Information Systems
Bridging Phase
National Report
on the drugs situation in
Slovakia
2000
© European Commission 2000
This report has been prepared within the framework of a Project undertaken by eesv MSDP. The findings, conclusions and interpretations expressed in this document are those of eesv MSDP alone and should in no way be taken to reflect the policies or opinions of the European Commission
Phare Project on DrugInformation Systems
Bridging Phase
National Report
on the drugs situation in
Slovakia
2000
eesv MSDP
WG Plein 65, NL - 1054 RB Amsterdam, The Netherlands
Tel: +31.20.685.50.82, Fax: +31.20.612.57.91
National Report on the Drug Situation
in the Slovak Republic
The report written by
PhDr. Alojz NOCIAR, CSc.
The National Central Node
of Drug Information System
Board of Ministers for Drug
Dependencies and Drug Control
General Secretariat
This document has been prepared within the Bridging phase of the Phare Project on the Drug Information System
Bratislava, May 25th 2000
NATIONAL TEAM MEMBERS CONTRIBUTING TO THIS REPORT :
MUDr. Ivan CHABAN, Hospital with Policlinics, Zilina
MUDr. Mária CHMELOVÁ, Board of Ministers General Secretariat, Bratislava
RNDr. Ján LUHA, CSc., Institute of Public Opinion Research, Bratislava
MUDr. Ľubomír OKRUHLICA, CSc., Institute on Drug Dependencies, Bratislava
RNDr. Imrich ŠTELIAR, Institute for Health Information and Statistics, Bratislava
PhDr. Eva TOMKOVÁ, Ministry of Education of the Slovak Republic, Bratislava
Ing. Jaroslav TRŠŤANSKÝ, Institute for Criminalistic Expertise, Bratislava
C o n t e n t s
Introduction...... 9
PART I NATIONAL POLICIES: LEGAL & ORGANISATIONAL FRAMEWORK
1.Trends and New Developments in Drug Policy
1.1 Philosophy, direction, scope, objectives...... 10
1.2 Policy developments on specific issues of particular interest...... 13
1.3 Developments in public opinion and perceptions of drug issues...... 17
2.Developments in Legislation (new laws, directives etc.)
2.1 Drug laws...... 20
2.2 Other legislation (e.g. public health, data protection)...... 21
3.Developments in Organisational Framework
3.1 Key actors, rolesand co-ordination structures...... 22
3.2 Budgets and funding arrangements...... 23
3.3 International activities and co-operation...... 24
4.Developments in Information Requirements for Drug Policy...... 28
PART IIDRUG MONITORING SYSTEMS AND SOURCES OF INFORMATION
5. Developments and Changing Priorities in National Monitoring Systems, Information Sources and Research
5.1 Epidemiology...... 29
5.2 Demand reduction...... 34
5.3 Drug policy and legislation...... 35
5.4 Documentation centres...... 36
6.Developments at the National Focal Point
6.1 Organisation, legal basis, operation, staffing, financing...... 37
6.2 Network of partners of the Focal Point...... 38
6.3 Role of NFP in national monitoring and information systems...... 39
6.4 Other roles and activities of NFP within the Slovak Republic...... 40
7.Developments in Reporting to other International Organisations...... 41
PART IIIEPIDEMIOLOGICAL SITUATION
8.New Information on Historical Development of Drug Use ...... 45
9.Trends and New Developments in Drug Use
9.1 Drug consumption in the general population...... 46
9.2 Problematic drug use prevalence...... 48
9.3 Patterns and modes of drug use, characteristics of users (for drug consumption and prevalence described in 9.1 and 9.2) ...... 50
9.4 New user groups, new drugs, new drug use patterns...... 53
9.5 Health consequences and risk behaviour...... 53
9.6 Legal consequences ...... 53
9.7 Drug markets (supply and availability, market indicators)...... 54
9.8 Social problems linked to drugs...... 56
9.9 Geographical/regional differences in trends in indicators...... 59
9.10 Risk and protective factors (individual and population level)...... 62
9.11 Social processes and cultural context (possible impact on trends)...... 64
9.12 Attitudes and public opinion...... 64
10. Trends per Drug
10.1 Cannabis...... 66
10.2 Synthetic drugs (amphetamine, ecstasy, LSD)...... 66
10.3 Heroin/opiates...... 67
10.4 Cocaine...... 67
10.5 Medicines...... 68
10.6 Multiple use (including alcohol)...... 68
10.7 Solvents...... 68
10.8 Doping...... 68
11.Conclusions
11.1 Main trends and new developments in drug use and consequences...... 69
