Report on Alcohol in the Czech Republic 2021

Overview of the current alcohol situation in the Czech Republic

The Situation Overview summarises the Alcohol in the Czech Republic Report 2021, which was published in March 2022. The report is part of an information pack of annual reports on the situation in the field of addictions in the Czech Republic. These reports are published in the Czech language. A summary of some of them is also available in English, as in this report on the alcohol situation.

Contents

The public health significance of alcohol use

Alcohol policy

Alcohol supply and the alcohol market

Alcohol use among children and young people

Alcohol use in the adult population

Health consequences of alcohol use

Social consequences and context of alcohol use

Alcohol-related crime

Alcohol prevention programmes

Brief interventions and treatment for alcohol users

Harm reduction services for alcohol users

Impact of COVID-19 on alcohol use

 

Public health importance of alcohol use

• The impact of alcohol on the overall health burden is considerable - alcohol is one of the leading causes of morbidity and premature mortality in developed countries, including the Czech Republic.
• Alcohol contributes to more than 200 diseases. Cardiovascular diseases, neoplasms, gastrointestinal diseases (especially liver diseases) and external causes of morbidity and mortality such as accidents, injuries or poisoning account for the largest share of the health burden of alcohol. Alcohol is also a common cause of harm in the user's environment (fetal alcohol syndrome, violence, accidents, loss of productivity, etc.).
• There is a clear correlation between the amount of ethanol contained in the alcohol drunk and harmful health outcomes, and any amount of ethanol is harmful to health. From a health perspective, it is the amount of ethanol consumed that is important, not the type of alcoholic beverage.
• Any amount of alcohol (i.e. as little as one drink per day) poses a risk of negative consequences and no amount of alcohol can be recommended as beneficial or considered safe.
• The average daily consumption of more than 20 g of ethanol for women and more than 40 g of ethanol for men is considered to be risky drinking. Harmful drinking (with a high risk of health consequences) is considered to be an average daily consumption of more than 40 g of ethanol for women and more than 60 g of ethanol for men. Consumption of large quantities of ethanol on a single occasion (binge drinking) poses an additional risk.
• A standard dose of alcohol (a standard glass), i.e. 0.5 l of beer, 2 dl of wine or 5 cl of 40% alcohol, contains 10-20 g of ethanol. Drinking on average more than 2-3 glasses per day for men and 1-2 glasses per day for women can therefore be considered risky (4 or more glasses for men and 2 or more glasses for women on average per day can then be considered harmful drinking). Binge drinking is defined as drinking 5 or more glasses on one occasion.
• The Czech Republic is one of the countries with the highest average alcohol consumption per capita. On average, the Czech Republic consumes 10 litres of ethanol per capita per year, which corresponds to approximately 22 g per capita/day, including children and the elderly. The incidence of binge drinking is also among the highest in the world.

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Alcohol policy

• Alcohol policy is part of the country's addiction policy, which since 2014 has integrated the topics of legal and illegal substances and non-substance dependence. Responsibility for its development and implementation lies with the government. The Government's coordinating and advisory body on addiction issues is the Government Council for Coordination of Drug Policy (GCCDP). The main strategic document determining the focus of the addiction policy is the National Strategy for Prevention and Reduction of Harm Associated with Addictive Behaviour 2019-2027 and its Action Plan for 2019-2021, which also include targets and activities for alcohol.
• There is international expert consensus on 5 main recommendations for effective policies to reduce the negative impacts of alcohol consumption: (1) increasing the price of alcohol through excise taxes and pricing policies, (2) limiting the availability of alcohol, (3) banning or extensively restricting alcohol advertising, (4) availability of screening, brief interventions and treatment, and (5) measures against drink driving. Some of these international recommendations are not consistently applied in the Czech Republic.
• Responsibility for different parts of alcohol policy falls under different ministries (as per the above 5 recommendations): (1) the area of pricing policy and taxation under the Ministry of Finance (MoF), (2) the area of alcohol as a commodity under the Ministry of Agriculture (MoA), (3) the area of advertising under the Ministry of Culture (MoC) for audiovisual broadcasting and under the Ministry of Industry and Trade (MoIT) for other advertising, (4) the area of prevention and treatment under the Ministry of Health (MoH), (5) the area of alcohol in transport under the Ministry of Transport (MoT) and the police.
• This complicated division of responsibilities makes it difficult to implement an effective alcohol policy and highlights the need for inter-ministerial coordination.

