Country overview: Poland
- Situation summary
- Data sheet
- Barometer
Contents
- Drug use among the general population and young people
- Prevention
- Problem drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-related deaths
- Treatment responses
- Harm reduction responses
- Drug markets and drug-related offences
- National drug laws
- National drug strategy
- Coordination mechanism in the field of drugs
- Drug-related research
| Year | Poland | EU (27 countries) | Source | ||
|---|---|---|---|---|---|
| Population | 2008 | 38 115 641 | 497 455 033 | Eurostat | |
| Population by age classes | 15–24 | 2008 | 15.9 % | 12.6 % 1 | Eurostat |
| 25–49 | 36 % | 36.3 % 1 | |||
| 50–64 | 19.6 % | 18.4 % 1 | |||
| GDP per capita in PPS (Purchasing Power Standards) 2 | 2007 | 53.4 | 100 | Eurostat | |
| Total expenditure on social protection (% of GDP) 3 | 2006 | 19.2 % | 26.9 % p | Eurostat | |
| Unemployment rate 4 | 2008 | 7.1 % | 7 % | Eurostat | |
| Unemployment rate of population agends under 25 years | 2008 | 17.3 % | 15.5 % | Eurostat | |
| Prison population rate (per 100 000 of national population) 5 | 2006 | 229.9 | Council of Europe, SPACE 2006.1 | ||
| At risk of poverty rate 6 | 2006 | 19 % | 16 % 7 | SILC, 2007 | |
p Eurostat provisional value.
1 2007 figures.
2 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
3 Expenditure on social protection contains: benefits, which consist of transfers, in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.
4 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.
5 Situation of penal institutions on 1 September, 2006.
6 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold in the current year and in at least two of the preceding three years.
7 EU-25 countries.
Drug use among the general population and young people
The second general population survey on drug use was conducted in 2006 among persons aged 15–64. In 2006, marijuana/hashish was the drug with the highest lifetime prevalence, at 9 % (compared to 7.7 % in 2002). Cannabis was followed in terms of lifetime prevalence rates by amphetamines (2.7 %), ecstasy (1.2 %), hallucinogenic mushrooms (1 %) and cocaine (0.8 %). Variations between lifetime prevalence of all substances between 2002 and 2006 were not statistically significant. In terms of age distribution, the highest proportion of use was found in the age group of 15–24, and lifetime prevalence drug use is rare among the group aged 34 and older. Results indicated a correlation between marital status and drug use, where most of the respondents reporting occasional drug use were single.
Comparison between national ESPAD studies conducted in Poland among the 15–16 years old students, from 1995 to 2007 indicated a lifetime experience with cannabis varying from 8 % in 1995 to 14 % in 1999, yet increased to 18 % in 2003. The latest ESPAD results of 2007, showed that 16 % of the students had ever tried cannabis. In 2007, inhalants lifetime prevalence was reported by 6 % of the students (9 % in 2003). Lifetime prevalence of amphetamines use was reported by 4 % of the sample, 4 % reported ecstasy use, all other substances were reported by 2 % of the students. In addition, results indicated that 12 % of the sample used cannabis during the last year (14 % in 2003), 6 % during the last month (8 % in 2003). Finally, the reported lifetime prevalence of cannabis use among males was 22 % and 11 % among females.
Prevention
The National Bureau for Drug Prevention and the State Agency for Prevention of Alcohol-Related Problems are central governmental agencies established to coordinate activities aiming at drug and alcohol prevention. The Ministry of National Education is responsible for universal drug prevention in schools. Schools and other units in the framework of the education system are obliged to implement children’s and youth’s problems school prevention programme which are coherent with school socialising programme.
At schools and other units of the education system there are implemented also universal and selective prevention programmes. For example, the programme ‘Zippie’s friends’ addressed to kindergarten children (six-year-olds) in the school year 2006/2007 over 7 000 children from all over Poland attended classes in 259 facilities. Educational programme ‘School for parents and educators’ aimed at increasing of upbringing attitudes as well as ‘Short school intervention’ targeted at pupils with drug problem are widely implemented nationwide.
