Co-operation Group to Combat Drug Abuse
and Illicit Trafficking
in Drugs (Pompidou Group)
Strasbourg, 25 November 1996 P-PG/UN-MC (96) 24
Bratislava, 6 December 1996
GS VMDZ KD
Joint Pompidou Group/UNDCP Project
Extension of the
Multi-city Network to Central and Eastern Europe
CITY REPORT
BRATISLAVA
(1995 Data)
by
PhDr. Alojz NOCIAR, CSc.
Senior Advisor for Epidemiology and Drug Information Systems
Board of Ministers for Drug Dependencies and Drug Control
Strasbourg -
Bratislava,1996
MULTI-CITY STUDY
OF DRUG MISUSE
1995
Data - Update
BRATISLAVA REPORT
by
PhDr. Alojz Nociar, CSc.,
Head of the Local Coordination Unit:
Foundation
Drug and You
Update under the auspices of the
General Secretariat
Board of Ministers for Drug Dependencies
and Drug Control
COUNCIL OF EUROPE
DIRECTORATE OF SOCIAL AND ECONOMIC AFFAIRS
POMPIDOU GROUP
B.P. 431 R6
67000 STRASBOURG
F R A N C E
Tel: (33) 88.41.21.00
Fax: (33) 88.41.27.85
T A B L E O F C O N T E N T S
SECTION A: DESCRIPTION OF BRATISLAVA
1. Demographic, Social and Administrative Profile
2. History of Drug Misuse and Current Situation
3. Drug Policy and Legislation
4. Treatment and Social Care Facilities
5. Control Structures
6. Monitoring Systems and Types of Research
SECTION B: INDICATORS OF DRUG MISUSE IN BRATISLAVA
1. Treatment Demand and 1st Treatment Demand
2. Drug-related Morbidity
(a) Hospital Admissions
(b) Viral Hepatitis
(c) Nonfatal Emergencies
3. AIDS and HIV
4. Drug-related Deaths
5. Police Arrests
6. Court and Penal Data
(a) Convinctions for Drug Offences
(b) Imprisonment
7. Seizures of Illicit Drugs
8. Price and Purity of Illicit Drugs at User Level
9. Population Survey Data
10. Other Surveys and Ethnographic Data
11. Other Indicators
SECTION C: DISCUSSION AND CONCLUSIONS
1. Use of Indicators in the City
2. Relationship Between Different Indicators
3. City in Relation to the National Situation
4. Conclusions
ANNEXES: I Tables
II Figures
III Surveys
SECTION A: DESCRIPTION OF BRATISLAVA
1. Demographic, Social and Administrative Profile
Bratislava is the capital of the Slovak Republic, situated on the
banks of river Dunaj, near Austrian and Hungarian borders. Bratislava
have had 452 053 inhabitants, who lived at the space of 367,6 km2 in
1995 (Table 1.0). That means 1 230 people/km2, i.e. 2-3 times lower
concentration in comparison with capitals of neighbouring countries.
The city consists from four main districts on the left bank of
Dunaj river (Table 1.1 in Annex I). Fifth district, which was built up
15-20 years ago, is situated on the right river bank. It consists from
over 130 000 agglomeration, with proportion of young generation being
much higher than in the rest of the city . This exceptional proportion
of 36 % children and teenagers being exposed to increased drug supply,
creates, of course, special problems in this district.
Structure of citizens was as follows in 1993 : Slovakian 91,0 %;
Hungarian 4,6 %; Czech 2,4 %; and the rest of 2% were German, Ukraine,
Jewish, Russian, Polish, Gipsy, and others nationalities. Extensive
social changes were reflected in clear shift from collective ownership
structures, with private sector creating 56,3%; state-communal 2,7%;
co-operative 3,24%; joint ventures - 19,2%; foreign companies
- 16,3%; other forms -
2,22%.
Most of important national institutions are in the city, such as
the National Council of Slovak Republic, the Government and Ministries
of Slovak Republic. Also Comenius University and other scientific
(Academia Istropolitana, University Library) and cultural institutions
(Slovak National Theatre, museums and two galleries) are in the city.
There are some noteworthy historical monuments, like old Bratislava's
Castle - architectonic dominant of the city, or ruins of ancient Devín
Slavonic Castle, situated above confluence of Morava and Dunaj rivers.
In the city there is strong chemical, textil and oil industry,
but also car production, with west investment (BMW).
Mean unemployment rates1 were rather low against those in other
parts of the country with high unemployment rates (e.g. 20-25% in some
parts of the Middle and East Slovakia).
Mean unemployment rates : 1989 1990 1991 1992 1993
Bratislava city - 0,89 3,95 5,61 4,43
Košice (2nd biggest town) - 4,24 6,04 7,36 8,77
Number of unemployed registered
at the Bratislava's Work Office: 1990 1991 1992 1993
All: 2 531 19 512 10 883 13 510
women 1 416 11 534 6 359 7 808
1 number of unemployed
Mean unemployment rate = -------------------- x 100
disposable sources
Disposable sources: people working in one job, or having one main
job + women during first or next mothering + all unemployed.
2. History of Drug Misuse and Current Situation
Some signs of drug problem in Slovakia were present from sixties,
but almost hidden, not very impressive before 1989. There was rise of
inhalants use in teenagers, quite rare cases of marihuana smoking, and
exceptional hard drugs use, mostly as experimenting. Worthy of noting
is, that in 40 - 60% of drug users (sedative/hypnotics/analgetics) the
secondary drug was alcohol, often used together with prescribed drugs.
Also, a small number of drug addicts came from health personnel, where
morphin, or dolsin had been accessible.
The same apply for Bratislava, where proportion of drug users at
the city Antialcoholic Counceling Center (by 1990 Center for Treatment
of Drug Dependencies) was before increased supply of illicit drugs
quite negligible against hundreds of alcoholics:
1975 - 22 cases 1991 - 46
1980 - 41 1992 - 78
1989 - 68 1993 - 208
1990 - 60 1994 - 590
1995 - 494 cases.
It is quite clear that drug problem had begun to accelerate in
Bratislava, especially in youngsters (49,3% of registered drug addicts
in 1994 was under 20; but 52,7% in 1995). The spectrum of drugs has changed from abused medicaments to frequent occurence of hard drugs, mainly heroin.