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Alcohol supply and market

• The availability of alcoholic beverages is very high in the Czech Republic. Alcohol can be sold by law at any time of the day or night and in many places, in any grocery store, food stalls, public transport, petrol stations, etc. A licence is required for the production, sale and serving of spirits, which can be applied for by any entrepreneur over the age of 18 with a clean criminal record. The sale of other alcoholic beverages is a free trade.
• Home production of spirits is prohibited by law; beer or wine can be produced at home up to 2000 litres per household. The Czech specificity is the so-called grower distilleries, where growers can have a limited amount of fruit spirit made from their own fruit.
• The availability of alcohol is restricted by law - there is a ban on the sale of alcohol to minors, a ban on remote sales of alcohol unless the purchaser's age can be verified, a ban on the sale of toys imitating the shape and appearance of alcoholic beverage packaging, a ban on the sale or serving of alcohol in health care facilities, schools and educational establishments, social and legal protection of children, and at events for persons under 18. At the same time, the law regulates the occasional sale of alcohol and eases or removes restrictions for a number of public events.
• Municipalities may, through general binding ordinances (GBOs), prohibit the consumption of alcohol or restrict or prohibit the sale and serving of alcohol in publicly accessible places or restrict the operation of hospitality establishments. In 2015-2020, according to MV records, 548 OZVs were issued, of which 86 regulated the operating hours of hospitality establishments. Out of 27 statutory cities, 25 cities regulated the consumption, serving or sale of alcohol, with the exception of Teplice and Plzeň (7 statutory cities regulated the operating hours of hospitality establishments).
• All packages of alcoholic beverages must indicate the ethanol content in percentage by volume. The indication of nutritional values is optional in the European Union and the Czech Republic. The indication of the composition of alcoholic beverages is generally optional in the EU, but some countries do indicate the composition on spirits. For products manufactured in the Czech Republic, the indication of the ingredients is mandatory. Warning of the risks and harm caused by alcohol on packaging is not mandatory.
• The availability of alcohol to minors is high in the Czech Republic. According to various studies and control actions, alcohol is sold to minors in 50-90% of cases (e.g. 72% according to the CTIA), e.g. beer is easily or quite easily obtained by 80% of 16 year olds (ESPAD study). The proportion of adolescents who consume alcohol in restaurants has been decreasing in the long term, yet the proportion is still high (41%), and a similarly high percentage of children report buying alcohol in shops (ESPAD study).
• In the Czech Republic, 100-150 million litres of ethanol are consumed annually, equivalent to 10-14.5 litres per capita, including children and the elderly. Approximately 49 % of the total amount of ethanol consumed is consumed in beer, 28 % in spirits and 23 % in wine. In recent years, 11-14% of the ethanol consumed in spirits has been produced in distilleries.
• The excise duty system for alcoholic beverages is set differently for spirits, beer and wine and intermediate products and does not correspond to the ethanol concentration in the beverage. For spirits the quantity of ethanol is decisive, for beer the quantity of malt (degree) and for wine and other beverages the quantity of the beverage. Reduced tax rates are applied to beer from microbreweries and fruit spirits from distilleries. Still wine has a zero rate of excise duty.
• Thus, for an alcoholic beverage containing 10 g of ethanol, different excise duty is paid depending on the type of alcoholic beverage: for wine it is CZK 0, for beer about CZK 1, for spirits CZK 4 (for fruit spirits from a grower distillery CZK 2), for liqueur wines CZK 1.5, estimates for cider and hard seltzer are complicated given that the tax is calculated on the type of alcohol contained in these beverages, which varies according to the producer.
• In recent years, the state has collected around CZK 13 billion a year in excise duties on alcoholic beverages: around CZK 8 billion (61-62%) on spirits, CZK 4.5 billion (35-36%) on beer and CZK 0.4 billion (3%) on wine and intermediate products.
• The setting of excise duties on alcoholic beverages has been criticised by experts in the field of economics and public health as unsystematic, as it does not correspond to the harmfulness of individual types of beverages, does not create sufficient incentives to reduce risky alcohol use and does not generate sufficient resources to address the negative impacts of alcohol use in the Czech Republic.
• Alcohol advertising in the Czech Republic is regulated by law with regard to its content and method, in particular with regard to the protection of minors and the prohibition of associating alcohol with increased performance, success or positive effects.
• Alcohol advertising is ubiquitous in the Czech Republic and is a common feature of television broadcasting. Alcohol marketing and sponsorship is particularly associated with sport, entertainment and culture. In recent years, covert advertising and marketing on the Internet have become a problem, to which children can be exposed without restriction.

