Josef Radimecky

The Times They Are A-Changing: Harm Reduction with Regard to Alcohol Use?

Traditional perception of addiction as a disease that as the only option for alcohol and/or drug users implies total and life-long abstinence has been more and more challenged recently. Critique of this concept provides a basis for discussion about the need to shift from paradigm of addiction as a disease to a problem drinking and/or use of drugs as an acquired behaviour which could be changed not only into a total abstinence but also to a controlled moderate use. In this context harm reduction (risk minimization) plays an important role. Harm reduction approach has been developed as an independent concept in relation to the use of illicit drugs but its interventions are common (possibly not reflected enough) part of an array of measures applied with regard to alcohol consumption. In this paper basic rationale of the critique of addiction as a disease concept are discussed as well as its pros and cons, and arguments for the shift towards paradigm of problem alcohol/drug use as an acquired behaviour. Also examples of harm reduction interventions with respect to alcohol use are introduced that might be and/or are already applied at various levels of influence.

Life-long Education in Addictology

With the use of brief summary of historical activities in the field of further education as well as of other significant influences the paper attempts to present recent steps aiming to develop a complex system of a life-long education in addictology. Aim and basic idea of the conception of life-long education are introduced as well as proposed four-level system of qualification of professionals in the field including the credit system as it is defined for the health sector by the Czech legislation. Pros and cons of presented proposals are discussed. These lead to conclusion that recently there seem to be more questions rather than definitive answers with regard to the conception of life-long education. Thus, an ongoing discussion about this topic within the expert community seems to be inevitable.

One Step Forward and Two Back..? A Critique of the Concept of Addiction as a Disease

Some authors argue that adoption and implementation of addiction as a disease concept into practice seems to be the greatest discovery in medicine of 20th Century. The reason is that it has significantly contributed to de-stigmatization of millions of users of mind-altering substances as well as their close persons and enabled them to undertake steps to change their problem behaviour (Heather a Robertson, 2000). At the same time however they point out that this concept has from scientific point of view become thing of past. Thus, they suggest to stop utilize it in practice and to re-define it with regard to recent evidence (Gossop, 2000). Concept of addiction as a disease undoubtedly builds upon false assumptions, and therefore its application in practice may result in various disadvantages. However, simultaneously it has its indisputable advantages.    This paper attempts to introduce and discuss: 1) meaning of discussion about the concept of addiction as a disease; 2) changing perspectives of dependent behaviour in the course of history; 3) birth of the concept of addiction as a disease as we know it today; 4) argument about the concept or pros and cons of the concept of addiction as a disease and 5) what to do with the model of addiction as a disease in 21st Century?

Rhetoric versus Practice in the Czech Drug Policy

Modern official Czech drug policies were initiated in 1993 when the government approved its first national drug policy program for 1993-1996. The current policy was defined in the National Drug Policy Strategy 2005-2009, a document that claims that the drug policy should be evidence-based and that it should take a balanced and interdisciplinary approach towards the problem of drug use. In order to assess the existence of possible discrepancies between these official statements and their practical implementation, the author provides an analysis of the Czech drug policy based on a review of official and other documents as well as interviews with representatives and key players in the Czech drug policy arena. The main finding is that conflicts exist between the official policy and drug policy practices, and these disparities serve as obstacles to its effectiveness. These conflicts result from the wide variety of ways in which key players have conceptualized drug use and the manner in which they have constructed particular reform measures to implement and mirror their main interests and priorities. Particular areas of concern that have been especially impacted by these phenomena are illustrated and discussed below. In order to improve the effectiveness of future Czech drug policy, further research, and especially into its practical application, needs to occur.

Rhetoric Versus Practice in Czech Drug Policy

Modern official Czech drug policies were initiated in 1993 when the government approved its first national drug policy program for 1993-1996. The current policy was defined in the National Drug Policy Strategy 2005-2009, a document that claims that the drug policy should be evidence-based and that it should take a balanced and interdisciplinary approach towards the problem of drug use. In order to assess the existence of possible discrepancies between these official statements and their practical implementation, the author provides an analysis of the Czech drug policy based on a review of official and other documents as well as interviews with representatives and key players in the Czech drug policy arena. The main finding is that conflicts exist between the official policy and drug policy practices, and these disparities serve as obstacles to its effectiveness. These conflicts result from the wide variety of ways in which key players have conceptualized drug use and the manner in which they have constructed particular reform measures to implement and mirror their main interests and priorities. Particular areas of concern that have been especially impacted by these phenomena are illustrated and discussed. In order to improve the effectiveness of future Czech drug policy, further research, and especially into its practical application, needs to occur.

When two do the same…: Comparative analysis of the EU and Czech drug strategies from 2005 onwards

Comparative analysis of documents defining both the EU and Czech drug policies from 2005 onwards has been made. The main evaluation criteria used were consistence as well as relevance of both texts to recent evidence available. Comparison has been made with the use of following questions: (1) how ‘drugs problem’ is defined? (2) how complex is defined policy? (3) how do the main aims correspond with declared principles and evidence? and (4) what priority do the policy-makers attribute to drug policy? Analysis suggests that politicisation of drug policy, various interests of key players in the Czech as well as EU ‘drug arena’ can lead to inner in-consistencies in both documents and to formulation of unachievable or immeasurable aims. This can make drug policy non-trustworthy in the eyes of expert as well as lay public.

Drugs as a political weapon

When two do the same: a comparison of recent EU and Czech drug policies