This is becoming true for whole country, but before all for the city, where drug problems are concentrated. In 1994, there was 86% from all heroin cases from Bratislava, but in 1995 it was 77% (i.e. 9% growth of cases for the rest of Slovakia).
3. Drug Policy and Legislation
Slovak Republic is party to the 1961 Single Convention on
Narcotic Drugs as amended by the 1972 Protocol; to the 1971 Convention
on Psychotropic Substances;and to the 1988 convention against Illicit
Traffic in Narcotic Drugs and Psychotropic Substances.
By October 1., 1994 is in force the Act Against Organized Crime.
According to it the possessor of any amount of illicit drug, even for
personal use, is breaking the law. At the same time the Penal Code was
novelized with paragraphs on drug possession, production, trafficking.
The Health ministry legislative section has prepared proposal of
the Act on Psychotropic substances by the end of October 1995.
Proposal of the Act on Diversification of Precursors was also
submitted to the Legislative Council of the Slovak Government.
Up to summer 1995 two governmental bodies were responsible for
drug policy: the Governmental Council for Fight Against Anti-social
Activities; and Coordinating Council for Citizens' Health Promotion
(first on the side of supply; second on the side of demand reduction).
By August 8, 1995 the Slovak Government accepted new proposal of
the National Program for Fight Against Drugs, written by the Ministry
of Internal Affairs. Subsequently the Board of Ministers, chaired by
deputy prime minister has been established, with executive General
Secretariat embedded within the structure of the Slovak Government's
Office. From ministries involved two vice-chairmen were appointed,
namely Minister of Health and Minister of Education.
By October 5 of 1995, the Slovak Republic has entered into closer
cooperative actions with the group of Visegrad countries and Slovenia,
under auspices of UNDCP. Signing of the Memorandum of Understanding in
Prague has formed basis for more effective drug control, institution
building and demand reduction within subregional frame of reference.
4. Treatment and Social Care Facilities
Ministry of Health has developed a program on strengthening of
specialized health services. Besides three existing Centers for
Treatment of Drug Dependencies (CTDD) in Bratislava, Nové Zámky,
Žilina another three have been established and should be extended
further. This fact is important because of problems encountered in
treatment of alcoholics together with drug addicts.
Counseling and detox services are provided either in the Centers
for Treatment of Drug Dependencies, in specialized Psychiatric
Hospitals, or also at the in-patient psychiatric units. There is one
small needle-exchange program at the CTDD in Bratislava. The HIV
testing is free of charge and can be done anonymously. Formal rules
for the methadone maintenance were elaborated as a proposal, submitted
recently to the Ministry of Health.
During 1995 and at the beginning of 1996, there appeared new social care structures in the district of Petržalka, as well as the first private clinic for the treatment of drug dependencies. Most of those new facilities implement besides medical and psychosocial care also some preventive activities.
Because of unfavourable epidemiological situation and lack of
treatment facilities for young heroin users, department in psychiatric
hospital near Bratislava (20 km) has been opened in spring 1995 for
young heroin users under 18, mainly from the Bratislava city.
5. Control Structures
Main role in illegal drug trafficking control and drug supply reduction have law enforcement forces, namely Police with the National Anti-drug brigade emboddied into the structure of Police Headquarters,
and Central Customs Service, both situated in Bratislava. Institutions
mentioned belongs under the Ministry of Internal Affairs and the
Ministry of Financies. Both police and customs bodies play important
role in the investigation of drug-related criminality, in national, as
well as international frames (e.g. cooperation with Interpol,
including computer network and information system of custom service).
Governmental Council for Fight against Antisocial Activities
elaborates proposal of the law on diversification of precursors control of which is required by United Nations convention from 1988.
Medical control of all legally used drugs (including methadon),
is implemented by the State Institute for Control of Medicaments
(Štátny ústav pre kontrolu lieèiv), governed by the Ministry of
Health. Also some departments of the Ministry execute control over
distribution and use of medicaments in treatment centers and
departments for drug users.
The Penal Code novelization, with paragraphs on drug production,
trafficking and possession, and the Act Against Organized Crime might
in some circumstances result in overcriminalization of drug user.
6. Monitoring Systems and Types of Research
From January 1., 1994 report system for health statistics has
been changed according to the rules elaborated by the Pompidou Group
and reporting list of the "Definitive protocol" was gathered from all
state inpatient and outpatient treatment modalities by the Institute
for Health Informations and Statistics.
Overall demographic, social and other statistical data on
Slovakia are gathered by the Slovak Statistical Office.
Under leadership of the State Health Institute of the Slovak
Republic all former centers of hygiene and epidemiology gather data on
various aspects of environmental, infectious, noncommunicable diseases
and partially also on drug issues (e.g. they were collecting data with
ESPAD questionnaire throughout Slovakia).
There are also small agencies implementing surveys on population
regarding various topics, including some drug issues. Also two NGOs
(FILIA, Drug and You) were taking part in school population surveys on
drugs in West Slovakia and in the whole country, including Bratislava.
By December 1., 1994 Bratislava entered into the Multi-city
Network: Joint Council of Europe (Pompidou Group)/UNDCP Project. Local
coordinating unit for municipal study was established under the
National Center for Health
Promotion in Bratislava.
Under PHARE: Fight Against Drugs program, the Focal Point for
drug data gathering on national level ought to be created as well.
After establishing of the Board of Ministers for Fight against Drugs
and Drug Control, it was decided to locate the Focal Point in the
General Secretariat of the Board.
Evaluation Program of Effectiveness of Substance Abuse Treatment
Modalities in Slovakia (in Heroin Addictions) is in preparatory phase.
After signing of the Memorandum of Understanding in Prague, six
subregional projects were designed and should be implemented within
three years.