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Alcohol use among children and young people

• Rates of both alcohol use and risky use among children and adolescents have been declining in recent years, but youth experiences with alcohol remain high, including rates of risky use.
• Overall, 17% of 11 year olds, 43% of 13 year olds and 76% of 15 year olds have experience of alcohol use, with around half reporting drinking alcohol in the last 30 days (HBSC 2018).
• Repeated experience of binge drinking (i.e. experience of being drunk at least 2 times in their lifetime) was reported by less than 1% of 11 year olds, 5% of 13 year olds and almost 24% of 15 year olds.
• Between 2010 and 2014, there was a significant decline in children's experience of alcohol consumption, which continued in the period 2014-2018. At the same time, there was also a decline in the prevalence of problem drinking, including the prevalence of repeated drunkenness, particularly among 15-year-olds (HBSC).
• 95.1% of 16 year olds had drunk alcohol at some point in their lives and 62.7% had drunk alcohol in the last month. Drinking excessive doses of alcohol on one occasion (i.e., 5 or more drinks) in the past 30 days was reported by 38.5% of students, and 11.7% of adolescents consumed excessive doses of alcohol 3 or more times in the past 30 days (i.e., once a week or more) (ESPAD 2019).
• Between 2011 and 2015, there was a significant decline in alcohol consumption among 16-year-olds, both in experience of alcohol consumption and in risky forms of consumption. Between 2015 and 2019, there was a further decline in drinking rates among adolescents, but not as marked as in the previous period (ESPAD 2019).
• For boys, there was a further decrease in all the indicators of alcohol consumption studied, including risky forms, while for girls, there was a slight increase in the prevalence of frequent heavy drinking (3 times or more) and the prevalence of repeated drunkenness between 2015 and 2019. There has been a long-term levelling out of the differences between boys and girls. However, differences between students by type of school attended also persist in the long term, with the highest values of the indicators among students in secondary schools without a high school diploma. By the age of 18, differences between school types are levelling out (ESPAD).
• Studies have long confirmed that the transition from primary to secondary school is an important turning point in terms of exposure to addictive substances.
• Subjectively perceived availability of alcohol has been declining in recent years, but still remains at a relatively high level. A positive trend in recent years is the increasing perception of the riskiness of heavy alcohol consumption.
• There are subgroups of children and adolescents who have above-average experience of alcohol - for example, socio-economically disadvantaged children (clients of low-threshold facilities for children and youth), children in institutional care of the Ministry of Education (diagnostic and educational institutions) or children with Roma origin.

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Alcohol use in the adult population

• The rate of alcohol use in the adult population of the Czech Republic is high. Results are consistent across studies. About 10% of adults drink alcohol daily. In recent years (since 2014), an increase in the prevalence of daily alcohol consumption can be observed, especially among men. The largest increase occurred in the 45-54 age group, but increases were observed in all age groups except the 15-24 age group.
• Frequent heavy drinking (5 or more drinks) on one occasion (at least once a week) is reported by 12-13% of adults.
• An estimated 17-19% of the adult population (i.e. 1.5-1.7 million people) in the Czech Republic consume alcohol at risk, of which 9-10% of the adult population (800-900 thousand people) fall into the harmful consumption category.
• Also, approximately 11% of the population meets the diagnostic criteria for an alcohol dependence disorder. The prevalence of harmful alcohol use is 2-3 times higher in men than in women in the long term. Long-term trends show an increase in the prevalence of harmful alcohol use between 2012 and 2020.
• A survey of doctors suggests that the estimate of at-risk drinkers that doctors are aware of as having a problem with alcohol consumption is 150-170 thousand people.
• Alcohol users entering alcohol treatment are 1/3 female and 2/3 male. The average age is around 45 years (increasing slightly in recent years) for both sexes, with the majority (78%) aged 30-59 years. The majority of alcohol dependent people consume a variety of drinks, but spirits (44%) and beer (37%) are predominant among men, wine (47%) and spirits (32%) among women.
• As many as 60-70% of women in the Czech Republic consume alcohol during pregnancy (although alcohol consumption during pregnancy is very risky in terms of teratogenic effects on the foetus), and as many as 8-19% of pregnant women consume alcohol regularly or at risk.
• There are vulnerable or at-risk population groups in which the rate of alcohol consumption is higher than in the general population. These include, for example, Roma, people living in social exclusion, homeless people or people with experience of imprisonment. For these people, alcohol contributes to further exacerbating their socio-economic disadvantage.
• One of the reasons for the high level of alcohol consumption in the Czech Republic is the tolerant attitudes of Czech society towards alcohol, although there has been a gradual decline in the acceptability of alcohol use. For example, 88% of people currently rate regular alcohol consumption as acceptable. Czechs are also relatively tolerant of alcohol advertising - only 24% would ban advertising for spirits, 12% for wine and 11% for beer.

