2010 was a year of realisation tasks of the fourth consecutive antidrug strategy and the action plan, scheduled for 2009 ? 2012; and also a year of preparation of the interim action plan achievement evaluation. In the beginning of 2011, the interim report was submitted to the Slovak government and to the National Council (parliament) to take cognisance of it.
According to the Programme Declaration of the new coalition government1, it intended to give particular attention to the fight against drug distribution and consumption in the area of repression, but also prevention. It will strengthen legal and executive authorities of the Police Force in the area of the fight against drugs, but it put less emphasis onto coordination structures and their coordination role.
In the second part of 2010, the Act No. 575/2001 on the Government activities organisation and on organisation of the central state authority was amended and drug issue dropped out from the competency of Deputy Prime Minister for human rights and minorities. By the government resolution no 135/2011, Board of Ministers for Drug Addictions and Drug Control, specialised advisory body to the Government in the drug field, has been cancelled and replaced with the universal Ministerial Council that lost connections to the expert background, supporting activities and functions of the Board of Ministers.
By the government resolution No. 1/2011, cancellation of the Antidrug Fund was decided, ending series of attempts to transform the Fund and make it more effective in money rising. In the course of 2010, some steps were undertaken, aimed to reduce ?legal highs? distribution via network of internet as well as of regular shops (Crazy Shops), and, at the same time, legislative activity was initiated by the drug coordinating bodies, based on NMCD?s expert information. Drug control was extended, and preparatory works in 2010 led to the Act No. 43/2011 Coll. approval at the National Council in the beginning of 2011 that renewed Act No. 139/2008 Coll., and added 43 new substances on the list of controlled narcotic and psychotropic substances.
Legislation adopted in 2010 enforced repressive steps against drug trafficker (property forfeiture) and against diversion of chemicals used as precursors.
Government Council for the Crime Prevention, advisory body acting within the ministry of internal affairs, prepared Concept of Crime Prevention Strategy for 2011 to 2014 that involved, to some extent, also drug problem. All population and school surveys carried out in 2010, have recorded the decline in marijuana consumption what is the overall trend in EU since 2009. On the other hand at least three surveys (NMCD population survey 2010 and Tobacco-Alcohol-Drugs school survey and 2011 Eurobarometer survey Young attitudes to drugs) showed that the gap didn?t stay empty. New designer synthetic drugs and herbal products which were not under legal control already penetrated the Slovak drug market and reached out young people. The public ?nuisance?, extensive media coverage of the legal highs issue and results of the survey contributed to rapid adopting of the further control mechanisms (see Chapter 1 - legislative development).
The effort of experts in education sector was mentioned in last Report regarding the establishing of standards and/or guidelines for qualified prevention. The absence of prevention standards is probably the reason that the number of evaluated programmes is dropping. Moreover the way of evaluation is not always perceived as the measurement of the effectiveness on target group.
The document of State Pedagogical Institute ?The Basis to Establish School Strategy to Prevent Risky Behaviour of Pupils? was the real kick off in development of national prevention standards. A step ahead was made in finding out the needs of school prevention coordinators for the effective prevention. The survey showed strong need and demand for innovative forms, the attractive way of presentation, and active involving children and young in the programmes. Simultaneously free access of teachers to the specialised training and education was voiced. An experiment with USI prevention system tailored for children and young in city district known by the prevalence of criminal offences incl. drug offences, and the highest2 amount of drug addicted patients living on the district territory, seems to be of good promise in community prevention.
In 2010 no new estimate of problem drug use in Slovakia was carried out. However, in 2011, based on 2010 data, study was carried out to know numbers of clients of low threshold harm reduction agencies that come to programmes of these agencies (especially to needles/syringes exchange/distribution programme) and the proportion of their clients that go to the treatment at the health care facilities. This was the first preparatory works for prevalence estimation, based on combined data from low threshold agencies and health care treatment centres. In 2010, notable decrease of the number of agencies? clients was observed. Among them proportion of heroin users dropped down slightly, contrary to other opioids (e.g. buprenorphine) that seemed to spread regionally and in quantity. Also proportion of pervitin users declined in harm reduction services, and even the proportion of polydrug users.
2266 patients treated due to drug-related problems were reported in 2010. This means slight increase (as high as almost 18%) in comparison with 2009, which was again for account of treatment facilities in prisons, because from health care sector the increase is not so high (some 7%). In terms of the representation of the primary drug as the cause for treatment, no essential changes occurred in the order of the most frequent problems. About one third of the patients were in treatment due to problems with stimulants, though in treated for the first time ever it created almost 40%) and their proportion increased in 2010. Number of opioids users declined among FTD as well as among all treated. The proportion of cannabis users remained practically unchanged. The
Proportion of injecting drug users among the treated drug users in healthcare facilities decrease slightly in 2010 again.The system of drug addiction treatment is well established and medical care is provided free of charge; its availability and accessibility depends on the specific agreements of the healthcare facilities with the health insurance companies. In 2010, data were completed on drug related deaths and mortality for 2009 too. 42 deaths caused by the direct effects of psychoactive substances were reported in 2010. The important proportion of these were caused by opioids only - 5 cases, and by opioids in combination with various substances ? 7 cases, which represents together 60% of all direct deaths caused by illicit drugs and solvents. Another 22 deaths (52%) of all direct deaths were caused by medicines, Other substances excluding opioids were identified in 8 cases (19%).
