2. For all data are responsible experts who contributed them to the Report.
PART 1
NATIONAL STRATEGIES:
INSTITUTIONAL & LEGAL FRAMEWORKS 1
1. Developments in Drug Policy and Responses 2
1.1. Political framework in the drug field 2
1.2. Policy Implementation, legal framework and prosecution 7
a) Law and regulations 7
b) Prosecution policy, priorities and objectives in relation to drug addicts, occasional users, drug related crime 10
c) Any other important project of law or other initiative with political relevance to drug related issues 11
1.3. Developments in public attitudes and debates 11
1.4. Budgets and funding arrangements 15
a) Funding (figures) at national level in following fields: 15
PART 2
EPIDEMIOLOGICAL SITUATION
17
2. Prevalence, Patterns and Developments in Drug Use 18
2.1. Main developments and emerging trends 18
2.2. Drug use in the population 22
a) Main results of surveys and studies 22
b) General population 23
c) School and youth population 24
d) Specific groups (e.g. conscripts, minorities, workers, arresters, prisoners, sex workers, etc.) 25
2.3. Problem drug use 26
a) National and local estimates, trends in prevalence and incidence, characteristics of users and groups involved, risk factors, possible reasons for trends 26
b) Risk behaviours (injecting, sharing, sex…) and trends 27
3. Health Consequences 28
3.1. Drug treatment demand 28
3.2. Drug-related mortality 31
3.3. Drug-related infectious diseases 34
3.4. Other drug-related morbidity 35
a) Non-fatal drug emergencies 35
b) Psychiatric co-morbidity 35
c) Other important health consequences (e.g. drugs and driving, acute and chronic drug effects...) 36
4. Social and Legal Correlates and Consequences 39
4.1. Social problems 39
a) Social problems - social exclusion 39
4.2. Drug offences and drug-related crime 41
4.3. Social and economic costs of drug consumption 44
5. Drug markets 45
5.1. Availability and supply 45
5.2. Seizures 45
5.3. Price/purity 47
6. Trends per Drug 48
7. Conclusions 50
PART 3
DEMAND REDUCTION INTERVENTIONS
51
8. Strategies in Demand Reduction at National Level 52
8.1. Major strategies and activities 52
8.2. Approaches and new developments 54
9. Intervention Areas 56
9.1. Primary prevention 56
9.1.1. Infancy and Family 56
9.1.2. School programmes 57
9.1.3. Youth programmes outside schools 64
9.1.4. Community programmes 65
9.1.5. Telephone help lines 65
9.1.6. Mass media campaigns 66
9.1.7. Internet 67
9.2. Reduction of drug related harm 68
9.2.1 Outreach work 68
9.2.2. Low threshold services 69
9.2.3. Prevention of infectious diseases 71
9.3.1. Treatments and Health care at national level 73
9.3.2. Substitution and maintenance programmes 80
9.4. Aftercare and reintegration 89
9.5. Interventions in the Criminal Justice System 89
9.6. Specific targets and settings 97
10. Quality Assurance 101
10.1. Quality assurance procedures 101
10.2. Treatment and prevention evaluation 101
10.3. Research 106
a) Demand reduction research projects: 106
b) Relations between research and drug services 106
c) Training in demand reduction research 110
10.4. Training for professionals 112
PART 4
KEY ISSUES
114
11. Infectious diseases 115
11.1. Prevalence of HIV, HCV, and HBV among injecting drug users 115
11.3. New developments and uptake of prevention, harm reduction and care 119
12. Evolution of treatment modalities 122
12.1. Introduction 122
12.2. Legislation/regulations that had an effect on a treatment provision 122
ANEX 1 129
References 129
ANEX 2 137
Drug Monitoring Systems and source of information 137
1. Evolution 137
2. Legislation 138
3. Sources of information 139
3.1. Epidemiology 139
3.2. Demand reduction 140
3.3. Documentation centres 140
ANEX 3 141
List of Abbreviations 141
ANEX 4 142
List of Tables 142
ANEX 5 144
List of Figures 144
ANEX 6 146
List of Institutions 146
ANEX 7 153
Standardised Epidemiological Tables 153
1. Developments in Drug Policy and Responses
1.1. Political framework in the drug field
Use and misuse of heroin, cannabis and other illegal drugs have been present in Slovenia since 1960s. Until 1990s it has been believed that illegal drug use is not a considerable problem in Slovenia. Becoming an independent country we have soon recognised drug problem as a topic of high priority. Rising HIV epidemic in some neighbouring countries among intravenous drug users has resulted in reconsideration of existing policies. In 1992 the National Programme was accepted in Parliament and the National Committee for the Implementation of National Programme for the Prevention of Drug Misuse was established.
The Coordination of Centres for the Prevention and Treatment of Drug Addiction and the Supervising Committee were formed at the Ministry of Health to guarantee a good realization and supervision.
Drug Information System in Slovenia has been developing since 1991 in agreement with the Pompidou Group methodology and Phare DIS Programme. The National Public Health Institute has been the chief actor in drug data collection. Nevertheless, we had also done some activities before.
FTD data has been collected since 1991 in the Centre for the Prevention and Treatment of Drug Addiction Koper and systematically since 1996 in all CPTDAs.
The decision was made at the ministerial level that the Ministry of Health would act as the Slovenian Focal Point, cooperating with the National Public Health Institute in connection with epidemiology in 1994.
Legal basis is now in the Act on prevention of drug consumption and treatment of drug addicts (Official gazette 98/99).
But out of nine gathered reported aids cases in Slovenia in 1999 there was only one with the history of possible intravenous drug use.
Several hundred intravenous drug users have been voluntarily and confidentially tested for HIV in recent years and only three have been found infected. However, the present low prevalence of the HIV infection among intravenous drug users may increase rapidly whenever and if HIV is introduced. Therefore HIV harm reduction interventions related to unsafe intravenous drug use and unsafe sexual behavior among drug users are considered a high priority within the National AIDS Prevention and Care Program.
That is why a network of fifteen regional centers for the Prevention and Treatment of Drug Addictions has been established since 1995 and the professional staff working at the centers has received an additional training. These facts might also contribute to low HIV prevalence in this population, together with introduction of substitutive treatment a few years earlier.
Within the framework of the UNDCP we are participating in the Sub-regional Programme involving six projects. The countries that are taking part in it are Poland, the Czech Republic, the Slovak Republic, Hungary and Slovenia. The Government of the Republic of Slovenia has verified and signed the Memorandum on Cooperation on these projects, although it has not yet approved the projects or participants. We have not yet received any training from the UNDCP nor have been offered any assistance in equipment.