POLISH LEGISLATION on DRUGS and DRUG ADDICTION Between Repression and Therapy Krzysztof Krajewski
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NATIONAL EDUCATION CAMPAIGNS 15 YEARS OF THE NATIONAL BUREAU FOR DRUG PREVENTION – tIMELINE Date Event Bureau for Drug Addiction established by way of Regulation of the Minister of Health and Social Care 1993 development of the first National Programme for Preventing Drug Addiction establishment of the Interdepartmental Team for Controlling Psychoactive and Narcotic Substances: Regulation of the 1994 Chairman of the Council of Ministers 1995 first issue of narkomania newsletter development the first complex National Programme for Counteracting Drug Addiction, including tasks of drug demand 1999 and supply reduction National Bureau takes over the responsibility for the implementation and financing of ESPAD research in Poland first national campaign of the National Bureau entitled Find time for your child] further national campaigns were centred on the following subjects: • The best way out is not to go in: 2002–2003 • Drug-free universities : 2004 • Closer to each other – further away from drugs : 2005–2006 2000 • Support for local communities in counteracting drug addiction: 2006–2007 • Watch your drink: 2007 • Do you know what you are carrying: 2008 National Bureau publishes a guide (in book form and online) on drug clinics (with the following editions in 2002, 2004, and 2007). establishment of the Information Centre for Drugs and Drug Addiction cooperating with the European Monitoring Centre for Drugs and Drug Addiction 2001 joining the EU-wide early warning system for detection of emerging trends and new synthetic drugs by the Centre for Information on Drugs and Drug Addiction establishing a network of 16 Regional Experts for Information on Drugs and Drug Addiction by Marshal Offices launching the system of specialist training in drug addiction therapy and rehabilitation 2002 appointing the Council for Counteracting Drug Addiction first general population survey according to EMCDDA standards concerning drug use among adults implementation of the first contract on international cooperation focused on supporting administrative structures and 2002−2003 adjustment of legal regulations to EU requirements connected to Poland’s accession to the European Union; the partner of the National Bureau was France (Phare 2000) implementation of another contract on international cooperation focused on supporting structures of governmental administration and local communities Fight against drugs: continuation; the partner of the National Bureau was the 2004−2005 German Ministry of Health and Social Protection (Phare 2003) launching works on standards in addiction therapy (establishing the team for developing accreditation) first national survey among students on the prevalence of psychoactive substance use Act of 29 July 2005 on Counteracting Drug Addiction: • introducing the obligation to approve community programmes and indicating sources of its financing 2005 • allowing non-public health care units to provide substitution treatment • introducing forms alternative to a punishment for drug users causing harm 2006 Polish Minister of Health assumes presidency of the Pompidou Group for the period of four years implementation of another contract on international cooperation focused on supporting structures of governmental administration and local communities “Supporting local authorities in counteracting drug addiction at the local level; 2006−2007 the partner of the National Bureau was the German Centre for Information on Drugs and Drug Addiction (Transition Facility 2004) completion of drafting and beginning of the implementation of the Ethical Code of Addiction Therapist launch of the pilot project on monitoring admissions to drug treatment, in line with the standards of the European 2007 Monitoring Centre for Drugs and Drug Addiction Poland joins the “FreD goes net” international project implementation of an international contract “Supporting local authorities in counteracting drug addiction at the local 2008 level – continuation”; the partner of the National Bureau was Spain (Transition Facility 2006) TABLE OF CONTENTS NARKOMANIA Newsletter COMMUNICATION WITH SOCIETY IS CRUCIAL Interview with Piotr Jabłoński.................................................................................................................................. 2 Law POLISH LEGISLATION ON DRUGS AND DRUG ADDICTION Between Repression and Therapy Krzysztof Krajewski .................................................................................................................................................. 