The Government of the SR took into consideration the report on complex fulfilment evaluation in April 2009. In the sequence, it was the third anti-drug strategy ? of the National Programme of fighting against drugs for the years 2005-2008. Simultaneously the draft of New Anti-Drug Strategy for the period 2009-2012 was taken into account by the Government. Both materials were subsequently discussed in parliamentary committees and in June 2009 Slovak Parliament (NR SR) approved evaluation report and National Anti-Drug Strategy for the years 2009-2012.
Part of the new, the fourth consecutive strategy is Framework Action Plan, which provides the participating sectors with clear targets specification in each one of five key areas ? reduction of demand for drugs, reduction of supply , coordination and cooperation, international cooperation, awareness, research and evaluation.
According to the Programme Declaration of the new coalition government1 in August 2010 is the essential anti-drug policy framework of the SR government 2005 ? 2012, reflected on the conditions of the Slovak Republic in the document National Antidrug Strategy. The SR government will 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.
Drug control was extended in 2008, according to Act No. 139/1998 Coll. on Narcotics, Psychotropic Substances and Preparations as amended extended drug control to include 1-benzylpiperazine (BZP) and other substances, and the tincture and extract of cannabis. The cultivation of opium poppy was partially liberalized. Handling narcotics and psychotropic substances and precursors for teaching, training and testing purposes by eligible individuals (military police) was legislatively facilitated. The further supplementing of the Act by new substances is expected.
In the course of 2009, NMCD was monitoring the situation in the area of supply and demand according to key and major indicators and within EMCDDA countries, and thus as it is up to now, they have been collecting and analysing data from the area of drugs and supply reduction of drugs.
Status of drug issue in terms of objectives fulfilment of sector Action plans also monitor respective sectors, coming from their own statistic findings and exceptionally also from research activities in this area. These findings are set to broader context and must respect sector priorities. In relation to Framework action plan, significance of National monitoring centre for drugs was strengthened in relation to domestic environment.
Within the indicator ?Drug consumption in population? (GPS), two population surveys took place in 2009 with financial participation of NMCD. The first pilot? regional one ? research of psychoactive substances in general population aged 15-64, is partially continuance of population researches having been performed since 1996 in two-year intervals by Public Opinion Research Institute at the Statistical Office of the SR in context of monitoring of legal and illegal psychoactive substances consumption. The module devoted to illegal substances was modified in respective periods at the most. For the period in 2008, there was a questionnaire prepared and updated, coming from European model questionnaire (EMQ). By implementation of additional screening scales, is mostly possible to estimate the ratio of respondents with problematic form of alcohol consumption (CAGE scale) and marijuana use (CAST) in general population.
The second survey within their long-term research activities ? aiming for the targets of sector Action plan of ME ? was performed by Institute of Information and Prognoses in Education (IIPE) n youth population aged 15-26, with paying exceptional attention to the sub-group of 15-24 year olds.
Both of these researches confirmed marijuana dominance, which is the most tested and even currently used illegal drug in Slovakia. CAST screening scale captured 1.6 % of marihuana consumers in Bratislava region, who are in the range of high risk of psychosocial problems related to frequent marihuana consumption and other 1.6% in the range of moderate risk.
In the range of further ?favourite? drugs, there was ecstasy and pervitin and the research captured also the problematic ? injection ? users 0.4%.
In 2009 no new estimate of problem drug use2 in Slovakia was carried out. Therefore, assessing a overall picture of the issue we need to analyse thoroughly data collected from the most important source in this field ? non governmental organisations providing low threshold harm reduction programmes and services. Considering also other, indirect indices, no major changes occurred as regard extent or structure of problem drug use. In line with general trend observed on drug scene, the number of heroin users appears more or less stable or slightly decreasing, consisting predominantly of long-term chronic users. On the other hand, among clients of NGOs mentioned, users of methamphetamines (pervitin) create increasing group. While in 2008 a percentage of clients having problem with heroin use made 46% and 35% of clients were amphetamine users, in 2009 this ratio change almost oppositely: of drug using clients of NGOs, 34% were problem heroin users and about 42% were users of pervitin. This perhaps influenced a bit some insignificant decrease in proportion of injecting drug users among all harm reduction programmes clients, from 98.5% in 2008 to 97.2% in 2009. Also, several cocaine users were reported which is a new fact because they were reported rather rarely from these organisation in past years.
