By Jindřich Vobořil
It is time to change the Czech’s approach to alcohol and tobacco, integrate new phenomena and be more active on the international scene
Prague, 28.6.2018 – At a symposium on the future of Czech drug policy the national drug coordinator Jindřich Vobořil presented the orientation and tasks of the new National Drug Policy Strategy for the period 2019-2027. For the last eight years Jindřich Vobořil has worked at the Department of Drug Policy of the Office of the Government and in the Government Council for Drug Policy Coordination. Now he is leaving the position and on this occasion he calls for/urges for a new approach towards the issue of drugs. He rejects the tendency towards repression and prohibition and advocates a principle of harms and risk minimization. He also addresses the issue of taxation of legal drugs, to decrease the accessibility of alcohol and tobacco to minors and provide targeted prevention and help for people with addictive behaviour problem. The National Drug Policy Strategy will also monitor the phenomenon of pharmaceutical overuse and addictive behaviour in the area of new technologies.
MAIN THESES OF THE NATIONAL STRATEGY FOR 2019 – 2027
1. The policy is based on monitoring and examples of best practice
The National policy will stand on clear analysis of monitored data and will search for the optimum solution with a balanced approach to regulative measures and the range of prevention and treatment on offer. On the basis of evidence, a state budget shall be created for this area in cooperation with local government and health and social insurance systems.
2. Minimising harm and risks
The impacts of a fully unregulated market are clearly the highest in terms of society costs. Similarly, a policy of over-regulation and prohibition is also highly risky. National policy will therefore be driven by the basic need to minimising harms and risks based on scientifically recommended practices. This means that it will regulate accessibility and price, while also creating conditions for preventive and curative measures, early detection and early intervention for individuals at risk of or with a problem as concerns addictive behaviour. The NS will also focus on creating conditions for the most effective penetration of the hidden population and the motivation of the risk groups of the population to cooperate with the helping institutions.
3. Balanced approach
Excessive repression brings with it unwanted consequences that outweigh intended protection of public order, public health and public resources. A balanced approach anticipates a balance between regulation / repression and preventive / curative interventions. This approach must be specifically reflected both in legislation and financial resources. Provisional predominant expenditure on repression should be balanced against prevention. Regulatory approaches based on legislation must be balanced by the range of help on offer. Regulation by high prices (excise duty on alcohol and tobacco) as recommended generally and by the WHO should be offset by the harm reduction approach, i.e. disadvantaging and the high price of tobacco should allow the market to "favour" and lower risk substitute products, etc.
4. Integrated approach of policies
The Czech Republic is the 11th EU country to decide not to base its policy on the legal status of individual substances, but takes into account that this is a disorder generally known as addictive behaviour. That is why the Czech national policy decided to deal with so-called illegal drugs together with legal drugs such as alcohol and tobacco, as well as the issue of gambling. In this respect, the NS will continue to follow up on future periods and action plans. NS will be open on other topics such as the problem of pharmaceutical abuse or the new phenomenon of addictive behaviour in the environment of new technologies. The addictive behaviour policy must perceive the interconnection of issues of availability and use of different types of addictive substances, both legal and illegal, and their interaction.
5. Nation policy shall be managed in coordination
Due to the numerous areas where repression and prevention, the free market and its regulations, significant tax and social impacts, state and local government policies, the problem of so-called departmental insularism, the educational role of education with intermingling social and health issues overlap, the NS requires coordinated management. This means that governments will give attention to these topics at the highest level for the duration of the NS. All relevant government ministers will guarantee their duties based on the AP of this NS, will work together for effective funding, and will work on the tasks at hand with government coordination mechanisms.
6. Preparing for the change in the concept of international control
Over a period of ten years, the national policy will notice and react to the approaching changes in world policy towards mitigation and the tendency to end the full prohibition of certain substances such as cannabis, coca leaves, cocaine, opium tinctures and other opioid preparations, or MDMA, etc. In this respect, legislative and policy changes so as to preserve the principle of minimising harm and risks. With respect to perceiving these changes, it is necessary to take into account the results of successful policies around the planet on the basis of regulation of the available market, such as successful tobacco or alcohol control policies, and to support and transpose these experiences to regulatory policies for some currently illegal substances. In this sense, the NS will seek an ideal compromise, avoid the pendulum effect and a completely uncontrolled open market.
7. Principle of empowering local government
National policy will transfer significantly more capacity and competence to local government, including sharing the principle of coordinated decision-making on the joint financing of local policies, as well as enhancing the potential for increasing the strength of municipal by-laws.
8. Principle of the participation of professional associations and non-governmental organizations
National policy will continue to work with relevant professional associations and non-governmental organizations active in the prevention, risk and harm reduction and treatment of addictive behavior in the process of drug policy setting and development, drug policy evaluation and implementation of Action Plan activities. The professional associations and non-governmental organizations will be represented in the drugs policy coordination authorities at all levels - from the Government Council for Drug Policy Coordination (GCDPC) and its committees and working groups to local level advisory bodies. National policy will support the creation of patient organizations in the field of addictive behavior, that are a partner in the implementation of changes in the health care system in the Czech Republic, and a significant partner in the implementation of drug policy measures abroad.
9. Principle of sharing responsibility
The National Policy for the prevention of harms and risks related to addictive behaviour will take into account that it cannot be expected that this phenomenon may be addressed only within the borders of the Czech Republic. The Czech Republic must therefore be an active player on the international scene. Here, especially in the area of ilegal drugs, the increasing polarization of the world is clearly visible. Some countries perceive the need for a rational and evidence-based policy which is a clear departure from harsh repression to a harm reduction policy. The Czech Republic plays a significant role due to its policy of decriminalization of drug users with a very positive result in this respect. On the other hand, some countries have already clearly crossed all the boundaries of acceptable consensus both within existing drug conventions, in particular the United Nations Single Convention on Narcotic Drugs of 1961, and for instance in the area of international human rights conventions. This includes unprecedented executions without trial, long-term imprisonment for minor offences, deployment of the army and destabilisation of part of the state services, or prevention of access to lege artis treatment and unprecedented, unnecessary and globally threatening HIV / AIDS and HepC epidemics among intravenous drug users. In this respect, it is necessary to initiate changes on the basis of clear evidence in the perception of international conventions, advocating an evidence-based policy that respects fundamental human rights, and advocating for a possible amendment of the Conventions or complementing them in view of their long-term unsustainability. In the event of a failure to change the perception of the repressive role of the Conventions, the Czech Republic should consider whether to remain a signatory to these conventions. The Czech Republic will therefore promote the principle of rational, humane, evidence-based and integrated drug policy at international level.
10. Human freedoms vs. protection of the inhabitants of the Czech Republic
The national policy will take into account the health of individuals as well as their fundamental rights and freedoms. In the situation of mandatory and thus public health and social insurance, it is necessary to take into account the impacts on public budgets, including public insurance. In this sense, both the national and international policy of the Czech Republic will sensitively consider the tension and degree between the necessary preventive regulations and the freedom of individuals, respect of fundamental human rights or the principle of a free market.