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Health consequences of alcohol use

• The overall health consequences of alcohol use are not systematically monitored in the Czech Republic.
• The last estimate of total mortality attributable to alcohol in the Czech Republic was made in 2010, when 6,500 deaths were estimated, representing 6% of the total mortality rate in the Czech Republic (10% for men and 2% for women). The largest proportion of total alcohol-related deaths occurred in older age groups, with the highest relative alcohol burden in the 35-44 age group (26% of total mortality in men and 17% in women).
• Of the total 6-7 thousand deaths from alcoholism, 17% were in the general population. The number of alcohol-related deaths per year is approximately one third of the cases in which alcohol is the main or only cause of death. The mortality rate for alcohol-related causes and the proportion of alcohol-related causes of death in the total mortality rate in the Czech Republic have been increasing in recent years, mainly due to an increase in the number of cases of alcoholic liver disease. The number of alcohol-related accidents and suicides is also increasing.
• Spatial analysis of mortality from alcohol-related diseases has shown that alcohol-related mortality is highest in the regions of Central Moravia and also Silesia. While men in Prague have the lowest alcohol-related mortality rates compared to other regions, women in Prague have the highest.
• Alcohol addicts die on average 24 years earlier than the general population, almost 83% of them in the economically active age group up to 64 years. The most common cause of death is external causes (24%), mainly accidental injuries (13%) and suicide (6%), followed by liver disease (18%), diseases of the circulatory system (15%) and malignant neoplasms (7%).
• In terms of alcohol-related morbidity, 13-14 000 hospital admissions for diseases entirely attributable to alcohol are reported annually in the Czech Republic, of which around 8 000 are for alcohol dependence (about 60%), 4 000 for alcoholic liver disease (30%) and 1 000 for alcoholic pancreatitis (8%). The male/female ratio is about 2:1.
• For other diseases and disorders for which alcohol is a cause, only some can be routinely monitored - e.g. 11-16% of tuberculosis cases occur in alcohol-dependent people, alcohol is the cause of 98% of substance-impaired injuries.

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Social consequences and context of alcohol use

• The most recent economic estimate of the total social costs of alcohol consumption in the Czech Republic is for 2016. The total social cost amounted to CZK 56.6 billion, of which the largest share (51.2%) was the indirect cost of lost productivity due to morbidity and premature mortality, and the cost of treating alcohol-related diseases (24.4%). In relative terms, the cost of alcohol consumption in the Czech Republic amounted to 1.2% of GDP.
• According to various sources, alcohol expenditure has accounted for around 2-4 % of total household consumption expenditure in the Czech Republic in recent years. This share is currently increasing.
• Alcohol is associated with domestic violence. It is estimated to be associated with up to 2/3 of all cases of domestic violence in the Czech Republic. Women are particularly affected by alcohol-induced violence. Binge drinking increases the risk of aggressive behaviour. In addition to physical violence, alcohol increases the likelihood of sexual violence as well as intense psychological violence.
• Alcohol is involved in approximately 5 % of road accidents and approximately 10 % of road deaths are caused by alcohol. The likelihood of a traffic accident increases with blood alcohol level - in 79% of all accidents caused by alcohol, the culprit had a blood alcohol level above 1‰, i.e. it was a criminal offence.

