Academic education in addictology (addiction science) in the Czech Republic: Analysis of the (pre-1989) historical origins

Abstract

Background In the Czech Republic, education in addiction science consists of a distinctive and interconnected system of non-medical healthcare education on the Bachelor's (Bc) and Master's (MA) levels, followed by a doctoral study programme (PhD). Addictology (addiction science) as a new term is defined as a distinct and independent field of scientific inquiry on addictive behaviours and the risk environment of substance use, aiming at scientific and professional excellence relevant to society. Aims This case study seeks to identify, describe and explain important events in shaping the historical context of the Czech education and research programmes in addictology. Design The historical review is based on qualitative content analysis of central written documents. Results In the 19th century Czech territory, problematic alcohol use was addressed through self-help activities in the second half of the nineteenth century. During the 1950s and 1960s, a new generation of Czech psychiatrists emerged with an interest in alcohol treatment and in research of hallucinogenic drugs. A patient education bulletin Apolinářský zápisník [Apolinar Diary] was launched in 1951 and was later also used for education of treatment professionals in connection with other self-help and quasi-self-help activities. The monographs Alkoholism (1957) and Toxicomany (1973) conceptualised the core of abstinence-oriented historical traditions and developments. A separation of approaches to legal and illegal drugs can be observed in the 1970s. In 1967, a new and intensive training model was introduced for psychiatrists and psychotherapists, leading into specialisation in psychotherapy and addiction. Because of the Iron Curtain, Czech practitioners had to develop their own concept of addiction and ideas on training psychotherapists so they could not be labelled western or anti-state, or be subject to intense state control. Conclusions The final profile of the study programmes is the outcome of a long-term process that commenced in the 1950s but with roots in the interwar years, when addictology in the Czech Republic reflected traditional healthcare-oriented models of training and education. In this context the historical development in Czecholovakia and later Czech Relpublic can be characterized as a combination of early interest in self-help activities followed by the development of specialized treatment programmes both affected by a futher 40 years behind the “iron curtain” and intensively confrontated with harm and risk reducation interventions after the Velvet revolution.