On regional and local level the responsibility for the drug prevention belongs to provincial and communal self-governments. The project ‘Support for regional and local communities in drug prevention’ coordinated by the National Bureau for Drug Prevention (NBFDP) was continued. It was directed towards teams appointed by self-governments and included the representatives of local authorities, welfare workers, police, local NGOs. In the frame of the programme, representatives of 802 communes of the 2 478 communes in Poland were trained in the planning and implementation of communal programmes for counteracting drug addiction.
Selective and indicated prevention activities are targeted at recreational settings, groups-at-risk and families-at-risk, and the National Bureau for Drug Prevention supports their implementation by NGOs in Poland. The programmes centres around community action in a number of areas: education on drug-related risk; motivation to change attitudes and behaviour; direct user-oriented interventions; providing information on drug outreach centres; and distributing information materials. Prevention activities targeted at the general population consist of drug prevention campaigns and the Internet Counselling Centre.
Problem drug use
An estimation of the number of problem drug users (where problem drug use was defined as regular illicit drug use causing serious problems, with all illicit drugs included) was conducted based on 2005 data, and using the benchmark method within the framework of a country-wide population survey. According to the outcome of the study, it was estimated that there are 100 000–125 000 problem drug users in Poland (3.7–4.7 per 1 000 inhabitants aged 15–64), a significant increase on a previous estimate made in 2002 with an estimate of 33 000–71 000 problem drug users.
Due to the political changes over the last decade, the availability of imported heroin has increased and has overtaken homemade opiates known as ‘kompot’ or ‘Polish heroin’. A new estimate of problem opioid use was constructed, amounting to 27 000 individuals in a range of 25 000 to 29 000 (1 per 1 000 inhabitants aged 15–64 with upper 1.1 and 0.9 lower bound).
The EMCDDA defines problem drug use as intravenous drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis are not included in this category.
Treatment demand
In Poland, information on the number of individuals treated for drug addiction should be collected by all inpatient psychiatric health services, including specialised drug treatment centres, and data are reported to the Institute of Psychiatry and Neurology. In 2006, all 358 inpatient treatment centres submitted data, and treatment demand data indicate that a total of 13 198 clients entered treatment, of whom 6 480 were first-time treatment clients. Drug users were reported in 257 centres, majority of them in specialist drug treatment health care units (86 in Poland today). A new system was introduced in 2008 and first results should be available in 2009.
In 2006, 43% of all clients entering treatment were aged less than 25 years. A higher percentage in age distribution was reported among new treatment clients, with 53 % under the age of 25 years. As in previous years, men constituted the majority among all clients entering treatment in 2006, with 76% for male and 24 % for female. Among new treatment clients, 75 % were males and 25 % were females.
Drug-related infectious diseases
In Poland, data regarding the prevalence of HIV infection is collected by the National Institute of Public Health — National Institute of Hygiene. The institute analyses data for the whole country reported by Provincial Sanitary and Epidemiological Stations (Sanepid). In 2007 the incidence of newly-reported cases of HIV infections among injecting drug users was decreasing (in 2005: 157 cases, in 2006: 112 cases and in 2007: 66 cases). However, there is a risk of underestimation of cases as the transmission route for a large percentage remained unexplained. No national data are available for HCV and HBV infection rates among IDUs. Development and maintenance of database of acute hepatitis B and C has been partly achieved.
Drug-related deaths
The basic source of information concerning drug-related deaths in Poland is the data of Central Statistical Office (GUS). Based on the general mortality registers, the number of drug-related deaths seems to be relatively stable. According to ICD-10, the trend for 1997–2004 showed that a peak in the number of deaths was reached in 2000. The number of fatal overdoses registered by the general mortality register indicates a stable trend in the last years and in 2006, the total number of drug-related deaths was 241.
