The Czech Republic has one of the world’s most progressive drug policies. Whilst this progressiveness has not necessarily led to wide spread decriminalisation across the board into the present day, it has more noticeably taken the form of a very pragmatic approach to informing drug legislation. Dialogue concerning drug reform has always been dogged by the tendency of entering into the realms of anecdotal, non-sequacious misinformation. In the Czech Republic, however, such dialogue and thinking has always been conducted with strict regard for the evidence emanating from the medical community, and frontline NGO experts in drug dependency.

After the ‘Velvet Revolution’ of 1989, which freed the Czech people from the manacles of the Soviet Union, there was little to suggest that the new Czechoslovakia would become a byword for evidence-based drug policy making. Under Soviet rule little time or money was expended considering the affects of drug use. Notionally the Communist party sought to glaze over the latent drug problems in the country, claiming either that the escapism afforded by drug abuse was only attractive to people not living under the auspices of the perfect Communist system, or that drug users were corrupted by Western degeneracy. However, the fact that there was an emerging drug culture throughout much of the country – mostly dominated by Pervitin dependency – was not lost on the intelligentsia or medical community on whose shoulders it now weighed as they sought to govern their country for the first time in over forty years. Dr Jaroslav Skála can be credited with setting the framework for the kind of legislation that would emerge after 1989. His drug treatment centre in Prague was established in 1948 and brought a more humane approach to drug treatment in the country, with patients and doctors working cooperatively to find the best ways to overcome addictions. Further to this he was instrumental in backing the country’s first needle exchange program and substitution therapies in 1987. Unsurprisingly, many of the experts who worked on the first Czech drug policies had worked with Skála, or were profoundly influenced by him.

In a political climate that demanded greater liberty then was permissible under Soviet rule, the penal code with regard to drugs was amendment in 1990 to remove possession of drugs as a criminal offense, whilst maintaining criminal sanctions for smuggling, selling, and ‘propagation of drug use’. However, by 1992 it became clear that drug use in the Czechoslovakia was on the rise now that the fall of the ‘Iron Curtain’ had opened the countries borders for increased drugs trade. This in turn was putting a strain on health providers who were becoming unable to satisfactorily help those who required drug related treatments. The issue was also becoming more visible in all strata of society, and the electorate were becoming concerned. This changed outlook prompted the 1992 ‘Christmas Memorandum’. This took the form of an open letter to government demanding a better structured and funded response to the country’s growing drug-related health needs from NGO-based health providers. It was an indication the NGO sector was ready to lead the fight in providing health services and harm prevention functions if the government could provide some funding and offer some kind of institutional structure. The letter bemoaned the “lack of detoxification treatment and rehabilitation facilities for drug addicts” whilst insisting that little would be achieved “without the underlying policymaking, technical, legislative and organizational involvement of the governmental sector, and particularly without drafting a fundamental framework drug policy”.

Within a few short months of this letter being published, the government responded by establishing the National Drug Commission who in turn drafted up the ‘Drug Policy Concept and Program for 1993-1996’. This would go on to become the first drug policy of the Czech Republic after the 1993 splitting of what was previously Czechoslovakia. The quick response time to the ‘Christmas Memorandum’ emphasises the faith placed in the NGO sector by the Czech government. By way of contrast one might consider the Brown administration’s response to Dr David Nutt’s revelations that LSD and ecstasy were less dangerous than alcohol in 2009. Nutt, who was chairman of the Advisory Council on the Misuse of Drugs, far from having his carefully researched opinions bound into legislation, was asked to resign the following day. More evidence to support the anomaly in UK drug-policymaking that if the evidence does not support policy it is not to be made public, nor is it to be considered. The Czech Republic has succeeded in not falling into this trap.

The new Czech policy, in keeping with the 1990 amendment, advised against enforcing criminal penalties on drug users and made clear the need for proper health services and harm reduction services for drug users. In addition to this, the report found that NGOs would be crucial in establishing and providing these health services on the ground. The government response had delivered not only a focussed policy program, but also a budget to deliver health services, and a leadership structure of competent experts. Dr Kamil Kalina became the country’s first national drug coordinator shortly after the NDG published it’s recommendations. It is a testament to the pragmatic approach adopted by Czech legislators that Kalina had spent much of his professional career working in a frontline NGO devoted to giving addiction health services, he was also a vocal supporter of the methods and mindset pioneered by Skála before him.