11.2 Possible reasons or hypotheses for major trends observed ...... 70
11.3 Methodological limitations and evaluation of data quality...... 70
11.4 Relationship between indicators (consistencies and inconsistencies)...... 71
11.5 Relevance of data to policy issues or interventions...... 71
11.6 New information needs, gaps, and priorities for future work...... 72
PART IVDEMAND REDUCTION INTERVENTIONS
12.New Developments and Information Needs
12.1 New developments during the reporting year...... 73
12.2 Specific events or programmes during the reporting year...... 73
12.3 Main issues and future information needs...... 73
13.Organisation, Structures and Responsibilities related to Drug Demand Reduction Activities
13.1 Changes in national structure...... 73
13.2 Involvement in European activities during the year...... 73
14.Demand Reduction Approaches in their Socio-cultural Context...... 73
15.Major Strategies and Activities in Demand Reduction...... 74
16.Specific Intervention Areas
16.1 First Childhood intervention...... 74
16.2 Prevention in the family...... 75
16.3 School programmes...... 75
16.4 Youth programmes outside schools...... 76
16.5 Mass media campaigns...... 77
16.6 Telephone help lines...... 78
16.7 Community programmes...... 78
16.8 Outreach work...... 78
16.9 Low threshold services...... 79
16.10 Substitution and maintenance programmes...... 79
16.11 Prevention of infectious diseases...... 80
16.12 Treatment systems...... 80
16.13 After-care...... 81
16.14 Self-help groups...... 82
16.15 General health care...... 82
16.16 Criminal justice system...... 82
16.17 Gender-specific issues...... 82
16.18 Children of drug users...... 83
16.19 Parents of drug users...... 83
16.20 Drug use at the workplace...... 83
16.21 Ethnic minorities...... 83
17.Quality Assurance
17.1 Research...... 84
17.2 Evaluation...... 84
17.3 Training...... 84
PART VSPECIAL TOPICS
18.Risk group defined from school survey data...... 85
CONCLUSIONS
- Main Issues and Future Information Needs
19.1 Summary of main points, key trends and new developments...... 90
19.2New information needs and priorities for the future...... 91
REFERENCES...... 92
5. Statistical Tables (Epidemiology) ...... 94
INTRODUCTION
Two years after the first National Report main points within the drug policy in the Slovak Republic might be briefly summarised as follows: the Board of Ministers for Drug Dependencies and Drug Control (further: Board of Ministers) function and composition, as well as its executive body – General Secretariat, has been confirmed after the Autumn 1998 elections. The Chairman of the Board of Ministers is the Deputy Prime Minister, responsible at the same time for human rights, minorities and regional development, with his two deputies being Minister of Health and Minister of Education respectively.
New National Program for the Fight against Drugs to 2003, with a perspective to 2008, taking into account the resolutions of 20th Special UN GASS devoted to drugs, has been elaborated and accepted by the Board of Ministers in March 1999 and subsequently approved by the Government of the Slovak Republic and the National Council of the Slovak Republic.
With respect to the Slovak Republic’s participation in the activities of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) in Lisbon, the Focal point has been accepted by the Board of Ministers as the “National Central Node of Drug Information System” (further CN DIS), entrusted to be an official contact point for the EMCDDA, which fact has been confirmed officially by its headquarters. CN DIS is up to now situated at the premises of the General Secretariat of the Board of Ministers at the Office of the Government.
Important sub-regional projects were finished, or are at final stages, such as those within the Memorandum of Understanding of the Visegrad countries, Slovenia and UNDCP, namely the 2nd phase of the joint Pompidou Group/UNDCP Project: Multi-city study, or the Project on drug scenting dogs, and also Treatment providers training in the Central Europe.
The Slovak Republic has been active in thePompidou Group of the Council of Europe, and its Permanent correspondent is one of selected members of the group for improvement of activities and management of this Council of Europe ministerial group.