Problem drug users (pursuant to the definition of EMCDDA) have long constituted a substantial share of the patients in treatment. Although their share, which in the 1990s was as high as 83%, has gradually dropped, it is still relatively high. In 2009, it comprised an estimated 60 to 70% of all patients in treatment, while in those treated for the first time in their life this share is close to the lower limit and in a group of repeatedly treated it slightly exceeds the upper limit of this estimation.
1909 patients treated due to drug-related problems were reported in 2009. This means slight decrease (by 7.5%) in comparison with 2008, which was for account of treatment facilities in prisons, because from health care sector they reported stable situation (decrease by 10 cases). The proportion of treated men in comparison to treated women dropped slightly and in 2008 it reached the value of 3.5 : 1. 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 40% of the patients were in treatment due to problems with opiates, over one third (35%) due to problems with stimulants of amphetamine type, and cannabis, with a practically unchanged 18% share, was the third most common primary drug. The proportion of injecting drug users among the treated drug users in healthcare facilities decrease slightly in 2009 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.
Specialized centres for treatment of drug dependencies also provided maintenance (substitution) methadone and buprenorphine treatment to approximately 500 patients in 2009. In addition, several tens of patients were set up to maintenance treatment by buprenorphine within the framework of outpatient psychiatric care.
Among the clients of 19 accredited RS, whose primary problem was illegal substance, there were most of them with the problem of methamphetamine (pervitin) consumption followed by poly drug consumers. Subsequently third place among illicit drugs belongs to consumers with heroin usage history. This sequence of illegal drugs, which are according to NMCD survey stable in 2007 to 2009, follows after dominant number of RCs´clients with history of alcohol problems.
In 2009, there were no data available on drug related deaths and mortality. The share of individuals infected by the HIV virus remains low and non-epidemic. This is also true for the high risk population of injecting drug users. One patients have been reported from CTDD in Bratislava, injecting user, as HIV positive (presence of anitibodies). 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 50%, which means stop of the growing trend from the period of 2006-2007, however still remain historically very high. According to this study, the percentage of patients with prevalence of antibodies of type B hepatitis is relatively high (20%) but not so bad in absolute numbers.
There was an increase in toxic psychoses of schizophrenic nature, especially in connection with use of methamphetamine.
In 2009, two methadone substitution treatment programmes continued for the regions of Bratislava and Banská Bystrica and the wide distribution of buprenorphine substitution preparation SuboxonŽ through a network of psychiatric healthcare facilities. In addition to the therapeutic goals, the aim of the substitution programmes is to reduce social and health risks and to disseminate information and education.
The sterile needle and syringe replacement/distribution programmes constitute a significant part of the activities of low threshold organizations in the field of harmreduction. In 2009, a total of 318,292 syringes were provided to clients of these facilities.
Syringes for clients in Bratislava are also provided by the Centre for Treatment of Drug Dependencies within the framework of its programmes; in 2009, they provided 26,765 pieces. Together with relatively high availability of needles/syringes in most pharmacies, this constitutes good prerequisites for the reduction of the spread of infectious diseases among drug users.
Chapter 9 Drug crime, prevention and drugs in prison concentrates data from supply reduction, and implementation of law statistical systems of the police, public prosecution office and courts (Ministry of Justice). According to this information, the growing trend of committed criminal offences grew in Slovakia also in the year 2009. The number of prosecuted perpetrators and committed criminal offences grew and from one year to another the number as well as share of sentenced perpetrators is increasing. Of those, who were possessing drug for their own need ? in 2009 (57.4%).
In 2009, the police registered higher share of drug-related criminal offences by 15% (2439 in total) and higher share of perpetrators of drug-related criminal offences by 8% (2011), in comparison with the previous year. Similarly, as it was in the years 2007 and 2008, there were more prosecuted perpetrators and criminal offences related to cannabis, pervitin and heroin.
For the past eight years, the number of sentenced perpetrator has been more than doubled (from 468 of the sentenced in 2002, up to 1079 in 2009), where only for the past year the share of the sentenced perpetrators of drug-related criminal offences has been increased by one fifth.