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Alcohol-related crime

• Criminal activity consisting in the violation of alcohol legislation, so-called primary alcohol-related crime, includes the offence of giving alcohol to a child (Section 204 of Act No.40/2009 Coll., the Criminal Code), the offence of endangering under the influence of an addictive substance (Section 274) and the offence of drunkenness (Section 360).
• In 2020, 178 offences of serving alcohol to a minor were registered (197 in 2019), 99 offences of serving alcohol to a minor were clarified and 76 persons were convicted for this offence. There has been a noticeable increase in this crime over the long term.
• In 2020, 8,076 DUI and DWI offenses were recorded, of which 5,466 were alcohol-related (68%). DUI offenses accounted for 13% of total cleared crime. The number of drink-driving offences and their share in total crime has been declining over the long term.
• If a person has committed a crime under the influence of alcohol or another addictive substance or in connection with the use of an addictive substance, the court may impose protective treatment. In 2020, 186 persons, most often those convicted of a disorderly persons offence, were placed under alcohol-related protective treatment. Compared to the previous year, there was a slight increase in the number of persons ordered to alcohol protective treatment by the court in 2020.
• The court may impose reasonable restrictions and obligations as part of diversion or along with an alternative sentence, which may include substance abuse treatment, an obligation to abstain from the use of alcoholic beverages or other addictive substances, or to undergo an appropriate counseling or treatment program. In 2020, the Probation and Mediation Service registered 22 122 persons in various stages of criminal proceedings, of whom 394 were ordered to undergo substance abuse treatment and 1 799 clients were ordered to abstain from the use of alcoholic beverages or other addictive substances.
• Alcohol-related economically motivated crime is regularly surveyed in a questionnaire study of sentenced prisoners. Theft or other illegal conduct with the motive of obtaining funds for alcohol was reported by 11% of inmates in the 2020 study.
• Alcohol-related offences in the context of public health protection are defined by Act No. 65/2017 Coll. on the Protection of Health against the Harmful Effects of Addictive Substances. In 2020, 1 515 offences (1 744 in 2019) related to alcohol use were registered, the most frequent being the sale or administration of an alcoholic beverage to a person under 18 years of age (57%).
• In the context of road traffic, offences related to addictive substances are defined by Act No. 361/2000 Coll., on road traffic. In 2020, 24,501 offences related to alcohol (or other addictive substances) were registered (27,409 in 2019).

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Alcohol prevention programmes