SECTION B: INDICATORS OF DRUG MISUSE IN BRATISLAVA
1. Treatment Demand and 1st Treatment Demand
From the beginning of 1994 are data on this indicator gathered by
Institute for Health Information and Statistics with standard Pompidou
Group instrument from reporting units. Besides improvement this change
caused also problems regarding much lower number of cases for Slovakia
(in 1992-1993 over 2.500; in 1994 only close to 1.200), in spite of
growth of hard drug use (see also Figures in Annex II) :
male female ALL
heroin & opiates 590 177 767
stimulants 7 7 14
hypno.sedat. 5 12 17
hallucinogenes 1 - 1
inhalants 33 4 37
cannabis 6 6 12
all others 1 - 1
great Bratislava 1994: 643 206 849
(with country district)
Clear definition of indicators by Definitive protocol, as well as
universal usage of Reporting instrument on city and country level,
will allow far better comparability of data from the next year.
After Bratislava took
part in the First treatment demand study and it wa possible to
define "first contacts" and "recontacts" from
1995 data (see Annex I).
2. Drug-related Morbidity
a) Hospital Admissions
Data were used from previous year 1993, and the type of facility,
where treatment was done was limited to the psychiatric hospitals and
wards, because practically all drug dependent patient are treated
there. Also from four new centers, which were up to now established in
the Slovak Republic, three are transformed from psychiatric wards, and
only one in the city, is broadened and restrucuralized out-patient
centre (in fact, former Anti-alcoholic ambulance for Bratislava).
b) Viral Hepatitis
Data on hepatitis were collected with problems regarding type C, which was during previous years followed and registered in Prague. In 1994 the register was available only for types A and B, which occurences were shown in CT-5. Additional data on "unspecified type", and also on the number of C types are in note to this core table. In 1995 data on A,B,C types were gathered for Bratislava, with C type not available for the country.
c) Nonfatal Emergencies
Data on this indicator
are not available.
3. AIDS and HIV
From 1986 to september
1995, 1 862 183 tests for HIV were done, yelding 46 positive
results among Slovakian and 34 cases among other nationalities
- 19 foreign students and 15 persons from Africa. No IVDUs were
between them (see CT-7; with note on 1st HIV+ IVDU). By november
1994 small program of needle exchange for heroin users was started
and still continue in Bratislava.
4. Drug-related Deaths
In Slovakia were registered drug related deaths from overdoses.
Most frequently young people under 26 were victims of overdoses. Today
drug-related deaths are not centrally followed, only between all cases
of death, including suicides, by Slovak Statistical Office.
Albeit no relation might be declared between diagnose of drug
dependence and suicide, in 1993 there were 29 suicides in the country,
where diagnoses had been "alcoholism and other narcomania"; with dg.
304 were 4; with dg. 305 were 5 suicides in whole country.
5. Police Arrests
Specifics of current situation: data on arrest are not yet
evaluated, because before October 1994 possession of drug had not been
considered an offence; hence no arrests for that were recorded before.
6. Court and Penal Data
(a) Convinctions for Drug Offences
Types of criminal acts: 1989 1990 1991 1992 1993
Illegal production and
possession of drugs........ - 1 4
Spread out of toxicomania.. - 1 4
Dangerousness under the
influence of drug........ - 70 9 7 11
Data for Bratislava;
from 1994 up to now non available.
(b) Imprisonment
In 1993 the specialized Police forces handled 19 cases of
criminal activities connected to drugs captures. There were 32
criminal prosecuted persons (included 9 in a jail), from which 25 were
of Slovak, 3 of Czech, 2 of Bulgarian, and 1+1 of Hungarian and
Austrian nationalities.
In drug transit are involved Slovak citizens as couriers,
organized by people from former Yugoslavia, mainly from Kosovo, but
also from Turkey, Bulgaria and from republics of former Soviet Union.
During 1993 the police forces on the borders captured 35 citizens of
Slovakia because of suspection of drug crime (biggest proportion in
Bulgaria: 9 persons, connected with 108.8 kg of smuggled heroin).
7. Seizures of Illicit Drugs
Data are not divided for the city and for national level, because
seizures were and still are done, and hence reported, on the borders.
The origin of drugs, ways of transit through Slovakia:
- heroin : Turkey
- cocain : Venezuela
- hasish : mostly home made, as marihuana
metamphetamin : Czech Republic
8. Price and Purity of Illicit Drugs at User Level
Recent prices on the "street market" are written in CT-16, with
respect to indicated current Slovak koruna (Sk) - ECU relations.
Purity is estimated from seized samples.
9. Population Survey Data
A representative general population survey has been implemented
by the Statistical Office of the Slovak Republic on national level at
end of the year 1994. According to that there are 711 "regular drug
users" per 100.000, and 4.262 per 100.000, who have tried drug at
least once in their life.
Beforementioned numbers have not great epidemiological weight and
are used only illustratively, because according to my mind, definition
of the drug did not allow to differentiate between sorts, addictivity,
soft and hard, etc.
Also trends are not
yet available.
10. Other Surveys and Ethnographic Data
Repeated surveys on drug use in elementary and secondary schools,
and also on knowledge and attitudes of the teachers (n = 2.200), were
made by National Health Promotion Center and State Health Institute of
Slovak Republic (n = 2500 pupils; and n = 2.700 students in 1993;
n = 11.889 elementary school children in 1994).
The National Center and State Health Institute, together with NGO
"Drug and You" and the Institute for Health Education, carried out the
Pan-European School Survey on Alcohol and Drugs (ESPAD) in students,
born in 1979. Data from students aged from 14 to 18, from 38 districts
of Slovakia (10.400 questionnaires were distributed), then evaluated and interpreted by LCU and Institute for Health Education.
As the results for Bratislava were already available at the time
of writing final version of Multi-city report, they are in Annex III.
11. Other Indicators
At this time : none.
SECTION C: DISCUSSION AND CONCLUSIONS
1. Use of Indicators in the City
Some of indicators, similar to those from Definitive Protocol,
were used in traditional ways: they were accessible in the form of
yearbooks, with epidemiological data old 1-2 years. Of course, this is
not sufficient in recent rapidly changing situation. Quantitative
indicators needs to be broadened (e.g. non-fatal emergencies); and
also to be investigated more exactly (e.g. drug related deaths).
More exact evaluations might follow from continuous application
of Pompidou Group guidelines, as well as from qualitative approaches,
like Rapid Assessment method (RAP), or Snowball sampling. This
complementarity is crutial for informed and responsible drug policy
decisions, because quantitative epidemiology used solely, will be soon
insuficient in description of rapid changes. This is true mainly in
reaching groups of users without clinical manifestations, those at the
beginning of their drug cariers, and many of those "hard to reach".