The Slovak Republic has been a liaison between the Pompidou Group of the Council of Europe and Phare multi-beneficiary program on drugs, as co-ordinating country of the First Treatment Demand Indicator extension from city to country level project for eight countries of Central and Eastern Europe, which has been finished recently and its 2nd phase for 10 CCEE has been proposed at the Epidemiology expert group meeting in Strasbourg. The country was present also in other projects, e.g. the project of drugs in prisons.
On top of the before-mentioned there were also another activities in the meantime: Slovak Republic actively participated in the program of the UN agencies, dealing with drug problems, and finally reinforced its position by successfully presenting the candidature for a post of a member of the Commission on Narcotic Drugs for the term 2000-2003.
Penal code has been amended from 1999 with more strict measures against drug dealers, organised crime connected to drugs, namely with respect to youth. Proposal of the Act on chemical substances misused for production of drugs (an act on precursors), drafted in co-operation with the European Union experts within Phare program, has been submitted to the Governmental Legislative Council and subsequently to the National Council approval.
There were also other events of high political importance in the field of drugs:
Mr. Pino Arlacchi, director general of the ODCCP in Vienna has visited the Slovak Republic at January 13th 2000 to negotiate about establishing of the UN Regional Office for crime and drug control inBratislava, which will take place during the year 2000.
On the EU level direct co-operation has been launched between top interministerial co-ordinating structures and official EU institutions, namely official working visit of the Deputy prime minister and the Chairman of the Board of Ministers, Mr. Pál Csáky, to the EMCDDA in Lisbon at April 13th 2000.
PART INATIONAL POLICIES: LEGAL & ORGANISATIONAL FRAMEWORK
1.Trends and New Developments in Drug Policy
1.1Philosophy, direction, scope, objectives
The main document which creates the framework of the national policy towards drugs on the governmental level is the National Programme of the Fight against Drugstill the Year 2003 with a Prospect to the Year 2008 (further NPFD).
Overall objectives of the NPFD are divided into four core areas: (A) Drug demand reduction (i.e. prevention, treatment and resocialisation); (B) Drug supply reduction and law enforcement in combating drugs; (C) Mass-media policy; and (D) International co-operation. Summarisation of these objectives in respective areas is below.
(A)Drug demand reduction area has nine main objectives:
In the field of education and primary prevention it is necessary to continue systematically to support the healthy lifestyle; to continue or to initiate new targeted preventive programmes at schools and at leisure time facilities and to provide children and youth with opportunities of meaningful leisure time spending. Except traditional ways of preventive work such as lectures, brochures or leaflets, to use contemporary media and technology that appeal to and draw the attention of children and youth. To increase the pro-social orientation of young people, it will be necessary to make more use of the positive influence of peer programmes.
Medical care should be done in accordance with the Drug AddictionBranch Concept. New or extended facilities shall provide screening, early diagnostics, treatment, risk reduction and to provide links to long-term re-socialisation. This requires a close co-ordination of activity of health-, social, but also self-help facilities. Besides doctors - psychiatrists, it is necessary to involve in the treatment and preventive process also general practitioners for adults, children and youth, with the objective of providing assistance also to persons at initial stages of drug addiction. Special attention needs to be paid to establishment and development of facilities that will provide health- and psychosocial care for drug addicted pregnant women, their new-born children and possible substitutive family care.
In re-socialisation care for drug addicted persons in a natural social environment with jobs and stabilisation of family ties, it will be necessary to involve both public and private entities providing assistance to drug addicts and to create conditions for their activity with respect to their regional differences. It is necessary to put emphasis on specialised training of personnel necessary to perform such activity, including skills of psychotherapy, system of work and regimen treatment in therapeutic community, family- and work therapy, and professional re-adaptation and reintegration into the natural social environment. It is necessary to co-operate with the healthcare sector in prevention of HIV and infectious hepatitis, with emphasis on supporting the treatment and social care for HIV+ people and people living with AIDS, including building of asylum homes for persons in advanced stages of the disease.
As the drug problem occurs also at prisons, adoption of efficient measures will be needed to improve conditions for protective and voluntary treatment in the course of imprisonment and to establish departments with elements of drug-free therapeutic community regimen also in prison facilities. Preventive and treatment measures in the army will be supported, where the drug problem turned up particularly with actual military service soldiers. In relation thereto, it appears as necessary to unify the ways of reporting and recording the drug addicts in prisons as well as in the army consistent with the standard ways thereof in the healthcare.