Treatment responses
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, some private organisations or sponsors are also involved in the support of material costs related to drug treatment.
Drug treatment services are provided through the network of outpatient and residential healthcare centres, detoxification wards, day care centres, drug treatment wards in hospitals, mid-term and long-term drug rehabilitation facilities and drug wards in prisons. In line with the public health perspective of drug treatment, the treatment system in Poland can be differentiated into three areas, namely; outpatient treatment, residential treatment and detoxification treatment. Outpatient interventions for users of illicit psychoactive substances are provided through addiction counselling centres, mental health counselling centres and daycare centres located in large cities. Residential treatment is dominated by long-term and mid-term residential treatment lasting more than one year. Detoxification treatment is provided in detoxification wards and usually lasts 8 to 21 days. Outpatient and inpatient drug treatment is mainly delivered by NGOs, followed by public services and private providers. Detoxification treatment is mainly provided by public services, as well as by private clinics and physicians.
Solely 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 2007, there were 1 522 clients in opioid substitution treatment.
Harm reduction responses
Harm reduction activities have been carried out in Poland since 1989 and consist predominantly of needle and syringe exchange programmes, prevention-related educational programmes and opiate substitution programmes. Polish decision-makers generally support the idea of harm reduction, which is also reflected in the drug act and in the National Programme for Counteracting Drug Addiction (NPCDA). Programmes are mainly operated by NGOs and based in big cities; they include outreach work at the meeting places of drug users and sex workers, homeless shelters, and specialised agencies providing needle and syringe exchange programmes. In 2007, the National Bureau co-financed 15 projects in the field, targeting active problem drug users; local governments also make important contributions. In 2007, 396 000 syringes were distributed through 13 needle and syringe exchange programmes in 11 cities for 3 228 clients. Generally, the geographical coverage is limited and programmes may not be available in all regions where injecting drug use is reported. Since several years, the National Health Fund aims to systematically increase the availability and reach of programmes aimed at reducing and treating infectious diseases among drug users, in particular by contracting antiretroviral treatment services, providing vaccination against HBV, as well as counselling and testing for HCV and HIV.
Drug markets and drug-related offences
The Police Headquarters in Warsaw and the Provincial Police Headquarters report data on drug-related offences. Since 1997, it appears that the number of offences concerning illegal production of drugs has been stable, as well as reports on the cultivation of poppies or hemp. Since 2000 a continuous increase has been observed concerning offences related to the encouragement of persons to take drugs. In line with the change of the drug law in 2000, the number of drug-related offences has been increasing steadily. In 2005, there a total of 67 560 drug related offences were reported, decreasing to 61 910 drug related offences in 2007. 56 % were cannabis related offences followed by amphetamine related offences at 30.8 % and 4.2 % for heroin related offences.
The analysis of police drug seizures in 2006 reveal the continuation of an upward trend in herbal cannabis seizures and an increase in cannabis resin seizures compared to 2005. A similar trend is also evident in the case of amphetamine, with a total of 424 kg of seizures in 2007 and cocaine with a total of 161 kg of seizures in 2007. Furthermore, a substantial quantity of heroin was seized in 2007, with a total quantity of 124 kg.
In 2007, the average price of amphetamines, cocaine, heroin and herbal cannabis increased when compared to the previous years. However, in 2007 the price for cannabis resin decreased when compared to 2005, from an average price of EUR 8.9/gram in 2005 to an average price of EUR 7/gram in 2007.
National drug laws
Drug addiction in Poland is regulated by the Act of Law of 29 July 2005 on counteracting drug addiction. The act generally has a preventive and treatment-oriented character, and the stipulated sanctions should not be used against problem drug users. Nevertheless, according to the drug law, any possession of drugs is penalised, even a small amount for personal use. In minor cases, the offender can be fined or ordered to serve a sentence involving limitation of liberty or deprivation of liberty of up to one year. The court may, however, also decide to oblige a sentenced drug user to undergo treatment.
