The impact of addictions costs Czechia billions annually. Harm reduction, the smart policy focused on prevention of the worst impacts, can save billions!

Prague, June 24, 2025 – The annual societal costs associated with addictive behavior in the Czech Republic are estimated to range from 150 to 250 billion CZK, accounting for nearly 10% of the state budget. Experts at a roundtable hosted by the Institute for Rational Addiction Policies, the Institute for Mental Health and Addiction Studies, and the Anglo-American University strongly called for the strengthening of scientifically verified and economically rational decisions in both Czech and European addiction policy. This could save billions on public spending and for insurance companies.

"As an abstainer, I would say that 100% abstinence as an ideal solution is not realistic. However, what we know for sure is that a policy focused on realistic risk reduction, known as harm reduction, works – whether it is about drugs, tobacco, alcohol or gambling. At the same time, without investments in prevention and research, we will continue to only cyclically address the consequences, not the causes," said Jindřich Vobořil, Chairman of the Board of the Institute for Rational Addiction Policies, and added: "The harm reduction approach must be systemic, and therefore must also include support for alternatives in the market, such as substituting high risk products with less risky ones, including smart taxation that reflects product risk, as well as integration of substitution therapy or brief interventions in healthcare."

The need for effective primary prevention, especially for children and adolescents, was also strongly highlighted. "The risks associated with new psychoactive substances, energy drinks or digital addictions have a significant impact on the development of young people. The past months and years show how devastating the effects on the mental and physical health of children are," said Member of Parliament and Health Committee member Renáta Zajíčková, adding: "Teachers, healthcare workers, and addiction specialists are sounding the alarm and calling for a change in the approach to these new addictions. Effective prevention and reasonable regulation are proven tools. If we don’t want to lose the emerging young generation, we must not only massively invest in prevention and regulate wisely, but also change the societal approach." She also called for greater interdepartmental cooperation particularly between the healthcare and education sectors, and the Ministries of Interior and Justice.

While prevention remains a vital pillar, experts also emphasised that a purely abstinence-based approach is not sufficient. The results of the National Tobacco and Alcohol Use Survey (NAUTA 2024) clearly show that abstinence-based policies alone fail to address the situation in the Czech Republic. A pragmatic policy must accept that part of the population will continue to consume nicotine products and alcohol. It is therefore essential to expand preventive interventions and integrate harm reduction practices across health and social services. This approach is reflected in practice by supporting the transition to less harmful alternatives for people who use drugs as well as for smokers, and introducing systematic interventions in the area of alcohol, where risky consumption threatens almost one-fifth of the adult population.

"The data on tobacco consumption are encouraging. The decline in traditional smoking, alongside the rise in the use of e-cigarettes, shows that people are actively seeking less harmful alternatives, which is perfectly in line with the principles of risk reduction. The key finding is that more than a third of e-cigarette users are former smokers, and the transition mainly happens among adult, already addicted smokers," said Ladislav Csémy, President of the Institute for Mental Health and Addiction Studies, and added: "This confirms that alternatives are serving their purpose and are not primarily an entry point for nicotine for newcomers, but rather a functional tool for those who want to reduce the risks associated with their addiction."

At the same time, there has been a sharp rise in anxiety, depression, and problematic behavior associated with digital technologies. Yet systematic support for prevention is lacking, and services in the field of digital or non-substance addictions remain absent. "Addictions and mental health are deeply interconnected, and without an integrated approach, we will continue to fail in helping those who need it most. Harm reduction is not only pragmatic but also economically rational, as it reduces harm and strengthens stability," was echoed during the discussion.

Experts agreed on the need to allocate at least 2% of the revenues from excise duties on tobacco, alcohol and gambling to prevention, harm reduction and treatment. This would create long-term and predictable support for these activities aimed at reducing the negative impacts of addictive products. Only in this manner can we ensure an effective and sustainable drug policy for the 21st century.