Addiction is not just about drugs. Its roots run much deeper—into the social and economic environment in which people live. At the AddictCZSK international conference in Bratislava, experts called for a fundamental shift in how we approach illicit substance use.
“People’s health is not just influenced by what they do but also by the environment they live in. Housing, education, employment, and social policies all play a crucial role,” emphasized Aileen O’Gorman, a professor at the University of the West of Scotland. She warned that simply restricting access to drugs will not solve the problem. “If we do not offer people an alternative, we are only pushing them into greater risks,” she added.
Prohibition is Failing, Europe Needs a New Approach
Speakers agreed that a repressive approach does not work. While some European countries are trying to balance repression with prevention, others are tightening restrictions—and in these places, drug-related deaths are increasing.
“In the UK, drug policy has shifted away from harm reduction and toward abstinence. The result? We now have some of the highest drug-related mortality rates in Europe,” O’Gorman explained.
In Czechia and Slovakia, the numbers are still relatively low—6 deaths per million people in the Czech Republic, 5 per million in Slovakia. In contrast, in Scotland, 240 deaths per million are linked to drug use. “Of course, the question is whether drug-related deaths in Slovakia and Czechia are reported as rigorously as they are in the UK,” she noted.
According to O’Gorman, it is essential to understand that addiction is not just an individual problem—it is shaped by social conditions. “Over the past 15 years, social support in the UK has been drastically reduced. If you lose your job, it is easy to become homeless. And when you’re homeless, overcoming addiction becomes even more difficult,” she explained.
Slovakia Lags Behind in Accessibility of Services
While some countries are expanding harm reduction services, Slovakia lacks a systematic approach to supporting people with problematic drug use. Sabína Lužica Brédová from the PRIMA civic association which co-organized the AddictCZSK conference highlighted this gap.
“The drug market is changing, new psychoactive substances are emerging, but our legislation still only allows for the most basic harm reduction services. This prevents us from effectively responding to new challenges.”
One of the biggest issues is the lack of access to substitution therapy. “People have to travel long distances to access treatment, and in prisons, substitution therapy is practically unavailable,” Brédová noted. Another problem is drug testing—Slovak laws do not allow for some of the most advanced detection methods.
Positive Change Does Not Have to Mean Abstinence
According to Dominika Jašeková, director of the Odyseus civic association, the primary goal of harm reduction services is to support any positive change in users’ lives—which does not necessarily mean complete abstinence. “When we started needle exchange programs in 1997, our main goal was to prevent infections. Today, our services are much broader,” she explained.
Odyseus focuses not only on safer drug use but also on education about the risks associated with sexual behavior. Their services include condom distribution, drug testing, and individual counseling.
“Testing allows people to know exactly what they are consuming. Often, after a test, they decide not to take the drug or adjust their dosage, which can prevent overdoses,” Jašeková added.
Another critical part of harm reduction efforts is community centers, which provide a safe space for individual support. “Homeless people come not just for counseling but also for a quiet place where no one will throw them out,” Jašeková said.
Recently, personal assistance programs have also been introduced, where outreach workers accompany drug users to medical facilities or government offices. “People with a history of drug use often face discrimination and don’t know how the system works. That’s why personal assistance is crucial,” she explained.
What Next? Changing the Approach, Not Just the Laws
Experts agreed that reforming drug policies is not just about changing laws—it requires a fundamental shift in the entire system. The current repressive measures are ineffective, and Europe needs a modern, evidence-based drug policy that focuses on helping rather than punishing.
“It’s not enough to tell people to stop using drugs. If they don’t have better living conditions, they will continue to use. We need a system that offers meaningful alternatives and gives people a real chance for change,” concluded Aileen O’Gorman.
Less Punishment, More Support
The AddictCZSK conference highlighted that prohibition and repression are not working. Experts are calling for a shift toward prevention, improved service accessibility, and a more systematic approach to harm reduction. The goal is not just to reduce drug use but to minimize harm and offer people real pathways out of addiction.
Reframing addiction as a social issue rather than just a criminal problem could mark a turning point—not only for drug users but for society as a whole. The first step toward a more effective drug policy is recognizing that people struggling with addiction need help, not punishment.