive and balanced approach. It is built around two pillars addressing (i) demand and (ii) supply reduction, and three cross-cutting themes focused on (i) coordination, (ii) international cooperation and (iii) research, information, monitoring and evaluation. In this respect, it mirrors the strategic approach taken at the EU level. The strategy builds on an awareness of current drug problems, including poly-substance use, stimulant (including methamphetamine) use, the need to control medications containing psychoactive or drug precursor ingredients, the challenges posed by blood-borne viruses (HIV, HCV), the need for improved treatment service coverage and the changing dynamics of the drug markets. The overall aim is to contribute to drug demand reduction and drug supply reduction, as well as the reduction of health and social risks and harms caused by drugs. These issues are addressed through the strategy’s objectives:
- To contribute to a measurable reduction of drug demand, drug dependence and drug-related health and social risks and harms.
- To contribute to combating drug-related crimes and illicit markets and to reduce the availability of illicit drugs and new psychoactive substances.
- To encourage multilevel coordination through active discussion and analysis of developments and challenges in the field of drugs at the national and regional level.
- To contribute to a better dissemination of monitoring, research and evaluation results and a better understanding of all aspects of the drug phenomenon, as well as the impact of interventions in order to provide a comprehensive evidence base for policy and action.
- To further strengthen dialogue and cooperation between the EU and third countries and international organisations in the field of drug demand and supply reduction.
View ‘National drug strategies’ for additional information.
The Government Council for Drug Policy is responsible for interministerial coordination in the Slovak Republic. Chaired by the Minister for Health, it is comprised of ministers from several policy areas. The Council has a wide brief addressing a range of issues. It functions as an advisory body for the government, and is tasked with submitting the national drugs strategy to the government, implementing and coordinating the strategy, proposing financial arrangements for drug policy issues, and suggesting responses to serious drug problems. The Council is also involved in the drafting of drug-related legislation, coordinating the Slovak Republic’s obligations under the international drug control treaties, and liaising with international organisations.
The Department of Drug Strategy Coordination and Monitoring of Drugs is based within the Ministry of Health. It functions as the Council’s secretariat and oversees the coordination and implementation of the national drugs strategy. The Department is the responsibility of the Director General of the Health Section at the Ministry of Health. The Department’s Director also functions as the Secretary of the Council. It consists of two sub-sections. The National Drugs Strategy Section is tasked with national coordination and implementation of the National Anti-Drugs Strategy. It also contains a section dealing with institutional and international relations and information transfers related to drug issues. The National Monitoring Centre for Drugs Section functions as the Slovak Republic Reitox National Focal Point. It is responsible for monitoring the drug situation and managing national drug information systems.
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 have been appointed, however, following the passing of the 2008 Act on the Prevention of Criminality and other Anti-Social Activity.
In Slovakia drug policy documents have no associated budgets and there is no review of executed expenditure. 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 2009–12. New developments are anticipated in the near future.
In 2006 total drug-related public expenditure (2) represented 0.05 % of gross domestic product (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 trends in drug-related public expenditure in Slovakia to be reported.
(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 (unpublished).
(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 2013 Slovakian National report mainly focused on aspects related to the consequences of drug use and responses to the drug situation, but studies focusing on the prevalence of drug use and supply and markets were also mentioned. Current drug research in Slovakia is affected by the very limited resources allocated to it in a regular way, which is a consequence of general restrictions on public expenditure. 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.