7 Prevention SELECTED PREVENTion STRATEGIES Katarzyna Okulicz-Kozaryn ....................................................................................................................................12 Treatment, rehabilitation, harm reduction BRIEF HISTORY OF TREATMENT OF ADDICTION AND POLAND VS THE CONTEMPORARY SYSTEM OF HELPING THE ADDICTED Jerzy T. Marcinkowski, Piotr Jabłoński ..................................................................................................................18 TYPOLOGY OF PATIENTS USING INSTITUTIONAL AID CONNECTED TO DRUG USE Czesław Czabała ......................................................................................................................................................25 CONTINUITY AND CHANGE. POLISH SYSTEM FOR REDUCING DEMAND FOR DRUGS Robert Sobiech ........................................................................................................................................................ 30 FORMS OF HELP FOR DRUG ADDICTS Robert Rejniak ........................................................................................................................................................ 36 MONAR MODEL FOR COUNTERACTING DRUG ADDICTION Jolanta Koczurowska .............................................................................................................................................. 39 METHADONE TREATMENT IN POLAND Marek Beniowski, Grzegorz Wodowski, Marta Gaszyńska, Marek Zygadło ..........................................................45 International cooperation INTERNATIONAL COOPERATION IN COUNTERACTING DRUG ADDICTION Łukasz Jędruszak, Artur Malczewski ......................................................................................................................53 Research, reports THE PROBLEM OF DRUGS AND DRUG ADDICTION IN POLAND. figures AND TRENDS IN THE PHENOMENON. Janusz Sierosławski ................................................................................................................................................ 58 Training REFLECTIONS ON THE TRAINING SYSTEM IN DRUG PREVENTION Bogusława Bukowska ..............................................................................................................................................67 Internet TO THE INTERNET FOR HELP Tomasz Kowalewicz .................................................................................................................................................73 Social campaigns NATIONAL EDUCATION CAMPAIGNS .................................................................................3rd and 4th cover NARKOMANIA NEWSLETTER COMMUNICATION WITH SOCIETY IS CRUCIAL Interview with Piotr Jabłoński, Director of the National Bureau for Drug Prevention, president of the Assembly of Permanent Correspondents of the Pompidou Group, by Tomasz Kowalewicz The year 2008 marks 15 years since the Minister of two phenomena: the fall in drug use and poly-drug use Health and Social Care established the Bureau on (i.e. combined use) of various substances, especially Drugs, which in 2000 was reformed into the National marijuana, amphetamine, ecstasy, and also pharmaceu- Bureau for Drug Prevention. How was the drugs scene ticals with alcohol. Yet it is to be emphasised that the changing in Poland in the meantime? studies estimating the number of all addicted people In the 1990s, the core of the market were opiates, pri- in Poland show a marked increase in their number (to marily home-made, the so-called Polish heroine. Today, the level of 100,000–130,000 people), which may be the the basic drug is marijuana. The CBOS study from 2008 result of increased consumption of drugs in the 1990s that diagnosed the use of drugs among young people and in the first years of the 21st century. from the last classes of secondary schools shows that A new challenges are the so-called legal highs (Polish: heroin has been altogether eliminated from the area of dopalacze), that is a group of psychoactive substances, interest of young people. In the national representative which is distributed legally through a network of online sample for that age group, there is not a single hint and “traditional” shops. at using heroin, be it the “compote”, brown sugar, or crystal heroin. It is a big change. When it comes to What have been the changes in institutional anti-drug the dynamics of the phenomenon, we observed until actions and in the law on drug addiction during the recently the growth – sometimes dramatic – in the last decade? numbers of people reaching for psychoactive substances, Quite revolutionary legislative and organisational changes both illegal and legal, in the successive studies. Since have taken place in these areas. Maybe not as impor- 2005, we have observed a decreasing tendency in this tant as the outbreak of activity of non-governmental field among the students of lower secondary schools organisations early in the 1980s, which initiated dealing aged 15–16, at the same time we observe a stabilis- with