The share of juveniles who committed drug related criminal offences reached the lowest level for the past eight years (4.7%) in 2009 according to the data of Ministry of Justice. One of the reasons may be the more frequent solution of such cases by off-courtsettlement and using alternative punishments.
Addiction itself to psychoactive substances led to committing drug-related criminal offences in 451 cases. In criminal offences (secondary drug-related crime) MS SR registered drug addiction as the reason for committing criminal offence in 54 cases ? theft at the most (16).
According to the data from prosecution office, number of the prosecuted3 3, who committed criminal offence under the influence of another addictive substance or alcohol ? has been still growing since 2006, on the contrary ? number of persons prosecuted for criminal offence under the influence of alcohol, has been slightly decreasing since 2007 ( by 134). The courts sentenced 30,953 persons in all, out of which there were 1.2% (379 sentenced) for criminal offences committed under the influence of another addictive substance than alcohol.
Drugs in prisons
At the end of the year 2009 there were altogether 9,133 convicted and sentenced persons in 18 facilities of CPCG, out of which 14.2% stated, that they had been using drugs before coming to prison (11.6% in 2008). The highest number of the drug addicted was registered in the facility of Leopoldov (197), similar to the year 2008, whereas the lowest number was in UVTOS in Trencín (14).
There were examinations done for the presence of illegal drugs and their using was detected in 826 cases (585 cases in 2008). The most frequently used illegal drugs were heroin, pervitin a marjjuana in 2009.
In 2009, treatments ordered by the court (so called protective) and voluntary treatments were performed in five selected facilities of CPCG ? number of those executed, drugs treatments ordered by the court was decreased by app. 16% in comparison to the year 2008. In 2009, there were 42 sentenced persons, who decided for voluntary treatment. Illegal market with drugs is still developed in Slovakia for domestic demand of clients and at the same time Slovakia remains an important transit point.
In 2009, the market was characterized by increased marijuana and pervitin supply and production, which is confirmed also by growing statistics of their seizure and the amount of drug seizured as well as occurrence of new drug types (e.g. mephedrone) and precursors (acetic acid anhydride). Overall number of seizures constituted 2,797 cases, which is increase by 15.6% in comparison to the year 2008. The highest share represented seizures of cannabis (59%), pervitin (29%) and heroin (8%). Policemen detained historically the highest amount of cannabis plants in 2009 ? over 2.5t. Mephedrone (also known as subkoka1 or synthetic cocaine) occurred at the Slovak drug market, it was sold particularly by internet. New phenomenon in 2009 was involving people of Vietnamese origin into growing marijuana by indoor method. There were attempts revealed regarding marihuana export (with higher concentration of active substance) to foreign countries ? Hungary. There was also occurrence of precursor greater amount (860 litres) acetanhydride, designated for some of heroin producer countries.
Among the seizures, the share of ecstasy tablets with active substance MDMA content significantly dropped, in 2009, pills with piperazines occurred more often at the market (particularly mCPP).
Concentration of active substance significantly dropped in the retained cocaine samples, and it was down to the lowest level for the past 5 years (weighed ratio 30%). On the contrary concentration of active substance in pervitin increased up to the value 67%, which might be assumed reason, why in some Slovakian regions the highest detected price of pervitin came close to the highest price of cocaine. (100 ?/ g).
Specific region in terms of drug issue in Slovakia remain the capital Bratislava with its surrounding, which is forming though the smallest municipality region out of eight regions in Slovakia. At the same time, it is the most populated and developed region. It has the lowest unemployment and its share on GDP creation of the whole Slovakia represents 25%. According to population research in the region in December 2009, the drug sequence, with which the Bratislava region population had the most frequent experiences, was as follows: Marijuana, ecstasy, pervitin. Declared detected accessibility of illegal drug as a very easy or easy one within 24 hours was according to this survey in the group of the youngest respondents aged 15-24: 67%.
Bratislava and Bratislava Region stand in the lead of all monitored indicators also in criminal area and 51.5% share in the overall drug crime is majority, similar to the previous years. In the region, the long-term highest number of perpetrators of drugrelated criminal offences ?133 persons per 100 thousand habitants in 2005, in 2009 yet 142/100,000 ? with the state average 37 per 100,000 habitants.