Alcohol, tobacco, gambling, sugar, social media, video games, or methamphetamine. Experts discussed various addictions and methods of their prevention, regulation, and treatment at the international conference AddictCZSK, held under the auspices of the Ministry of Health of the Slovak Republic.
The European market has high drug availability, with new forms and methods of use emerging, including a trend of smuggling through smaller ports. Dr. Liesbeth Vandam from the newly established European Union Drugs Agency (EUDA) pointed this out, adding that significant amounts of synthetic drugs are produced directly in Europe. In recent years, hundreds of illegal laboratories have been discovered, mainly producing methamphetamine and amphetamine, and to a lesser extent, cocaine.
According to Dr. Vandam, the development of monitoring, warning systems, a network of forensic and toxicological laboratories, and international cooperation is crucial to maximize the ability to respond to the drug situation.
Two Pillars of Regulation
“The most common causes of death currently in the Czech Republic and Slovakia are smoking… Followed closely by alcohol, which has even broader social impacts on families and communities,” said Jindřich Vobořil, Chairman of the Board of the Institute for Rational Addiction Policies, advisor to the Czech Prime Minister, and former National Drug Coordinator.
He noted that more attention is given to illegal drugs, even though alcohol, smoking, and gambling are far more widespread problems, with digital addiction now being added to the list.
A regulated market should stand on two pillars, he explained: not only the well-known regulations of availability, price, and advertising but also the substitution of alternative, lower-risk products. The harm reduction approach, which in the case of tobacco includes supporting less harmful alternatives such as e-cigarettes or nicotine pouches, has proven effective in managing nicotine addiction.
The Czech Republic and Slovakia partly share a vision of modern regulation that protects vulnerable groups while offering less harmful alternatives for adults. This approach draws inspiration from Sweden, the country with the lowest smoking rates in the EU.
Slovakia has already adopted regulation for nicotine pouches based on the Czech model, and the Slovak parliament is currently discussing broader regulation of nicotine products.
The harm reduction approach (e.g., supporting less harmful alternatives like e-cigarettes or nicotine pouches in the case of tobacco) has shown to be effective in managing the impacts of nicotine addiction.
“The European Union still approaches the regulation of addictive substances inconsistently. Alcohol, which has a high addiction potential and significant health risks, is widely available and inadequately regulated. In contrast, the non-medical use of other psychoactive substances is prohibited, and users of such substances face strict legal penalties,” explained Viktor Mravčík, a member of EUDA’s board and a physician.
“This imbalance does not reflect the actual risks of individual products, undermines trust in established regulations, and prohibition-fueled illegal markets weaken the rule of law. The EU should adopt a modern approach based on harm minimization while considering the relative risk of substances. A new regulatory framework for so-called psychomodulatory substances could serve as a model for the entire EU,” he added. The Czech parliament recently passed the so-called Psychomodulatory Law.
Interventions by Doctors
“We are failing with legal drugs, which cause 90 percent of health, economic, and social damages. Do we have specific goals? Are there links to scientific approaches? Does the allocated financial support enable the fulfillment of these goals?” asked Ladislav Csémy, a psychologist from the National Institute of Mental Health in the Czech Republic. Based on research, Csémy, the President of the Harm Reduction Academy, recommends interventions by general practitioners for alcohol users, as the costs are lower than the potential savings. However, it is essential to ensure political and financial support for these programs, as well as to train and convince doctors.
Jakub Popík from the Sociological Institute of the Slovak Academy of Sciences argued that Slovak drug legislation was primarily driven by fear rather than data. “While the Czech Republic is often referred to as a methamphetamine powerhouse, in the early 1990s, we were a heroin powerhouse and one of the largest transit hubs.” He added that the topic of drugs is often misused in political marketing.
Digital Addictions
Former MEP Mikuláš Peksa highlighted the emerging phenomenon of digital addiction. “It is somewhat different, even more personal, as digital companies precisely individualize content for individuals. In contrast, every molecule of ethanol in alcohol is the same.” He stressed the need for legislation to address the impact of large digital platforms on mental health. Professor Gabriele Fischer from the University of Vienna added that while most countries regulate gambling, they do not regulate video games, whose developers hire specialists to increase addiction.
The AddictCZSK conference was organized by the Institute for Rational Addiction Policies, the Prima Civic Association, and the Harm Reduction Academy.
The article was published on 25/11/2024 in Slovak Hospodárské noviny.