Indicators usage in drug policy planning might be improved also
by the UNDCP subregional projects implementation following the
Visegrad countries and Slovenia Memorandum of Understanding, e.g. by
exchange of epidemiological informations and documents between PHARE
Focal Points and Multi-city
study LCUs.
2. Relationship Between Different Indicators
At the time of writing the first version of the Report from data
gathered through new guidelines and somewhat experimentally, it would
be premature to draw firm conclusions and make claims on relationship.
Nevertheless, some hypotheses and estimations, based on the history of
drug problem in Slovakia during past five years, are conceivable.
Epidemiological data during this period reflect extensive growth
of the problem. In 1992 we got first warning signal on possible heroin
epidemic, both in sudden growth of registered cases, and in seizures:
over 66 kg of heroin confiscated at Berg (Austrian/Slovakian borders,
few km from Bratislava), was one of signs of illicit drug smuggling
through Slovakia. Then supposed growth of heroin abuse, frequent IVDU
has been confirmed, namely with respect to the Bratislava city.
Now, tentative conclusion is, that it might be expected occurence
and subsequent growth of HIV+ cases, between them IVDUs, in the city.
This is probable in spite of not very exact problem delineations.
- Albeit no information was available regarding various ways and
locations of drug confiscation - and no distinction has been made (at
least in 1994) between seizures on the street and on the borders; and
similarly, in spite of the fact, that no direct information on IVDUs
behavior using street drugs is today available from (not yet existing)
street work, or RAP methodology.
3. City in Relation to the National Situation
Comparison of drug situation in the city with national had shown
concentration of illicit drugs' abuse within the city, and prevailing
drug from 1993 was, and still is, heroin. Situation outside the city
is similar to that experienced by Bratislava three years before: there
is constant level of new alcoholics and few cases of drug addicts, but
also subcultures of users, not yet defined as clients or patients.
Unfavourable signs of Bratislava's drug situation in comparison
with that of country are today : over one half of all drug addicted
persons is under 20; over three quarters of registered cases addicted
to heroin; far more then one half of all cases using heroin are IVDUs;
hence up to now not fully recognized threat of HIV-AIDS epidemic might
explosively break out precisely in young drug addicts.1
If we compare recent trends in the city to that of the country,
there is evident concentration of the drug problem in Bratislava. Also
in the second biggest town, Košice, and some other locations where
services are available, the problem seems to be greater. Surely, this
problem's proportion might be caused not only by availability of
treatment services, but also by greater anonymity, possibility to hide
problem from surroundings, overall functions of big towns as centers
of political, economic, cultural and scientific life, etc.
1 At the end of September 1995, the first case of HIV+ case of young IVDU has been detected. Transmission probably by sexual contact, but past and current injecting of heroin was admitted.
4. Conclusions
What might be considered main positive at this time: introducing
of the Guidelines within framework of Definitive protocol had been
timely business, because of possible between-countries comparability,
more exact description of current drug situation, cross validation of
findings, and last but not least : delineating drug situation of the
country near "zero point", which will allow (e.g. like repeated ESPAD)
comparison and analyses of trends. Those comparative studies will be
possible inside country from various aspects, as well as between
countries.
A n n e x I
LIST OF CORE TABLES
REFERENCE NUMBER
Population Data CT-1
First and All Treatment Demands CT-2
First Treatment Demands (% of All TD, Age, Gender) CT-3
Hospital Admissions CT-4
Hepatitis B & C CT-5
Nonfatal Drug-related Emergencies CT-6
Reported AIDS Cases CT-7
Drug-related Deaths CT-8
Police Arrests, All Drugs CT-9
Police Arests, by Drug CT-10
Court Convinctions for Drug Offences CT-11
Drug Law Offenders Sentenced to Imprisonment CT-12
Drug Misusers in the Prison Population CT-13
Quantities of Illicit Drugs Seized (kgs.) CT-14
Number of Seizures of Illicit Drugs CT-15
Retail Prices of Illicit Drugs in ECUs per gram CT-16
Purity of Illicit Drugs at User Level CT-17
General Population Survey Data CT-18
School Survey Data CT-19
Other Survey Data CT-20Population Data (CT-1)
Table 1.0 Population of Bratislava up to 31. 12. 1995:
(a) Bratislava
age male female total % of total
range population
<15 44 136 42 491 86 627 19.16
15-19 19 730 18 812 38 542 8.53
20-24 16 629 16 240 32 869 7.27
25-29 13 399 14 638 28 037 6.20
30-34 15 325 18 015 33 340 7.37
35-39 17 804 20 295 38 099 8.43
40-44 20 495 23 225 43 720 9.67
45-49 16 528 18 983 35 511 7.86
50 + 48 772 66 536 115 308 25.51
total 212 344 238 432 450 776 100.00
15-39 years 82 789
88 357 171 146 37.97
(b) Slovakia (1995 data)
age male female total % of total
range population
<15 610 853 584 435 1 195 435 22.27
15-39 1 057 808 1 026 086 2 083 086 38.82
40 + 945 051 1 143 557 2 088 608 38.91
total 2 613 712
2 754 078 5 367 790 100.00 %
Previous Years (Bratislava)
year total 15-39 % 15-39
1980 381 186 152 504 40.01
1985 417 088 163 914 39.30
1990 444 660 172 973 38.90
1995 452 053
170 887 37.80
Table 1.1 Data on differences between five districts of Bratislava for
the year 1995:
I II III IV V
age % % % % %
range
<15 6739 14.1 18625 16.5 9868 15.3 20200 21.0 31195 23.9
15-19 3200 6.7 7955 7.0 4819 7.5 6313 6.6 16195 12.4
Child. % = 20.8 23.5 22.8 27.5 36.4
& Teen.
Source:
1. Štatistické èísla a grafy. Vekové zloženie obyvate¾stva SR v roku
1995. Štatistický úrad SR, Bratislava, 1996. (Statistical numbers
and figures. Age distribution of population in Slovakia at 1995).
