Topics
1. National context
Poland is the central and eastern European country with the longest tradition of therapeutic communities aimed at rehabilitation and prolonged abstinence. The first centre was established in 1978. The role of these communities has superseded the overriding role given to psychiatric institutions in other central and eastern European countries.
The implementation of drug treatment falls under the responsibility of communities and provinces, while drug treatment is delivered by different providers. Funding for drug treatment is primarily covered by health insurance, yet also by the public budget of communities. However, there is an option to receive also treatment at private clinics or from private practitioners, but for an additional fee paid by a client/patient.
Drug treatment services are provided through the 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 and drug wards in prisons, and also post-rehabilitation programmes. In line with the public health perspective of drug treatment, the treatment system in Poland can be differentiated into two approaches: ‘drug-free’ treatment and pharmacological treatment (i.e. substitution treatment). Treatment is provided in two modes: outpatient and residential treatment. Outpatient interventions for users of illicit psychoactive substances are provided through addiction counselling centres, mental health counselling centres and day-care centres located in large cities. Residential treatment is dominated by long-term and mid-term residential treatment lasting more than one year. Detoxification which is not a treatment in itself but is the first step to treatment is provided in detoxification wards and usually lasts 8 to 14 days. Outpatient and inpatient drug treatment is mainly delivered by NGOs, followed by public services and private providers. Detoxification is mainly provided by public services, as well as by private clinics and physicians. Polish post-rehabilitation programmes are also implemented, mainly by non-governmental organisations. These are subsidised from the state budgets and with resources from local authorities.
Methadone maintenance treatment is available as opioid substitution treatment in Poland. The first methadone maintenance programme was introduced in Poland in 1993. Since 2005, such treatment was only carried out by public healthcare units which have been granted permission by the governor of the region in collaboration with the Ministry of Health. According to the new drug law from 2005, NGOs can also establish and carry out an opioid substitution programme, and the first programmes provided by non-public health centres and private facilities were established in 2007. In 2009, 22 substitution treatment programmes (including five programmes in prisons) provided services to 1 945 clients, of whom 1 921 received methadone as the substituting substance.
2. Treatment registries and monitoring systems
There is no national monitoring system for clients in medically-assisted or drug-free treatment. The National Focal Point collects data on clients in residential (drug-free) treatment for basic statistical purposes.
3. Treatment demand
| Clients in treatment | 2007 | 2008 | 2009 |
|---|---|---|---|
| Number of all clients entering treatment | 12582 | 14709 | N. Av. |
| % of which for opioid use | 31.9 | ||
| % of which for cocaine use | 1.6 | ||
| % of which for cannabis use | 32.5 | ||
| % of which for stimulants use (other than cocaine) | 26.1 | ||
| Number of new clients entering treatment | 5690 | 6362 | N. Av. |
| % of which for opioid use | 13.4 | ||
| % of which for cocaine use | 2.3 | ||
| % of which for cannabis use | 47.8 | ||
| % of which for stimulants use (other than cocaine) | 27.4 | ||
| Notes: The variation across time, in particular with regard to the absolute numbers of clients in treatment, should be interpreted with caution as coverage data may have changed over time. For further information on coverage details please refer to the relevant EMCDDA Statistical Bulletin. ‘N. Av.’ stands for ‘No information available’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2009 and TDI tables (ST34) V. 1.0-2007, questions 13.1.1 and 13.1.2. EMCDDA Statistical Bulletin 2007 (Tables TDI 4 and 5), 2009 and 2011 (Tables TDI 2 and 5). | |||
4. Treatment provision
| Type of treatment | Availability |
|---|---|
| Psychosocial out-patient interventions | Extensive |
| Psychosocial in-patient interventions | Full |
| Detoxification | Extensive |
| Substitution/maintenance treatment | Limited |
| Notes: For an explanation of terms used, see the definitions of terms. Based on question 3.1 " Please assess the current availability of the treatment interventions below in relation to the user needs, judging the degree to which treatment capacity matches the demand" of Structured Questionnaire SQ27P1 on 'Treatment programmes'. Rating Scale (level of availability):
Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | |
| Opoid substitution treatment | 2007 | 2007 | 2009 |
|---|---|---|---|
| Number of clients in opioid substitution treatment | 1522 | 1522 | 1945 |
| of which with methadone | 1522 | 1522 | 1945 |
| of which with buprenorphine | 0 | 0 | 0 |
| Notes: For a detailed European overview please see Table HSR-3 in the EMCDDA Statistical Bulletin 2011. ‘N. Av.’ stands for ‘No information available’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | |||
| Applied substances in opioid substitution treatment | Officially introduced in |
|---|---|
| Methadone (MMT) | 1993 |
| Buprenorphine (HDBT) | N.App. |
| Heroin assisted treatment,including as trials | N.App. |
| Slow-release morphine | N.App. |
| Buprenorphine/naloxone combination | 2008 |
| Notes: For a detailed European overview please see Table HSR-1 in the EMCDDA Statistical Bulletin 2011. ‘N. App.’ stands for ‘Not applicable’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | |
| Legal framework of opioid substitution treatment | Methadone | Buprenorphine |
|---|---|---|
| Do office-based medical doctors have the right to initiate the prescription of substitution treatment? | N.App. | N.App. |
| Do specialised medical doctors have the right to initiate the prescription of substitution treatment? | N.App. | N.App. |
| Notes: For a detailed European overview please see Table HSR-2 in the EMCDDA Statistical Bulletin 2011. For an explanation of terms used, see the definitions of terms. 'Specialised medical doctors' refers to specifically trained or accredited office-based medical doctors. Sources: Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | ||
Treatment availablity in Europe
The graphic below presents an overview of treatment provision by different types of service (psychosocial outpatient, substitution, psychosocial inpatient and detoxification) in different European countries and can be used for comparative purposes. Click on the thumbnail to view it.
Figure 1: Treatment availability in Europe, 2007
5. References and links
Related EMCDDA resources
- Health and social responses statistics
- Treatment demand statistics
- Annual report on the state of the drugs problem
- National reports for Poland
- Country overview for Poland
- Drug treatment responses page
- Best practice portal
- Treatment demand key indicator page
For a comprehensive overview on drug treatment systems, availability and utilisation in Europe, please consult the 2008 online report on ‘Quality of treatment services in Europe — drug treatment — situation and exchange of good practice’ published by the Directorate General for Health and Consumers.
External links
Please note that the EMCDDA is not responsible for the content of external sites.
- Association Monar (PL, EN, RU)
- Association Monar in Krakow (PL)
- Association Familia (PL)
- Institute of Psychiatric and Neurology (PL, EN)
- National Bureau for Drug Prevention (PL, EN)
Treatment inventories
- narkomania.org.pl (PL, EN)
Treatment research centres
- Polish Evaluation Society (PL)
- Institute of Psychiatry and Neurology (PL, EN)
- Warsaw University (PL, EN)
- Polish Psychological Association (PL)