• There are a number of public websites in the Czech Republic dedicated to reducing consumption, the negative effects of alcohol use and providing information on how to get help: National alcohol reduction support sites alcohol-skodi.cz, alcoholpodkontrolou.cz, suchejunor.cz, anonymnialkoholici.cz. In 2020, the National Health Information Portal nzip.cz was launched, which includes alcohol in the section Addictions and addictive substances.
• As of August 2019, the National Quitline 800 350 000 also integrates the topic of alcohol, and there is a website chciodvykat.cz and an e-mail counselling service poradte@chciodvykat.cz. The phone number of the line is owned by the Office of the Government of the Czech Republic, the line has been operated since 2016 by the Czech Coalition against Tobacco from subsidies.
• Media campaigns on alcohol have been visible in recent years. The campaign Alcohol under the Control of the Clinic of Addiction Medicine of the 1st Faculty of Medicine of the Charles University in Prague includes radio spots, posters in public and public transport, video spots on social media and on public transport buses. In 2020, Charles University launched the Stop Alcohol in Pregnancy campaign in cooperation with other medical and health faculties. In July 2021, Alcoholics Anonymous launched a public transport campaign highlighting the risks of alcohol use and promoting the association's services.
• A significant campaign aimed at reducing (risky) alcohol consumption in the country is Dry February. In addition to the event itself in February, it is dedicated to reducing alcohol consumption in the country all year round and contributes to destigmatising the whole issue of alcohol, addiction and addiction treatment. Dry February mainly affects middle-aged and higher-educated men and has the greatest impact on occasional to frequent alcohol users (consuming alcohol 1-4 times a week), with the lowest impact among daily or near-daily alcohol users. It is estimated that the campaign in its current form has the potential to reduce overall alcohol consumption in the Czech Republic by an order of magnitude of one percent.
• There are also campaigns by alcohol producers and distributors in the Czech Republic. In general, however, the effectiveness and purpose of these campaigns are questionable according to the available evidence, as they are primarily part of marketing strategies and corporate social responsibility image building. What they have in common is that they emphasise 'responsible drinking', targeting primarily children and young people, pregnant women and drivers, i.e. population groups where there is a social consensus that they should not consume alcohol. On the contrary, they avoid the most effective measures to reduce alcohol consumption, i.e. measures to restrict advertising or increase the price of alcoholic beverages.
• Community programmes aimed at preventing underage drinking are very rarely implemented in the Czech Republic.
• Activities in the field of alcohol consumption prevention are also implemented by the State Institute of Health (SZÚ) and its dislocated workplaces - most of them are focused on children and youth, but since 2018 the SZÚ also implements a prevention project selectively aimed at residents of socially excluded localities, which also includes the topic of alcohol.
• Addiction prevention targeting children and youth is part of the broader framework of risk behaviour prevention coordinated by the Ministry of Education and Science. There are regional school prevention coordinators at the regional level, prevention methodologists anchored in the pedagogical and psychological counselling system at the level of the former districts, and school prevention methodologists in schools. In 2020, prevention in the school environment was affected by measures related to the COVID-19 pandemic.
• In the 2019/2020 school year, a total of 65,739 cases of risky behaviour in schools were reported, of which 3,576 (5.4%) involved alcohol use. Alcohol use was significantly more prevalent in secondary schools and corresponding grades of multi-year colleges. Alcohol use cases were most frequently dealt with in the 4th year of secondary school (721 cases).
• Prevention programmes implemented in schools in the 2019/2020 school year most often focused on the prevention of bullying and aggression (16.6% of programmes), prevention of criminal behaviour (10.4%) and prevention of cyberbullying (10.3%). Prevention of alcohol use was addressed in 7.2% of programmes.
• The largest amount of hours in the school curriculum is devoted to the prevention of bullying and aggression, with an average of 45.5 hours in total across all grades in primary and secondary schools (aggregated across all grades) in the 2019/2020 school year. An average of 21.3 hours was spent on the prevention of alcohol use by primary and secondary school students as part of the school curriculum, with the most time devoted to this topic in the first year of secondary school (2.4 hours).

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Brief interventions and treatment for alcohol users

• In practice, brief interventions are implemented on a relatively low scale and in a non-systematic way, despite the fact that they are a legal obligation for all health professionals to implement them in justified cases. Brief interventions for at-risk or heavy alcohol users are carried out by about half of the doctors. It is estimated that only half of people are asked about their alcohol consumption when they visit a doctor and less than one tenth are advised to stop or cut down. The trend in recent years shows that the situation is not improving.
• Treatment of addiction in the Czech Republic is basically abstinence-oriented, both outpatient and residential. The typical treatment model is the so-called Skál model, i.e. residential treatment with a structured programme comprising various therapeutic activities with strong elements of psychotherapy and physical activities, with possible pharmacological support, taking place in several follow-up phases. A detoxification phase is typically included at the beginning of treatment.
• Alcohol dependence treatment and other interventions targeting alcohol users are provided in addiction programmes that provide services to substance users and addicts, gamblers and those suffering from other non-substance addictions. Alcohol users are their clients to varying degrees.
• There are currently estimated to be nearly 300 addiction programmes of various types in the country, of which 30-40 are residential programmes and 40 are aftercare programmes. Approximately 30 thousand alcohol users are in contact with addiction programmes annually, the largest part of them (about 27 thousand persons) is in contact with psychiatric institutions (20-23 thousand in outpatient care, about 6 thousand in inpatient care).
• Addiction services are also available to alcohol users in prisons. Alcohol users make up 10-30% of the clientele of addiction programmes in prisons. An estimated ten alcohol users are treated in prison each year.
• There are 19 therapeutic communities (TC) for addiction treatment in the country with an estimated capacity of about 320 places. Approximately 100 alcohol users are treated there annually.
• There are several self-help associations providing assistance to alcohol users in the Czech Republic. Alcoholics Anonymous (AA) is active in 45 cities, and there are currently 67 AA groups in the Czech Republic. Apart from AA, there are few other self-help projects in the Czech Republic in Brno and České Budějovice.
• As of September 2021, there were 34 registered aftercare providers, 25 of which offered sheltered housing with a capacity of 310 beds. Alcohol users make up about 60% of their clients.