First and All Treatment
Demands
(CT-2)
Table 2.0 First Treatment
Demands
First Contacts Recontacts All Treatment Demands
(a) Bratislava
year No rates No No rates
1995 473 352 825
(b) Slovakia
year No rates No No rates
Male Female
Male Female Male Female
n.a.
First contact: outpatients and inpatients treated for the first time.
Recontact: outpatients and inpatients treated repeatedly.
Source: Ústav zdravotníckych informácií a štatistiky SR (Institute
of Health Information
and Statistics of the Slovak Republic)
First Treatment Demands (% of All TD, Age, Gender) (CT-3)
Table 3.0 First Treatment
Demands by Age & Gender
% of All TDs Mean Age % <25 yrs % Female
(a) Bratislava
year % male female total % %
1995 57 20,4
20,1 20,3 87 26
% of All TDs Mean Age % <25 yrs % Female
(b) Slovakia
year %
male female total % %
n.a.
Source: Ústav zdravotníckych informácií a štatistiky SR (Institute
of Health Information and Statistics of the Slovak Republic)
Hospital Admissions (CT-4)
Table 4.0 Hospital Admissions in the city and country
Psychiatric Hospitals Nonpsychiatric Hospitals
(a) Bratislava
year No rates* No rates*
(1) (2) (1) (2)
1995 264
n.a.
(b) Slovakia
year No rates* No rates*
(1) (2) (1) (2)
n.a.
Source: Ústav zdravotníckych informácií a štatistiky SR (Institute
of Health Information
and Statistics of the Slovak Republic)
Hepatitis B & C (CT-5)
All cases of B & C Drug-related cases % Drug-
related
(a) Bratislava
year No rates* No rates* %
(1) (2) (1) (2)
1993 A: 33 7.3 n.a.
B: 32 7.1
nonspecified: 17 3.8
1994 A: 89 19.7 n.a.
B: 15 3.3
nonspecified: 5 1.1
1995 A: 53 11.7
B: 17 3.7 1 0.2
C: 4 0.9 1 0.2
(b) Slovakia
year No rates* No rates* %
(1) (2) (1) (2)
1994 A: 1 279 23.9 n.a.
B: 379 7.1
nonspecified: 158 2.9
1995 A: 1 346 25.1 n.a.
B: 338 6.3
nonspecified: 132 2.5
Source: Štátny zdravotný ústav(ŠZÚ)SR; ŠZÚ hl. mesta Bratislavy; Špecializovaný ŠZÚ v BanskejBystrici. Informaèný systém (IS)infekèných ochorení.(State Health Institute (SHI)of the Slovak Republic; SHI of Bratislava; Specialized SHI of Banská Bystrica. IS of infectious diseases).
*rates: (1) per 100.000 total population (all ages);
*rates: (2) aged 15-39 per 1.000 population aged 15-39
Note : C type was not reported in used sources; however, information from the Institute of Preventive and Clinical Medicine was given, that in 1994 there were 44 Hepatitis C type in whole Slovakia (that means 1,1 by 100.000 citizens for Bratislava; highest occurence was between age group of 20-24 years: 5,3 by 100.000 citizens).
Nonfatal Drug-related
Emergencies
(CT-6)
(a) Bratislava
year No rates*
(1) (2)
n.a.
(b) Slovakia
year No rates*
(1) (2)
n.a.
Source & Definition:
Data are not collected
Reported AIDS Cases (CT-7)
All HIV + AIDS Cases IVDU Risk Factor % IVDU
(a) Bratislava
year No rate No rate %
1994 n.a. HIV+ 1 0.22 0.29
1995 n.a.
HIV+ 1 0.22 0.27
(b) Slovakia
year No rate No rate %
1993 HIV+ 42(6) 0.79 -
1994 HIV+ 51(9) 0.95 HIV+ 1 0.01 0.17
1995 HIV+ 65(12)
1.21 HIV+ 1 0.01 0.15
Source: Ústav preventívnej a klinickej medicíny; Štátny zdravotný ústav SR (Institute of Preventive and Clinical Medicine; State Health Institute of the Slovak Republic)
Definition: HIV+ = All cases which are HIV positive
Note: Numbers in parentheses denote patients with AIDS
*rates: (1) per 100.000 total population (all ages);
*rates: (2) aged 15-39 per 1.000 population aged 15-39
Drug-related Deaths
(CT-8)
(a) Bratislava
year No (excluding deaths rates* No AIDS deaths
from AIDS) (1) (2) (IVDUs)
Only data on country level
(b) Slovakia
year No (excluding deaths rates* No AIDS deaths
from AIDS) (1) (2) (IVDUs)
1993 6 0.11 n.a.
1994 12 0.22 n.a.
1995 14 0.26
n.a.
Source: Police Headquarters files.
*rates: (1) per 100.000 total population (all ages);
Note: In 1993 were 29 suicides in the country, where diagnosis had
been "alcoholism and other narcomania"; with dg. 304 were 4;
with dg. 305 were 5 suicides.
Police Arrests,
All Drugs
(CT-9)
Use-related Traffick Total Arrests % Use -
(a) Bratislava related
year No No No rates* %
(1) (2)
1993 n.a.
1994 43 0.001
1995(5 months) 130 0.03
(b) Slovakia
year No No No rates* %
(1) (2)
1993
1994
Source: Prezídium policajného zboru SR (Police Headquarters of SR),
Governmental Council
for Fight against Antisocial Activities
*rates: (1) per 100.000 total population (all ages);
*rates: (2) aged 15-39
per 1.000 population aged 15-39
Police Arests, by
Drug
(CT-10)
(a) Bratislava
year: 1992 1993 1994
No % No % No %
Cannabis
Heroin
Other Opiates n.a.
Cocaine
Amphetamine
Other Drugs
Total (100%) (100%) (100%)
(b) Slovakia
year: 1992 1993 1994
No % No % No %
Cannabis
Heroin
Other Opiates n.a.
