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POLAND New Development, Trends and In-Depth Information on Selected Issues

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POLAND New Development, Trends and In-Depth Information on Selected Issues Bogusława Bukowska, Dawid Chojecki, Piotr Jabłoski, Łukasz Jdraszak, Agnieszka Kolbowska, Michał Kidawa, Artur Malczewski, Małgorzata Maresz, Elbieta Milczarek, Danuta Muszyska, Katarzyna Pacewicz, Klaudia Palczak, Anna Radomska, Jolanta Rogala-Obłkowska, Janusz Sierosławski 2006 NATIONAL REPORT (2005 data) TO THE EMCDDA by the Reitox National Focal Point POLAND New Development, Trends and in-depth information on selected issues REITOX Table of Contents for National Reports Page Summary ................................................................................. 3 Part A: New Developments and Trends .................................. 6 1. National policies and context ............................................... 6 2. Drug Use in the Population .................................................. 21 3. Prevention ........................................................................... 33 4. Problem Drug Use ............................................................... 41 5. Drug-Related Treatment ...................................................... 55 6. Health Correlates and Consequences ................................ 59 7. Responses to Health Correlates and Consequences........... 71 8. Social Correlates and Consequences ................................. 76 9. Responses to Social Correlates and Consequences........... 86 10. Drug Markets...................................................................... 89 Part B – Selected Issues ......................................................... 100 11. Drug Use and Related Problems among Very Young People ............................................... 100 12. Cocaine and Crack – Situation and Responses ................ 108 13. Drugs and Driving .............................................................. 124 Part C ...................................................................................... 128 14. Bibliography o Alphabetic list of all bibliographic references used ........... 128 o Alphabetic list of relevant data bases ............................... 131 o Alphabetic list of relevant Internet addresses ................. 131 15. Annexes ............................................................................. 132 o List of Standard Tables and Structured Questionnaires used in the text ............................................................... 132 o List of Graphs used in the text ........................................ 133 o List of Abbreviations used in the text .............................. 136 2 SUMMARY Licit and illicit psychoactive substances and the related problems have been monitored in Poland for many years. Despite the methodological limitations connected with estimating the drug phenomenon as well as the availability and credibility of some data we are able to describe the phenomenon and portray the scope of the drug problem and its trends. The demand for drugs can be measured through the prevalence of use. There are several sources of information on this subject. One of them is the national survey audit on the use of alcohol and other drugs by school youth. The survey was conducted on a representative sample of pupils of third grades at lower secondary schools “gimnazja” and second grades at secondary schools according to the methodology of the European School Survey on Alcohol and Other Drugs (ESPAD). The aim of the survey of 2005 was to estimate the prevalence of substance use by school youth prior to coming into force of the National Programme for Counteracting Drug Addiction 2006-2010. The results indicate far higher prevalence of illicit substance use than licit one. The comparison of the results of the survey of 2005 with the results of the previous surveys points to the decline in the upward trend in the use of both licit and illicit psychoactive substances. Among the illicit substances the highest prevalence is noted in cannabis. The lifetime prevalence of cannabis use stood at 14.2% in the younger pupils and 31.5 in the older ones. Second comes amphetamine (3.6% of the younger pupils and 12.4% of the older pupils). Both experimenting with illicit substances and the occasional use are more prevalent in boys than girls. The majority of the adolescents are well-oriented in the health and social threats related to substance use. The degree of risk, according to the pupils, is more dependent on the frequency and the way of use rather than the type of substance. It must be noted that cannabis is viewed more liberally by than other illicit substances. Both 70% of third-graders of lower secondary schools and second-graders of secondary schools participated in preventive classes the year before. The majority of the respondents notice the influence of the classes, at least in the field of their own perception of drug use. Another source of information on drug use in our country is the survey conducted in 2002 on the national random sample of adult citizens of Poland. The survey called “Psychoactive substances – attitudes and behaviours” dealt with the prevalence of substance use and the attitudes of Poles to alcohol and drug-related problems. It was the first survey of such type carried out on a national scale. Its results showed that drugs in Poland ceased to the problem of young people. They are entering the world of adults. Among the citizens of age, especially in big cities, the prevalence of illicit substance use does not deviate from the prevalence in schools. Poles regard drug addiction as a problem of public health rather than public security. 3 Trends in the development of drug addiction understood as a regular drug use that causes acute problems i.e. mental and behavioural disorders may be followed through statistical data of the residential psychiatric treatment system. The number of patients treated at specialist facilities and hospital wards due to addiction has been rising in recent years. In 2004 12 836 users were admitted to residential treatment. It was an increase of 9.0% compared to 2003, when 11 778 patients were admitted. The percentage of first-time patients did not change a lot and stood at 56.4%. The gender structure of patients admitted to residential treatment has been holding steady for many years. In 2004 the percentage of women was 23.6% (22% in 2000, 24% in 2003). The changes are also observed in the age structure, in 2004 the percentage of patients aged 16-24 fell to 48% (54.7% in 2000, over 51% in 2003) and the proportion of the oldest patients (over 45) rose to 12.7% (8% in 2000, 11.3% in 2003). A decrease in young patients may mark the beginning of the trend stabilization. The most numerous group still remains the group of opiate users (20%) then, in terms of numbers, came users of tranquilizers and sleeping pills (11%), amphetamines (9%), cannabis (3%) and inhalants (2%). The remaining categories of patients do not exceed 1%. It must be stressed that more than a half of patients falls in the category: mixed and undefined substances. In 2005, similarly to previous years, there were strong territorial variations in the prevalence of drug addiction. The territorial distribution of the phenomenon provides three areas of increased drug prevalence: western part of the country - regions of dolnoslaskie, lubuskie and zachodniopomorskie, northern part – warminsko-mazurskie region and central part – mazowieckie region. The latest estimate of the number of drug addicts in Poland which included persons not covered by the reporting treatment system is based on the results of the study conducted in 2002. According to this estimate the number of drug addicts ranges from 35 000 – 75 000. One of the most serious drug-related health problems is infectious diseases. Injecting drug use poses a great risk of HBV, HCV or HIV infection. The data on drug-related HIV infections and AIDS cases as well as data on the incidence of infectious diseases in injecting drug users come from the National Health Institute. The number of new HIV infections in injecting drug users reported in standard statistics in recent years has been decreasing similarly to AIDS cases, which are reported with considerable delay. The most dramatic consequences of using drugs are fatal overdoses. The source of information on this subject is the register of the Main Statistical Office. Drug-related deaths selected according to the national definition include ICD-10 codes: F 11-12, F 14-16, F19, X42, X44, X62, X64, Y12 and Y14. In recent years in Poland the trend has been stabilizing and since 2002 it has been falling. The data of 2002 reveal 324 drug-related deaths, 179 deaths in 2003 and 149 in 2004. 4 Pursuant to Article 26.5 of the Act of Law of 29 July 2005 on counteracting drug addiction benefits of treatment, rehabilitation and reintegration are provided free of charge for a drug addict regardless of his or her place of residence in Poland. Health services for drug addicts are provided through the network of ambulatory and residential public or non- public health care centres. The basic link of the first aid and psychological counselling are ambulatory clinics. The most popular ambulatory clinics include Prevention and Treatment Counselling Centres (Poradnie Profilaktyki i Leczenia Uzalenie). In 7 years from 1998 to 2004 the number of counselling centres doubled and the number of patients increased sixfold (number of counselling centres rose from 34 in 1998 to 73 in 2004, number of patients at these centres rose from 4 991 in 1998 to 30 601 in 2004). The system of health care for drug addicts is still dominated by long-term and mid-term
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