After the establishment of the NDC and the drug policy-making sub-structure, the mid 1990s heralded a difficult time for Kalina and his successor Dr Pavel Bém. With drug use becoming noticeably more visible, particularly in urban areas, the political atmosphere with regard to drugs became tense. International institutions like the UN and the International Narcotics Control Board were putting considerable pressure on the Czech government to conform to a more repressive drug policy, one more in keeping with international trends. Both the Christian Democratic Party and the Communist Party sought to capitalise on the increasing political hysteria surrounding the subject by submitting draft legislation for far-reaching repressive drug policy reforms. It was at this time that the Czech Republic came closest to falling victim to the false morality of sensationalism with regard to drugs, political parties started running campaigns in which they promised to deal with ‘junkies’ and the rhetoric that has succeeded in demoting drug-users to second class citizens in many countries almost came to prevail here too. In light of this pressure, and possibly seeking to mitigate the extreme proposals coming from other political factions, the government passed a penal code amendment in 1998 that criminalised drug possession in amounts that were considered ‘greater than small’. This categorisation was left deliberately ambiguous in order to have an implicit distinction in the eyes of law enforcement between the gravity of possession in differing amounts, and more crucially, to uphold the legal precedent of having some possession offenses which would not be prosecuted at all. Alongside this new legislation, Dr Pavel Bém decided that there should be a major scientific evaluation of the new legislation that would assess whether the increased criminalisation was having the desired effect.

This decision, more then any other, demonstrated the unerring commitment of the NDC to having evidence-based legislation which was informed by properly researched fact, not sensationalised media testimony. The study, carried out by Dr Tomáš Zábranský, was called Impact Analysis Project of the New Drug Legislation (PAD). It aims were to assess whether drug criminalisation affected the following factors: availability of drugs, numbers of people using drugs, numbers of people initiating drug-use, health consequences of drug-use, and social cost of drug-use. The study was carried out by a team of appropriate experts, and the whole process was overseen and reviewed by two American professors whose role was to evaluate the validity of methodology and due diligence to data. Zábranský and his team’s findings concluded that; the availability of drugs did not decline, numbers of people using drugs had increased, the law did not work to reduce initiation of new drug-users, adverse health consequences related to drugs had increased, and they made a modest estimate of the social cost of the 1998 amendment at around 37m Czech crowns. In essence, PAD exposed the new legislation as costly, ineffective, and bereft of beneficial health impact. Further to this, the authors of the report were adamant that distinction was needed in law between the severities associated with different types of drugs.

Once more showing admirable consideration of expert scientific opinion, in 2001 the government ordered the Ministry of Health to ready a team of medical savants to consider this recommendation. Ultimately, and after much research in tandem with Zábranský and other PAD experts, the panel suggested to government a three-tier system of classification. This system would distinguish between; cannabis (and other THC containing products); MDMA, LSD, and Mushrooms; and finally all other illicit drugs. This suggestion, despite support from the NDC, was met with hostility from the Ministry of Justice and eventually the government moved forward with legislation that distinguished in two categories between cannabis and all other drugs - this came into affect in 2010. At face value the Czech Republic drug legislation is not so different from many other fairly progressive European states, it is not the nature of the laws that offers such a good example to other countries, but the process through which they were implemented. Rigorous research, coupled with scrupulous peer-review has paved the way for evidence-based drug policy to endure in the Czech Republic and offers a good model for other states to copy. Not only has their attention to pragmatism delivered them from the frenzied sanctimoniousness of those prefer the incidental to the evidential, it has provided them with the means of saving lives. Many ex-Soviet powers have been waging war on crippling HIV epidemics since emerging from behind the Iron Curtain, the Czech Republic has faired well thanks to its attentiveness to those who actually know most about preventing such spreads. Readily available medication-assisted therapies for those struggling with dependence, and a high-profile needle exchange program have been crucial to this relative success. Czech society has reaped a myriad of benefits from succeeding in listening to those best informed about drug policy where many other states have failed. The UK, in particular, has long shown contempt for evidence about drug-use where the evidence does not support proposed policy. It can’t be right, and Czech policy-making exemplifies how it can work another way.

To find out more about Czech drug policy, read Joanne Csete's brilliant report.