The share of individuals infected by the HIV virus remained low and non-epidemic. This is also true for the high risk population of injecting drug users. One new case was reported as HIV positive in Slovakia 2010 from among injecting users. The sub-population of injecting drug users traditionally includes high numbers of the prevalence of type C hepatitis antibodies, especially among the injecting users of opiates. According to the sentinel study at the CTDD Bratislava, the proportion of serum-positive VHC cases in patients reached 40%, which means declining trend in comparison with 2009. According to this study, the percentage of patients with prevalence of antibodies of type B hepatitis rose further (up to 28%) but in absolute numbers (17) it was continuation of decrease.
There was an increase in toxic psychoses of schizophrenic nature, especially in connection with use of methamphetamine. The deaths related to psychoactive substance intoxication did not rise up dramatically in 2010, yet their monitoring was, as usual, impeded by limited sources and the complexity of toxicological expertises. This applies in particular to the determination of a direct cause of death by a specific substance in case of the escalating poly-use amongst users, in which case use of different illegal psychoactive substances is often combined with alcohol and psychotropic medicine. The emergence of new synthetic substances on the drug scene makes analyses even more difficult..
The sterile needle and syringe replacement/distribution programmes constitute a significant part of the activities of low threshold organizations in the field of harm-reduction. In 2010, a total of 317,416 syringes/needles were provided to the clients of these facilities, which is approximately as many as the year before Drug addicts and individuals with other dependences are not explicitly mentioned in relevant measures to prevent social exclusion and to assure integration into society. However, they are not excluded from benefits what these measures provide.
The significant proportion of patients entering into treatment
The distinctive facilities only for people with problem of dependence were established to provide different social services serving to backward return of clients to society. There are at leas 19 such facilities ? resocialisation centres (RCs) which are certified by Ministry of Labour, Social Affairs and Family for their activities. According NMCD surveys in 2007-2010 the number of clients in these resocialisation centres are increasing (802 in 2010). Prevailing psychoactive substance what has led to the problem was alcohol, followed by illegal methamphetamine ? pervitin and poly-drug abuse. So far the effectiveness of resocialisation programme (in RC) is concerned an important proportion of clients monitored after one year was abstaining of drugs, starting or completing their education, 67% of such ex-clients hold stabile jobs and were lodged.
The police recorded in 2010 drop of drug-related criminal offences (28%) and prosecuted offenders (6%). Almost two thirds of drug offenders were prosecuted for criminal offences related to marijuana and a quarter of offenders were prosecuted by the police in relation to pervitin. What concerns the convicted, their number slightly increased as compared to the previous year (by 5%). Courts found guilty more than half from 1135 convicted (2010) for keeping drugs for personal consumption. The biggest number of persons was convicted for criminal offences related to marijuana (62.6%) and pervitin (17.3%). The court imposed suspended sentence on more than two thirds of offenders for drug-related criminal activity and not suspended sentence on approximately one fourth. The share of convicted, on which the judge imposed sentence of obligatory work or sentence of home confinement did not exceed 2%.
There were 1370 persons in detention facilities in the Slovak Republic in 2010 who declared drug use in civil life prior to the start of the custodial sentence. The share of positive drug screenings dropped as compared to the previous year (2009) (from 31.1% to 8.8%). The presence of benzodiazepines (107), cannabinoids (71) and amphetamines (31) was most frequently confirmed in prisoners.
Marijuana remained also in 2010 the most available drug in Slovakia, the seizures of which formed 59% from the total number of seizures (2042), followed by pervitin - 27% and heroin ? 7%. Home production of marijuana grew, which was grown especially by citizens of Vietnamese nationality. A new trend registered in 2010 was seizures of fentanyl (N17), which has started to substitute the active component in heroin. The share of ecstasy pills with content of MDMA significantly decreased in 2010 on the Slovak drug scene; these were substituted with pills containing mCPP. The concentration of heroin got in 2010 to the highest level since 2001 (median reached 14.6% and weighted average 16.2%). The increase of concentration was reflected also in price of heroin, the highest value of which reached the level of max. price of cocaine, i.e. ? 60 /g.
The precursor for production of ecstasy ? PMK-glycidate was seized in Slovakia for the first time. Ephedrine/pseudoephedrine remained also in 2010 the most abused precursor in Slovakia, although its seizures as well as seized volume have been dropping systematically since 2008. Selected data on drug situation are displayed in the table below:
27 Prevalence of use at sometime of one?s life, LTP (experience), use of the drugs in the past 12 months/ last year (LYP) and the last 30 days/last month ? current use 2 In 2010 171 drug addicted patients were reported in Bratislava II.district , similarly in Bratislava V.district, comparing Bratislava I, (45),Bratislava III.( 60) and 87 drug addicted patients in Bratislava IV. Source:Drug User Treatment in Slovak republic in 2010.