Cocaine
Amphetamine
Other Drugs
Total (100%) (100%) (100%)
Source:
Definition:
Court Convinctions for Drug Offences (CT-11)
Total Persons Persons Convicted Drug Law Offences
Convicted for Drug Law as % from All
(a) Bratislava (all Offences) Offences Persons Convicted
year No
No %
1993 32.040 19 0.06
1994 33.865 88 0.26
1995(5 months) 11.866
182 1.53
(b) Slovakia
year No No %
1993 146.125 151 0.10
1994 138.117
426 0.31
Source: Governmental Council
for Fight against Antisocial Activities
Drug Law Offenders Sentenced to Imprisonment (CT-12)
Sentenced to Imprisonment in the Year In Prison During
the Year
% of All
Total DLOs Prison % of All Imprisoned DLOs in % Prison
(all ofences) Prison Population
(a) Bratislava
year No No % % No %
n.a.
(b) Slovakia
year No No % % No %
1993 32 9
Drug Misusers in the Prison Population (CT-13)
During Year % All Prisoners At One Time % Prison
(a) Bratislava Population
year No % No %
218 (10)
(b) Slovakia
year No % No %
1991 231
1992 265
1993 267
1994 271
1995 281 310 (58)
Source: Prison and Law Enforcement Directorate (Riadite¾stvo zboru väzenskej a justiènej stráže)
Note: - Numbers of all
persons receiving compulsory treatment within prison psychiatric
departments (including drug addicts)are in the left column
- Numbers in the right column signify capture of drug dependent
persons, mostly heroin cases in prison population (other
drugs are in parenthesis)
Quantities of Illicit
Drugs Seized
(CT-14)
Cannabis Heroin Cocain Amphetamine
(a) Bratislava
year
data
available only for country
(b) Slovakia
year : 1992 1993 1994 1995
cannabis 2.2 47 362.00 68 700.00 325 876.70
cocaine 0.25 1 505.00 - 25 709.40
heroin 66 200.00 4 281.00 300.30 120 949.80
morphine - 2 970.00 - 2 160.00
LSD - - - (13 tablets)
cannabis plants -
10.000 pieces - 17 pieces
Note: Amounts are in grams.
Source: Central Customs Service (1992-4). Criminology and Expertise
Institute of the Police Headquarters(1995).
Number of Seizures
of Illicit Drugs
(CT-15)
(a) Bratislava
year: 1992 1993 1994
No % No % No %
Cannabis
Heroin n.a.
Other Opiates
Cocaine
Amphetamine
Other Drugs
Total (100%) (100%) (100%)
(b) Slovakia
year: 1992 1993/94 1995
No % No % No %
Cannabis 164 20.0
Heroin 559 68.1
Other Opiates n.a. 7 0.9
Cocaine 24 2.9
Amphetamine 35 4.2
Other Drugs 32 3.9
Total (100%)
(100%) 821 (100%)
Source: Criminology and Expertise Institute of the Police (1995)
Definition: Numbers of
cases when analyses of seizures were requested and done
in 1995
Retail Prices of Illicit Drugs in ECUs per Gram (CT-16)
(a) Bratislava
Small Street-level Quantities Larger-Off Street Retail Quant.
Cannab Heroin Cocaine Amphet Cannab Heroin Cocaine Amphet
ECUs ECUs ECUs ECUs ECUs ECUs ECUs ECUs
year:
1994 data available
only on country level
(b) Slovakia
Small Street-level Quantities Larger-Off Street Retail Quant.
Cannab Heroin Cocaine Amphet Cannab Heroin Cocaine Amphet
ECUs ECUs ECUs ECUs ECUs ECUs ECUs ECUs
year:
1995
**2.1-2.6 21-39 65-78 2.6-13.1 data n.a.
*1.0-1.6
Cocaine : 2500 - 3000 Sk
Heroin : 800 - 1500 Sk
Amphetamins : 100 - 500 Sk
**Hasish : 80 - 100 Sk
*Marihuana : 40 - 60 Sk
Sk is "Slovak koruna" (1 ECU = 38.3 Sk)
Cocaine & Heroin in grams; Hasish & Marihuana = one dose (cigarette);
Amphetamins only estimated; according to the sort.
Mean exchange rate in 1995: 1 ECU = 39 Sk
Purity of Illicit Drugs
at User Level (CT-17)
(a) Bratislava
Heroin Cocaine Amphetamines
% % %
year
1994 data available
only on country level
(b) Slovakia
Heroin Cocaine Amphetamines
% % %
year
1994 45 to 65 % 50 to 70 60 to 70
13 to 40 %
Percentages in captured samples
Percentages in "street
samples"
Source: Prezídium
policajného zboru SR. Police Headquarters.
General Population Survey
Data (CT-18)
Description of survey:
data collection is described also in part B; representative sample
(n=1338) was gathered for Slovakia, with additionsl groups defined
for Slovakian youth (n=860)and for the Youth from Bratislava
(n=117). Specific information regarding scheme was not
gathered according sort of drug.
% of the sample: Ever tried drug Last 12 months Last 30 days
any drug(whole population) 6 - -
any drug(Slovakian youth) 10 - -
any drug(Youth from City) 16
cannabis non available
cocaine
amphetamines
LSD
heroin
other
Source: Ústav pre
výskum verejnej mienky (Institute for Research of Public
Opinion - Statistical Office of the Slovak Republic)
School Survey Data
(CT-19)
Description of survey: done at April 1995 within ESPAD; representative
sample of secondary school students, aged 15-16.
Size: 1261 boys, 1123 girls from whole country, and (581 boys, 287 girls were from Bratislava).
