2011 was a year of tasks realisation of the fourth consecutive antidrug strategy and the action plan, scheduled for 2009 – 2012;. 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. And, in 2012, preparation of the final evaluation of the national action plan has started to be submitted to the government session by the end of March 2012.
Although drug policy is not a priority for the new government that arose from elections in March 2012, there are some references to drugs in the Manifesto of the Government of the Slovak Republic1, focused on a) international cooperation within UN antidrug policy programmes2, and b) measures against tobacco, alcohol and drugs in the frame of health protection and health life style promotion3.
In the second part of 2010, the Act ? 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 ? 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. A new government created in 2012 did not restitute the role and competention of the Deputy Prime Minister, such position has not been established within the new government.
By the government resolution ? 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. This process has not been finished as yet and Fund issue has been remained deadlocked and unsolved.
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 ? 43/2011 Coll. approval at the National Council in the beginning of 2011 that renewed Act ? 139/2008 Coll., and added 43 new substances on the list of controlled narcotic and psychotropic substances. 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.
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.. Although lifetime prevalence rates for cannabis more than tripled from 9 % in 1995 to 32 % in 2007, the results of the last survey show decline to 27%. In 2011, this prevalence was reported by 31 % of males and 23 % of females. In 2011, last year prevalence of cannabis was reported by 19 % of the sample and 9 % reported a last-month prevalence. The proportion of those who reported having used ecstasy at least once in their lives was 0 % in 1995, raised to 6 % by 2007 and declined to 4 % in 2011. Lifetime prevalence rates for amphetamines and LSD remain unchanged from 2007 and 2011 at 2 % and 4 % respectively, while lifetime prevalence of inhalants dropped from 13 % in 2007 to 10 % in 2011.
In 2011 no new estimate of problem drug use in Slovakia was carried out. However, in 2012, like in 2011, 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 2011, the number of agencies’ clients remained relatively stable, compared to 2010. The number, as well as a proportion of heroin users increased slightly in 2011, on the other hand, the number of buprenorphine using clients has stopped to increase. Also, the proportion of pervitin users declined in harm reduction services in 2011, but the proportion of polydrug users increased markedly.
2313 patients treated due to drug-related problems were reported in 2011. This means slight increase (as high as about 2%) in comparison with 2010, that concerns treatment facilities in prisons, as well as those of health care sector. 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. More than one third of the patients were in treatment due to problems with stimulants (about 35%). 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 2011 again.
In 2011, 20 deaths caused by the direct effects of psychoactive substances were reported. The important proportion, more than a half, of these were caused by opioids. The monitoring of deaths related to psychoactive substance intoxication was, as usual, impeded by limited sources and the complexity of toxicological expertises. 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. No new case was reported as HIV positive from among injecting users in Slovakia 2011. 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 remained 40% in 2011, which means stable trend. According to this study, the percentage of patients with prevalence of antibodies of type B hepatitis decreased to 22%.
There was an increase in toxic psychoses of schizophrenic nature, especially in connection with use of methamphetamine.
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 harmreduction. In 2011, a total of 281,416 syringes/needles were provided to the clients of these facilities, which is about 12% less than the year before. Further 15064 syringes were delivered within stationary programme of the Centre for Treatment of Drug Dependencies in Bratislava.
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 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 2007-2011 the number of clients in these resocialisation centres is increasing (842 in 2011). Prevailing psychoactive substance that had led to the problem was alcohol, followed by illegal methamphetamine – pervitin and poly-drug abuse.
Some other data overview from demand reduction and supply reduction areas are in the table below (“Fact Sheet”):
2 ARC – Accredited re-socialisation centre
3 Only toxicologically confirmed direct deaths from the forensic registry
4 Consisted of a sentence of convict labour in 2011