Despite the rhetoric of official political documents, Czech drug policy is apparently driven by political and moral rather than public health concerns. Although the main goal of Czech drug policy is reduction in drug use, the philosophy and practice for achieving this goal are poorly defined. Although a balanced approach that counters the drug supply through law enforcement and interdiction and attempts to reduce demand through prevention and treatment is claimed in the rhetoric of government officials, in practice the emphasis is almost exclusively repressive law enforcement. In the development of drug-related legislation, decisionmakers have found it easier to reach agreement on law enforcement measures, but difficult or impossible to formulate a policy on drug-related public health measures. The gaps between the rhetoric and implementation of Czech drug policy result from the interplay of the distinctive perspectives and relative powers of various groups of professionals, civil servants, and politicians. These discrepancies between official statements on drug policy and actual practices pose obstacles to the development of an efficient and effective drug policy. The four main data sources for this study were all published relevant scientific literature in both English and Czech languages, all published official and semiofficial literature on Czech drug policy since its modern beginning in 1993, face-to-face semistructured interviews with key stakeholders in the Czech drug-policy field, and the author's personal observations and written memoranda. 5 figures, 21 notes, and 53 references