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Harm reduction services for alcohol users

• Alcohol users are also clients of low-threshold harm reduction programmes primarily for people who use illicit drugs. In 2020, 38.8 thousand substance users were in contact with low-threshold programmes, of which 3.3 thousand were alcohol users (8.5%).
• Harm reduction interventions aimed at reducing or controlling alcohol consumption are not widespread in addressing problem alcohol use or dependence in the Czech Republic. Since 2013, Selincro (nalmefene) has been available in the Czech Republic and is used to reduce alcohol consumption in people with problem drinking or alcohol dependence. However, its use in the Czech Republic is minimal, and the disadvantage of its wider use is its high price.
• An innovative harm reduction approach is represented by so-called managed alcohol programmes, i.e. the administration of alcohol to alcohol-dependent people under controlled conditions. It is a method used especially for severe addicts with other health and social problems (homeless persons, problems with the law, etc.). Since 2020, 2 day centres, the so-called wet centres, have been operating in Brno on this principle, while the third one has been in operation only temporarily. In addition, elements of managed alcohol programmes can be found in some homes with special regime for people with or at risk of addiction in the Czech Republic.
• The harm reduction function in the alcohol field is also fulfilled by detention centres: they provide medical supervision and care to intoxicated persons, prevent health damage in a state of intoxication and the threat to other persons, public order and property caused by the behaviour of intoxicated persons. In 2020, there were a total of 18 detention centres in the Czech Republic providing services to 17,800 persons.
• There are about 15 programmes providing counselling and information interventions, harm reduction material or breath tests for alcohol in entertainment settings. In 2020, they contacted about 6.5 thousand persons, including 2.3 thousand alcohol users.
• In 2019-2020, a so-called night mayor was appointed by the City Council to address problems related to nightlife, including problems related to alcohol use. In April 2020, the position of night mayor was abolished.

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Impact of COVID-19 on alcohol use

• Information on the impacts of the COVID-19 epidemic on patterns and rates of alcohol use is incomplete and ambiguous. However, it appears that there may have been a worsening of the situation, particularly for heavy alcohol users who may have increased both the frequency of use and the doses consumed during the emergency. Although the negative impact of the epidemic in the mental health field is clear, a clear association of COVID-19-induced anxiety with alcohol use has not been demonstrated.
• It is those at risk of addiction or addicted that may have experienced a worsening of their addictive disorder and an increased need to seek help services.
• Addiction services reported an increased demand for services from users following the relaxation of anti-addiction measures, although this increase is not evident from the health statistics data. The reason for this appears to be under-reporting in health registers and information systems due to the difficulty in operating facilities during and after the emergency. Data for 2020 should therefore be treated with caution.
• The COVID-19 epidemic and related counter-epidemic measures have made it more difficult for clients with alcohol dependence problems to contact and access services. On the other hand, the provision of online counselling and treatment services has developed. Some organizations have taken advantage of the emergency related to COVID-19 to conduct prevention campaigns aimed at preventing risky alcohol consumption.
• The increased difficulty in accessing health and social services and the deterioration of the social situation of clients during the epidemic have contributed to the development of new harm reduction services for alcohol users.
• The COVID-19 epidemic also affected the alcohol market and people's consumption behaviour. Alcohol use shifted from public places to private spaces during the emergency. It is questionable to what extent the shift of consumers from public catering outlets to the retail network will be reflected in the next period.
• The market in the Czech Republic has also been affected by a drop in tourists and a reduction in cross-border purchases. Sales of alcoholic beverages in the Czech Republic declined in 2020 due to these factors. Excise duty collections on alcoholic beverages fell by CZK 0.6 billion (4.5%) year-on-year, despite an increase in the tax rate on spirits from the beginning of 2020. Excise duty collections fell for both spirits (most significantly) and beer.
• The COVID-19 epidemic has also had a major impact on reducing the black market in alcohol. As a result of the closure of public catering establishments, the possibility of recourse to untaxed and illegal alcohol was reduced.

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Translated with www.DeepL.com/Translator (free version).

 

More information

The Summary of the Report on Alcohol in the Czech Republic 2021 in English is available also in the attached PDF.

Full Report on Alcohol in the Czech Republic 2021 is available in Czech language.