Addictions Under the Microscope: Why It’s Time to Rethink Prevention and Smart Policy
Addictions are not just a problem of individuals who have “failed.” They are closely linked to how our society functions, how we set rules, and how we support health and education. At an expert meeting bringing together politicians, specialists, and health insurers, it became clear that the Czech debate on addictions is shifting – away from repression and myths and towards evidence-based and economically rational solutions.
Harm reduction jako politická filozofie
The Institute for Rational Addiction Policy Chairman Jindřich Vobořil opened the discussion with a clear statement: “We don’t want a world without drugs, we want a world without unnecessary harm.”
He stressed the need to recognize that addictions are part of human life and cannot be eradicated. Instead, the focus must be on minimizing their negative impacts. “Because of myths, we create flawed policies that are responsible for premature deaths, health problems for tens of thousands of people in the Czech Republic and around one million across the EU. We incarcerate unnecessarily and fuel a massive black market,” he warned.
According to Vobořil, harm reduction is not just about specific interventions such as needle exchange or substitution treatment. “It is a political philosophy, a comprehensive approach that includes prevention, therapy, counseling, and smart legislation,” he explained.
He also called for redefining our understanding of addiction itself:
“Addictions are not evil. They are a natural part of human life, rooted in the brain’s reward system. Without it, we would not reproduce, create, or experience joy. The problem arises when control fails – and that is when intervention is needed.”
The Czech Republic, he said, has earned international respect in this area. “We became recognized leaders not because of dogmas, but thanks to evidence-based and financially accessible policies. We even pushed through a precedent-setting EU Council decision that human rights must be respected in addiction policy,” he noted.
Yet paradoxes remain: the Czech economy loses an estimated CZK 150–250 billion each year due to addictions, while spending on prevention amounts to only 0.03% of GDP – several times less than in neighboring countries.
Schools as the First Line of Defense
MP Renáta Zajíčková continued with a perspective from everyday practice: “Addictions have always existed. The difference today is that the supply of substances and behavioral temptations is so overwhelming that the average person can hardly resist it. This is especially true for the younger generation.”
Relying on families alone is unrealistic. “Children themselves admit we know it’s bad, but we can’t cope with it on our own. Parents are not with their children 24 hours a day, which is why schools and the state must step in,” she explained.
Schools today stand on the frontline but often lack resources. “There are too few prevention specialists, and the role often falls to teachers without proper training. Yet the problems are increasingly complex – no longer just alcohol and tobacco, but digital addictions, social networks, or energy drinks,” she warned.
Zajíčková also highlighted legislative progress: “We managed to adopt a law on psychomodulatory substances, we are preparing regulation of energy drinks, and curriculum revisions are bringing more emphasis on mental well-being in schools. Some steps are genuinely progressive.”
But the economic side of addictions is often misrepresented:
“Everyone knows that alcohol and tobacco bring in billions in tax revenue. But no one talks about how much treatment of addictions costs, the breakdown of families, or the broader social consequences. The economics here are merciless – yet public debate remains silent about it.”
She also pointed to the destructive impact of the digital age: “Children are on their phones and social networks until two or three in the morning. Parents are asleep, unaware that their children are suffering from severe sleep deprivation. If we don’t help them, we risk losing an entire generation.”
Insurers Must Change Their Mindset
VZP representative Miroslav Jankůj brought an economic and healthcare perspective. He noted that his health insurance company alone spent CZK 1.6 billion on addiction treatment in 2024 – and that costs have doubled over the past decade. “Alcohol is the dominant cost item,” he added.
But the issue, he argued, is broader.
“Healthcare accounts for only 10–15% of what determines health. Lifestyle, environment, and social status are key. And yet we focus too little on these determinants of health. We need to change the mindset – not only in education but also within insurance companies,” he said.
Prevention funding remains minimal. “In 2024, out of CZK 298 billion in revenues, only CZK 1.9 billion went to prevention – less than one percent,” he pointed out. Specific programs show the limits of this imbalance: “For example, we allocated CZK 630,000 for smoking cessation support, and only 349 people used it.”
International research clearly shows that prevention pays off. “One crown invested in prevention brings back 1.7 crowns. The problem is that the benefits are long-term, while the system is short-term by design,” Jankůj explained.
VZP has introduced incentive programs for both clients and providers. The VZP Plus scheme increases reimbursement for general practitioners who actively invite patients for preventive check-ups. “The result? The number of clients undergoing preventive care rose by six percent, which is almost 100,000 people. Still, that’s only 56% of our insured population,” he noted.
He also drew inspiration from abroad. “In Spain, the state systematically tracks risk factors and actively works with at-risk groups. They run courses, exercise programs, targeted support. We need to start seeing prevention as a strategic investment, not as a cost,” he emphasized.
Prevention as a Political and Societal Choice
The common thread across all contributions was clear: Czech society needs a fundamental shift in how it approaches addictions.
Addictions are not moral failings but a natural feature of human behavior.
Effective policies must be based on harm reduction – reducing harm, protecting health, and respecting human rights.
Schools, families, and the healthcare system must be supported so they can detect problems early.
Prevention is not a cost but an investment that pays back many times over – economically and in human lives.
A policy built on prevention and harm reduction is not just an expert strategy. It is a civilizational choice: do we want a society that punishes and pays the price of consequences, or one that protects the vulnerable, saves resources, and builds the foundations for a healthier future?
