Poland Country Drug Report 2017

Treatment

The treatment system

The National Programme for Counteracting Drug Addiction 2011-16 contains a number of measures related to drug treatment and rehabilitation. These aim to increase the availability of outpatient drug services, OST programmes and HIV- and HCV-related infectious disease treatment programmes. Moreover, a wide range of other measures designed to improve the quality of drug treatment services are included in the strategy.

The system of specialised drug services in Poland is integrated into mental healthcare and a number of legal acts govern drug treatment in Poland. The implementation of drug treatment is the responsibility of the communities and provinces, where it is delivered by a range of providers who have signed contracts with the NHF. Treatment activities that are not covered by the NHF can be funded through other resources on a competitive basis. Treatment at private clinics or from private practitioners is also available, although this attracts an additional fee to be paid by the client.

Drug treatment in Poland: settings and number treated

NBYear of data 2015.

 

Trends in percentage of clients entering specialised drug treatment, by primary drug in Poland

NB Year of data 2015.

Opioid substitution treatment in Poland: proportions of clients in OST by medication and trends of the total number of clients

NB Year of data 2015.

Drug treatment services are provided through a network of inpatient and outpatient treatment centres, detoxification wards, day-care centres, drug treatment wards in hospitals, mid-term and long-term drug rehabilitation facilities, drug wards in prisons and post-rehabilitation programmes. In territories where there are no specialised drug treatment services, treatment is delivered by mental health counselling or alcohol rehabilitation clinics. In line with the national public health perspective of drug treatment, the treatment system in Poland has two approaches: ‘drugfree’ treatment (psychosocial models) and pharmacological treatment (i.e. OST). Of these two, the ‘drug-free’ model prevails and includes therapeutic communities, cognitivebehavioural psychotherapy, 12-step programmes, case management and self-help groups.

Outpatient and inpatient drug treatment are mainly delivered by NGOs, followed by public services and private providers. Detoxification is mainly provided by public services and by private clinics and physicians. Polish postrehabilitation programmes are also implemented mainly by NGOs. These are subsidised by the state budget (up to 18 months of therapy) and by resources from local authorities. In recent years, taking into account the changing profile of treatment clients, a new treatment programme, CANDIS, aimed at cannabis users, has been promoted in Poland.

OST with methadone has been available in Poland since 1993. Only public health care units that have received permission from the governor of the region, in collaboration with the Ministry of Health, can deliver OST. According to the law, NGOs can also establish and carry out OST.

Treatment provision

Of all those treated for drug dependence in Poland, the majority were treated in outpatient settings. In 2015, a total of 9 013 clients were admitted to treatment, of whom 4 296 were clients entering treatment for the first time. In 2012, a new treatment registration system was put in place, which has expanded in recent years to cover around half of specialised outpatient and inpatient treatment centres. Caution must be exercised when interpreting data because of the evolution of the national monitoring system, particularly with regard to coverage. Among all clients who entered treatment in 2015, around one third entered treatment for primary use of cannabis, and one quarter for stimulants, mainly amphetamines. Opioids, mainly heroin, were the third most common primary drug reported by treatment clients. However, the largest proportion of clients in treatment cited another nonspecified drug as the primary substance used.

Data from the National Bureau’s Registry of Substitution Treatment show that the number of clients receiving OST has remained stable in recent years, with more than 2 500 clients receiving this treatment in 2015. The majority of clients treated with OST received methadone, although buprenorphine-based medications are also available.

In 2015, it was estimated that fewer than one fifth of problem opioid users received OST in Poland.


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