% of the sample: Ever tried drug Last 12 months Last 30 days
City Country City Country City Country
marihuana 23.9 9.0 18.1 6.0 11.3 2.8
inhalants 7.8 6.5 2.7 2.0 1.5 0.6
tranquilizers 6.4 4.4 n.a. - n.a. -
heroin 3.9 0.7 n.a. - n.a. -
LSD & hallucinogens 2.2 0.5 n.a. - n.a. -
cocaine 2.1 0.3 n.a. - n.a. -
amphetamines 1.6 0.7 n.a. - n.a. -
ecstasy 1.0
0.1 n.a. - n.a. -
Source: National Center for Health Promotion
State Health Institute of Slovak Republic
Institute for Health Education
Foundation Drug
and You
Other Survey Data (CT-20)
See additional tables and
graphs in Annexes II and III
A n n e x II
LIST
OF
FIGURES
1. Number of treated drug dependent patients in Slovakia: 1992-1995
2. Patients treated for inhalants or heroin use: Slovakia 1992-1995
3. Treated drug dependent persons according to primary
drug: Slovakia 1994-1995
4. Drug dependent patients treated for heroin and other opiates - Slovakia 1995(Bratislava and the rest of Slovakia)
5. Drug dependent patients treated for heroin and other opiates - Slovakia 1994-1995 (proportions of men and women)
6. Ways od drug application (comparison Slovakia - Bratislava 1995)
7. Treated heroin and opiates dependent patients by age and sex - Slovakia 1995
8. ESPAD survey - 9 secondary schools in Bratislava
9. Comparison of secondary
school students from Bratislava and Slovakia - ESPAD
A n n e x III
TABLES FROM SCHOOL SURVEYS
1. Overview of results in elementary school children
(with TDA1: "Tobacco-Drugs-Alcohol 1" questionnaire)
2. Overview of results in secondary school students
(with TDA2: "Tobacco-Drugs-Alcohol 2" questionnaire)
3. Overview of results in teachers
(with
TDA3: "Tobacco-Drugs-Alcohol 3" questionnaire)
Sources: - National Health Promotion Center: Coordinating Division for Drug Dependencies.
- Center for Treatment of Drug Dependencies in Bratislava
- State Health
Institute of the Slovak Republic
Tab. A OVERVIEW OF RESULTS IN ELEMENTARY SCHOOL CHILDREN
Overview of the results (in percentages) is as follows:
I T E M contents CITY WEST MIDDLE EAST
1. Father or grandfather are smokers 54,3 55,8 48,7 66,5
2. Mother or grandmother smoke 37,7 35,8 29,4 35,8
3. Parents give him/her drink with guests 16,4 14,9 18,0 23,1
4. He/she had tried to smoke 1 cigarette 21,5 31,9 17,7 27,0
5. At New Year toast he/she get champagne 61,7 71,6 63,9 63,4
6. Thinks that heroin is drug 92,5 94,3 88,6 90,4
7. Thinks that alcohol is drug 62,3 84,2 69,9 74,7
8. Adult offers him/her alcohol 29,1 30,7 30,1 25,3
9. Drinking at party with friends 8,1 13,7 8,2 10,5
10. Somebody from family drinks too much 20,5 33,4 23,1 30,3
11. Sibling or peer is smoking 23,1 31,0 13,3 20,9
12. Father drink a beer at home 87,0 84,5 85,1 90,4
13. Mother drink a little from beer 66,6 66,0 70,3 70,0
14. Child taste/drink a little from beer 69,7 71,0 72,5 77,4
15. The same for wine 60,5 66,3 62,7 60,6
16. Knows somebody, who is sniffing 18,4 7,5 3,8 14,9
17. Thinks it is convenient do drink 48,2 37,6 41,8 43,5
18. He/she would smoke in the future 7,1 11,0 6,0 11,8
Acording to age, growing percentages of 2nd, 4th a 6th graders:
- had tried to smoke at least 1 cigarette 19,7 17,4 29,7
- their friends or their peers smoke 17,4 16,3 30,6
- parents give alcohol as New Year toast 51,7 58,7 74,3
- another adult had offered alcohol 17,4 24,1 39,4
- taste, drink a little from wine 49,4 57,6 71,8
- taste, drink a little from spirit 12,4 14,4 33,2
- child felt drunkennes
to some extent 1,1 6,6 12,0
Notes to Tab. A:
Differences between boys and girls were found in items, which indicated that more boys and their friends had tried to smoke cigarette or are sniffing, and more had drunk alcohol during parties.
Age, sex and TDA1 data from 2514 children (1296 boys, 1218 girls; mean ages = 10,18, SD = 1,84; and 10,11, SD = 1,82, with span from 7 to 14) were entered into PC AT 386 by PSYDO (Psychological questionnaires) and MDS (MUMPS Discrete Statistics) programs. Frequencies of items were plotted by histograms for the whole sample, then data were sorted according to seat, age, gender and tested for significance by simple analysis of variance. Raw results for the City and three Slovakia's regions are as follows.
As for seven items added lated on, data indicated mainly growing in spirits tasting, and experiencing of drunkenness by age. Attempt to taste or drink a little from spirit had made: 12,4% of 2nd graders; 14,4% of 4th graders; 33,2% of 6th graders. Drunkenness had experienced: 1,1%; 6,6%; and 12,0% of them. Unfavourably high were also children's indications of involuntary smoking (29% of the sample was never exposed to indoor tobacco smoke; sometimes exposed was 57% of the sample; and often or daily 14%).
Definitely, it was clear, that experimenting with/or taking some drugs in school children are intertwinned problems. For example correlations of TDA2 items tapping occasional use of coffee and cigarette were 0.24; in items expressing belief that wine and beer with cigarette belong to the man it was 0.28; in smoking and drinking on school trips it was 0.35; and finally, occasional and regular tobacco smoking correlated with marijuana smoking from 0.37 to 0.42.
Also distributions of children's positive answers to question whether adults offer or force them to drink give us following interesting picture:
AGE 7 8 9 10 11 12 13 14 15 16 17 18 19
% 16 18 24 24 32 39 50 78 85 88 93 98 100
(The same is true for champagne offered by parents as a New Year toast:
AGE 7 8 9 10 11 12 13 14
% 52 52 57 60 67 75 83 90
It ought to be said that the objective of this survey study was to obtain as much and as actual data as possible. In order to make preventive actions goal oriented we ought to know target populations and to map rapidly changing situation in the capital of Slovakia and in other regions.
Teacher's results in Modified MAST indicated minimal involvement with alcohol, both in male and female, but those are results which probably are not very reliable because of unpleasant meaning associated with evaluative situation. Hence we tried to devise new method, named TDA3, constructed for teachers and preliminary results gave us more informations than traditional screening methods, where tendency to conceal real facts was evident.
Teacher's results
in TDA3 indicated mainly very poor knowledge of drug field and
lack of specific informations regarding hard drugs, but also
low ability, or unpreparedness to deal with so called gateway
drugs if their students would indicate problems (e.g. to answer
what is it for, where to get and approximately how to use nicotine
chewing gum, etc.).
