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Drug treatment overview for Poland

Map of Poland

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 The role of these communities has superseded the overriding role given to psychiatric institutions in other central and eastern European countries.The implementation of drug treatment falls under the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 it is delivered by a range of providers that have signed contracts with the National Health Fund. Funding for drug treatment is primarily covered by health insurance, while uninsured patients can be treated using funding provided by the National Health Fund. There is also an option to receive treatment at private clinics or from private practitioners, but for an additional fee paid by a client/patient.

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 and drug wards in prisons, and post-rehabilitation programmes. In territories where there is no specialised drug treatment service, help can be obtained from mental health counselling or alcohol rehabilitation clinics. In 2013 new standards for accreditation of residential treatment programmes were approved by the Ministry of Health, and work is underway to develop specific guidelines on accreditation audits.

In line with the public health perspective of drug treatment, the treatment system in Poland has two approaches: ‘drug-free’ treatment (psycho-social models) and pharmacological treatment (i.e. opioid substitution treatment). Of these two, the ‘drug-free’ model prevails and includes therapeutic communities, cognitive behavioural psychotherapy, 12-step programmes, case management and self-help groups. Treatment is provided in two modes: outpatient and residential. Outpatient interventions for users of illicit psychoactive substances are provided through more than 200 addiction counselling centres, day-care centres and consulting points located in large cities. Inpatient treatment, available through around 100 units, is dominated by long-term and mid-term residential treatment that usually lasts no 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 for 8–14 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, and by private clinics and physicians. Polish post-rehabilitation programmes are also implemented, mainly by NGOs. These are subsidised from the state budgets and with resources from local authorities. In recent years, taking into account the changing profile of the treatment clients, a new treatment programme aimed at cannabis users has been promoted in Poland.

Opioid substitution treatment (OST) is available in Poland, and the first methadone maintenance programme was introduced in 1993. Since 2005 such treatment has only been carried out by public healthcare units that have been granted permission by the governor of the region in collaboration with the Ministry of Health. According to the 2005 drug law, NGOs can also establish and carry out OST, and the first programmes provided by private health centres and facilities were established in 2007. In 2013 some 25 non-prison OST programmes provided services to about 1 725 clients, of whom the majority received methadone as the substituting substance, while buprenorphine-based medications are also available. In addition, 138 clients received OST within seven programmes in 23 prison units.

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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.

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3. Treatment demand

Table 1: Number of clients entering treatment in Poland by year
Clients in treatment 2010 2011 2012 2013
Number of all clients entering treatment 1342 N.Av. 2833 2759
Number of all clients entering treatment with known primary drug 1333   2817 2740
% of which for opioid use 48.2   29 26.4
% of which for cocaine use 1.3   2 2.4
% of which for cannabis use 23.5   36 33.4
% of which for stimulants use (other than cocaine) 21.5   22 28.7
Number of new clients entering treatment 364 N.Av. 1171 1118
Number of new clients entering treatment with known primary drug 360   1162 1114
% of which for opioid use 14.7   9 8.2
% of which for cocaine use 2.2   3 1.9
% of which for cannabis use 44.4   54 51.6
% of which for stimulants use (other than cocaine) 27.0   22 27.3
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 2014 and TDI tables.
EMCDDA Statistical Bulletin 2015.

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4. Treatment provision

Table 2: Opoid substitution treatment provision in Poland
Opoid substitution treatment 2010 2011 2012 2013
Number of clients in opioid substitution treatment 2114 2200 1583 1725
of which with methadone 2079 N.Av. 1543 1699
of which with buprenorphine 63 N.Av. 40 N.Av.
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:
Standard Table 24 (ST24) on 'Treatment availability' submitted in 2014.
Table 3: Year of official introduction of opioid substitution treatment substances in Poland
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 the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. App.’ stands for ‘Not applicable’.
For an explanation of terms used, see the definitions of terms.
Sources:
Reitox national reports.
Table 4: Legal framework of opioid substitution treatment in Poland
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 the EMCDDA Statistical Bulletin 2015 (HSR section).
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:
Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2014.

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5. References and links

Related EMCDDA resources

 

External links

Please note that the EMCDDA is not responsible for the content of external sites.

Treatment inventories

Treatment research centres

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About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Friday, 22 May 2015