Trafficking of drugs is penalised by a fine and deprivation of liberty of between 6 months and 8 years. In case of a minor offence, the perpetrator may be fined, subjected to limitation of liberty, or imprisoned for a maximum of one year. In cases where the amount of drugs is substantial, the perpetrator may be subjected of a fine and the penalty of deprivation of liberty for a term up to 10 years.
Despite the fact that treatment in Poland is voluntary, teenagers under the age of 18 can be obliged by the court to undergo treatment.
National drug strategy
Poland’s ‘National programme for counteracting drug addiction 2006–10’, adopted in August 2006, is divided into five pillars: (i) prevention; (ii) treatment, rehabilitation, harm reduction and social reintegration; (iii) supply reduction; (iv) international cooperation; and (v) research and monitoring. This comprehensive programme focuses on illicit drugs, with its objectives being the reduction of drug use and drug-related social and health harm. It follows closely the targets of the EU drugs action plan and includes performance indicators.
Coordination mechanism in the field of drugs
The Council for Counteracting Drug Addiction is the coordination and advisory body in the field of counteracting drug addiction. The Council is comprised of the Secretary or the Undersecretary of State in the Ministry of Health (chairman); the Secretary or the Undersecretary of State in the Ministry of Interior and Administration (Deputy Chairman); the Director of the National Bureau for Drug Prevention (Secretary); the Secretary or the Undersecretary of State from the ministers of: Justice; Defence; Science; Foreign Affairs; National Education and Sport; Agriculture and Rural Development; Economy, Labour and Social Policy; Finance — the head of the Customs Service, a member — a representative of the self-government side in the Joint Commission of the Government and Self-government.
The NBFDP, which is a state budget unit subordinated to the Ministry of Health, is responsible for coordinating the implementation of the National Program for Counteracting Drug Addiction and the preparation of an annual report on the state of its implementation. Its activities also include setting priorities in the field of drug prevention. The secretariat of the Council for Counteracting Drug Addiction is located in the Bureau.
At the provincial level Marshal proxies for counteracting drug addiction/ provincial drug coordinators are responsible for coordination of regional drug policy and of implementation of regional strategy which by law is in line with national strategy and action plan. Additionally at the provincial level there are provincial experts on drugs and drug addiction who collect and exchange information , data and documentation concerning drug problem. The provincial drug coordinators and experts are often the same person. Every year Provincial Experts prepare reports on the situation of drugs and drug addiction. The summaries of these reports are available at the NBDP website.
Drug-related research
Research and monitoring constitute one of the five main areas of activity presented in the current ‘National Programme for Counteracting Drug Addiction’, with the main objective of providing information support on the national programme’s implementation. Coordinating the implementation of the National Programme in the area of research and monitoring is carried out by the national focal point by the National Bureau for Drug Prevention. At present, the National Bureau for Drug Prevention remains the main body commissioning and financing the implementation of research in the field of drugs and drug addiction, although Poland’s global Scientific Research Committee also represents a funding source for drug-related research. Numerous research projects are conducted on the basis of grants awarded by the Ministry of Science and Higher Education as well as by international programmes. Scientific activity in the field of drugs and drug addiction in the scope of statutory activities is also conducted by the Institute of Psychiatry and Neurology.
Some of the research projects are carried out by NFP. The implementation of research commissioned in the field of drug addiction is also conducted by the National Institute of Public Health — National Institute of Hygiene, universities and research agencies functioning on the Polish market The main priorities for drug-related research are: population surveys, qualitative studies on use patterns and consequences, cohort studies, and HIV and HCV cross-sectional studies. Research findings are disseminated through scientific journals, websites and national focal point activities which also include the publications in a newsletter, a dedicated website and participation in conferences. Recent drug-related studies mentioned in the 2008 Polish National report mainly focused on aspects related to prevalence of drug use.