Tab. B OVERVIEW OF RESULTS IN TEENAGERS
Data from 2347 teenagers (1387 girls, 960 boys; mean ages = 16,03, SD = 1,29; and 16,13, SD = 1,34 respectively, with span from 14 to 20) were evaluated in the same manner as above and results for three main regions of Slovakia are in the following table.
ANSWERS DEALING WITH TOBACCO AND COFFEE DISTRIBUTED AS FOLLOWS:
I T E M contents CITY WEST MIDDLE EAST
2. Smoking 1-2 cigarettes per month 26,0 25,6 16,9 13,6
3. Sometimes drinks coffee 49,6 64,7 44,4 41,0
4. Friend who smoke at least 1 per day 71,2 74,6 52,4 62,2
10. Thinks that cigarette belongs to man 10,9 9,0 8,6 8,4
12. Drinking 1-2 coffee per week 18,2 28,2 13,5 13,3
14. Smoking 1-2 cigarettes per day 11,9 13,5 8,9 6,0
15. Sect+light cigarette belongs to lady 11,6 11,6 7,2 14,7
29. Mother is a smoker 32,4 29,9 22,6 19,8
30. Father is a smoker 43,1 42,4 39,3 51,4
32. Smokes during school trips 17,9 20,1 12,9 9,0
42. Thinks majority of teachers smoke 72,8 82,5 71,9 77,4
ANSWERS DEALING WITH ALCOHOL:
1. Drinking is social duty at parties 38,2 36,3 45,3 42,4
6. Glass of wine or beer belong to man 23,5 21,8 31,2 29,1
27. Someone told he/she drink too much 14,1 19,2 14,3 12,5
31. Adults offer him alcohol beverages 88,0 96,7 88,3 81,0
33. Teacher offers him/her alcohol 13,5 21,1 6,3 5,7
34. Sometimes drink a glass before school 10,9 10,2 12,0 5,2
36. Drinks at the school trips 45,3 54,3 36,4 27,2
37. Drinks during school hours brakes 9,1 9,5 11,2 2,4
38. Go after school to drink with friends 23,5 25,1 23,8 16,6
43. Teacher under influence of alcohol 33,5 57,3 43,3 28,5
ANSWERS DEALING WITH ATTITUDES TO/AND OWN USE OF DRUGS:
13. Agree when forced to try marihuana 22,1 26,3 9,7 6,3
20. Marihuana should be freely in shops 20,8 18,0 11,5 4,6
21. He/she know what is Crack 31,1 43,8 32,4 9,5
22. Have friend who smoke marihuana 31,9 28,4 11,7 4,9
23. He/she know what is Pervitin 16,2 20,6 16,9 4,3
26. Have a friend who is sniffing 13,4 7,8 4,0 2,4
28. Smoked at least 1 marihuana cigarette 12,2 11,4 4,0 1,9
35. Knowing groups
of sniffers at school 18,2 8,8 10,0 2,7
Tab. C OVERVIEW OF TEACHER'S RESULTS IN TDA 3 QUESTIONNAIRE
Smoking - own attitudes & opinions % YES
1. Would you include antismoking education into Study schedule?................ 81.7
13. Smoking ban for teachers during school tuition might be, by your opinion, carried out successfully (without cheating) ?............................... 29.8
14. Will you be able to give up cigarette smoking during school tuition ?........88.6
Smoking - own knowledge
19. If your student want to know what is your opinion regarding nicotine chewing-gum, will you be able to answer and explain .....................66.6
Smoking - own usage
4. Are you personally a smoker ?.............................................. 23.7
7. While staying at school, do you smoke at least during one break ?........... 18.3
12. Do you smoke your first cigarette along with coffee in the morning
(or after breakfast) ?..................................................... 12.8
D1. How many cigarettes do you smoke daily ?
a) None b) 1-15 c) 16-25 d) 26 and more
% : 75.1 21.7 2.2 0.4
Smoking in students
24. Do your students smoke during school trips ?............................... 16.9
Alcohol - own attitudes & opinions
2. Do you think that teacher ought to be an example of normal behavior for students, hence he/she can drink socially?.................................. 73.1
18. Would you include antialcoholic education into study schedule ?............ 84.5
D3. How many beers do you consider to be nonharmful dose ?
a) None b) 1 beer c) 2 beers d) 3 beers e) 4-10
% : 11.8 39.1 33.0 6.1 2.2
Alcohol - own usage
6. Were you lecturing, at least one time, when under influence of alcohol beverage (including minimal dose, like toast, etc.) ?................................ 44.9
20. Does it happened that your colleague, or chief in private talk, told you that you drink too much ?.................................................... 2.4
Alcohol use in students
11. Sometimes at important occasion had you offered an alcohol beverage to your student ?.......................................................... 4.1
22. Do your students drink more alcoholic beverages during school trips than within the rest of school year ?...................................... 10.0
23. Had you noticed in some of your students was under influence of alcohol during school tuition ?......................................... 3.5
Drugs - own atitudes & opinions
10. Would you include antidrug education into study schedule ?................. 90.4
Drugs - own knowledge
3. Can you explain to your students what is Crack?............................ 36.0
16. When students ask you questions on altered states of consciousness after psychedelic drugs, will you be able to give answers?................. 49.7
21. Would you agree that marijuana belongs to so called "soft drugs" because it does not induce dependency ?.................................... 19.7
D4. Are you able to describe from what is composed Crack ?..................... 27.2
Drugs - use in students
8. Had you ever observed
a student being under influence of some drug during
school hours ?......................................................
8.1
Note to Tab. C
Survey done at the autumn 1994 by the National Center for Health Promotion (Alojz Nociar, Jan Krajèík); and by the State Health Institute of Slovak Republic (Jana Nováková).
TDA 3 has 35 questions. There were 2.265 teachers, who responded to the questionnaire (cca 60 by each of Slovakia's districts). There were 1855 females, 406 males -4 didn't write sex item-. Age range of the sample was 18-67 years. From the primary schools at village there was 1163 teachers, while from towns there was 1101 teachers.
Some results from
all abovementioned studies were used not only as an adjunct within
epidemiological data reviews or studies, but were embedded into
preventive programs used in anti-drug education at primary and
secondary schools, as well as in the work of various state health
care and prevention facilities and NGOs working at the prevention
field.