To establish an accreditation system and periodic quality of services verification to guarantee professional level of all entities acting in the given sector, as well as systematic education of staff to ensure a qualified and multidisciplinary approach to drug problem. To assess drug situation on the basis of results of repeated national and regional surveys of occurrence and scope of drug use and specialised scientific studies of the drug phenomenon with respect to particularities of cultural, social, demographic and age character so that new knowledge and experience from the past can be reflected in the future measures.
To create conditions for active and direct participation of the youth, as the most threatened part of the population, in the creation and performance of preventive programmes and to take into consideration the documents like the Youth Charter for the 21st Century. With respect to the menacing results of the repeated surveys in children and students in Slovakia, it is necessary to include in the anti-drug preventive programmes also a reduction of consumption of legal drugs such as alcohol and tobacco, but also of other substances of the inhalation type or of medicines with habit forming potential that are not treated as illicit.
With respect to the extraordinary growth in marihuana use, a programme of effective short-term treatment or counselling in withdrawal of marihuana using the most recent knowledge should be used and subsequently effective programmes developed (e.g. motivation interview and therapy according to the stages of change model and the therapeutic change processes).
To develop a co-ordination mechanism for two basic programmes: The National Programme for the Fight Against Drugs and the National Programme of Health Promotion taking into consideration basic documents concerning legal drugs, adopted by WHO member countries, particularly the European Alcohol Charter and the Second European Action Plan against Alcohol from the year 2000 to 2005.
With respect to the results obtained in fulfilment of the NPFD and with respect to the new tasks for the period by the year 2008 as well as the binding nature of declarations, action plans and policies adopted by governments of the UN member countries at the 20th special session of the UN GASS in New York, the NPFD co-ordination by the Board of Ministers proved justified. However, in the future years, either substantial personal and technical strengthening of the General Secretariat, or the possibility of implementation of anti-drug policy through a central state administration authority for drugs should be considered.
(B)Drug supply reduction and law enforcement area has eight main objectives:
The most important task will continue to be the harmonisation of legal regulations governing the drug problem with international conventions and legal norms adopted at the level of the UN and the EU.
In accordance with EU recommendations to complete the legislation on control of chemical and special pharmaceutical production and distribution to prevent its diffusion into the illegal sphere. To complete the legislative process of the draft law on handling of chemical substances that can be used for illegal manufacture of narcotic and psychotropic substances (act on precursors) as well as the edict through which provisions of this law are implemented.
To perform activities directed towards achieving the conclusions adopted at the session of the CEI Working Group for Drugs in June 1998 in Bratislava and presented at the meeting of ministers of interior of CEI in October 1998 in Trieste to the initiative of the Slovak Republic to create conditions for establishment of a Regional Anti-Drug Office and Training Centre of CEI countries for staff of agencies enforcing law in combat against drugs in Bratislava. To continue the activity within the CEI.
To ensure conditions for strengthening the staff of that part of the state administration that enforces law in combating drug related crime, for material stimulation thereof and adequate technical equipment, continued education and improvement thereof also employing international co-operation.
To complete the re-codifying of the Penal Law and the Penal Code with an emphasis on increasing the penal charges for criminal offences with a drug element and to provide training for law enforcement agencies to the issue of the new legal regulation of criminal offences with a drug element with the objective of unified application of these provisions.
To adopt effective measures to prevent penetration of drugs to our territory, to reveal organised groups committing the criminal activity of illicit drug trafficking, to reveal cash flows related to committing of drug criminal activity and leading to legalisation of the illegal profit, and measures to eliminate distribution of drugs to end users.
To reconsider Act No. 73/1995 Z. z. on Residence of Foreigners in the Territory of the Slovak Republic, particularly concerning the regime governing aliens, which is presently indulgent towards aliens residing in our territory without authorisation and supportingthemselves by committing criminal activity with links to the drug underworld.
To adopt legal regulation comprehensively providing for protection of judges, prosecutors, police officers, customs officers, members of their families and their homes.
(C)Mass-media policy area has three main objectives:
The main objective of mass media policy will be, in an appealing form and truthfully, to continue informing on situation on the drug scene using creative epidemiology and results of activities of individual entities involved in anti-drug activities. To provide information on possibilities of help to persons under threat and to addicted persons. All information must be clear, accurate and reliable, effective from the cultural standpoint, early, addressed, trustworthy, it should avoid sensationalism and it should strengthen the trust.