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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 2007 NATIONAL REPORT (2006 data) TO THE EMCDDA by the Reitox National Focal Point POLAND New Development, Trends and In-depth information on selected issues REITOX 1 Krajowe Biuro ds. Przeciwdziałania Narkomanii – National Bureau for Drug Prevention Warsaw, Poland 2007 Editor: Artur Malczewski Authors: Centrum Informacji o Narkotykach i Narkomanii – Reitox National Focal Point: Artur Malczewski - Head of NFP Michał Kidawa Marta Struzik Ewa Sokołowska Beata Policha Krajowe Biuro ds. Przeciwdziałania Narkomanii - National Bureau for Drug Prevention: Piotr Jabłoński – Director Bogusława Bukowska – Deputy Director Anna Radomska Dawid Chojecki Łukasz Jędruszak Danuta Muszyńska Katarzyna Pacewicz Agata Kręt External experts: Zofia Mielecka - Kubień Janusz Sierosławski Jacek Kurzępa Translation: Paweł Nowocień Kamil Nowocień 2 List of Contents Page Summary ................................................................................. 4 Part A: New Developments and Trends .................................. 7 1. National policies and context ............................................... 7 2. Drug Use in the Population .................................................. 23 3. Prevention ........................................................................... 38 4. Problem Drug Use and the Treatment Demand population 50 5. Drug-Related Treatment ...................................................... 66 6. Health Correlates and Consequences ................................ 73 7. Responses to Health Correlates and Consequences........... 83 8. Social Correlates and Consequences ................................. 90 9. Responses to Social Correlates and Consequences........... 99 10. Drug Markets...................................................................... 102 Part B: Selected Issues ........................................................... 116 11. Public expenditures............................................................ 116 12. Vulnerable groups of young people………………………… 140 13. Drug-related research in Europe ....................................... 179 Part C ...................................................................................... 199 14. Bibliography…………………………………………………… 199 o Alphabetic list of all bibliographic references used ........... 199 o Alphabetic list of relevant data base………………………. 206 o Alphabetic list of relevant Internet addresses……………. 206 15. Annexes……………………………………………………….. 207 o List of Standard Tables and Structured Questionnaires used in the text ............................................................... 208 o List of Graphs and Tables used in the text ..................... 208 o List of abbreviations used in the text…………………….. 208 Part D – Standard Tables and Structured Questionnaires 213 3 SUMMARY prepared by Marta Struzik The history of drugs and drug addiction in Poland goes back to the 1970s and since then the use of illicit psychoactive substances and related problems have been monitored. Despite methodological limitations related to the nature of the phenomenon as well as the availability and credibility of some data, the picture of the size of drug problem and trends in drug use are becoming increasingly accurate. Demand for drugs can be measured by drug use prevalence. One of the sources of information is the national questionnaire survey on alcohol and drug use in school youth conducted according to the methodology of ESPAD studies. The aim of the 2005 survey was to measure prevalence of psychoactive substances in young people before the National Programme for Counteracting Drug Addiction 2006-2010 came into force. The results indicate a far higher prevalence of licit than illicit substances. In illicit substances a relatively high prevalence was noted in relation to cannabis. Second came amphetamine. Both experimenting with illicit substances and occasional use is more prevalent in boys than girls. Most young people are well-oriented in terms of health and social risk related to using psychoactive substances. Both 70% of middle school third graders and high school second graders attended prevention classes at school. Most participants noticed the impact of prevention classes, at least on their opinions on drug use. Another source of information on drug use is the study conducted on a national random sample of Poles. In 2006 the second edition of the research project on the prevalence of psychoactive substances and Poles’ attitudes towards alcohol and drug- related problems was launched (the first study was conducted in 2002). The results of this edition show that marijuana still remains the most prevalent drug. The occasional drug use trend levelled off. The results also revealed downward trends in the availability of drugs and a slight rise in people exposed to drug offers, especially cannabis. No increase in drug driving trends were noted. Similarly to 2002 drug addicts are considered ill people who need treatment and care. Trends in drug addiction understood as regular use causing serious problems e.g. mental and behavioural disorders can be monitored on the basis of statistical data of residential psychiatric treatment. The number of drug patients at specialist clinics and hospital wards was rising steadily in previous years. In 2005 the residential treatment system admitted 3.7% more patients compared to 2004. The percentage of first-time patients did not change and stood at 55.9%. The sex distribution of patients admitted to residential treatment changed in 2005 – the percentage of women rose to 31% (24% in 2004). Changes were also noted in the age structure, in 2005 the percentage of patients aged 16-24 fell to 45% (48% in 2004), whereas the percentage of the oldest group (45 and older) increased to 14% (13% in 2004). Since 2001 we have been observing an annual percentage increase in patients aged 4 25-34. Lower percentages of younger age groups might imply that the trend is starting to level off. The most numerous patient group is still opiate users (18%), then in numerical order come users of tranquillisers and sleeping pills (11%), amphetamine (8%), cannabis (3%) and inhalants (2%). The remaining categories of patients do not exceed 1%. It is worth stressing that more than a half of drug patients fall into the category of “miscellaneous and undefined substances”. The latest estimation of the number of problem drug users that also included persons not covered by the drug treatment reporting system is based on the 2002 study results. According to this estimation the number of drug addicts ranges between 35 000 and 75 000. The results of another estimation using this year’s national survey will be available at the end of 2007. Due to increase in drug use in the 1990s and at the beginning of the 21st century the number of drug addicts is expected to rise. One of the most serious drug-related health problems is infectious diseases. The result of the 2005 study “Incidence estimation of infectious diseases (HBV, HCV, HIV) in IDUs” show that incidence rates in Poland are comparable with those recorded in Europe. In the study group HCV infection rates occurred twice more often than HIV infection rates. At present HIV is predominantly transmitted sexually. HCV antibodies were detected in 57.9% of the study participants compared to 24.1% of the participants with HIV antibodies. It must be stressed that only a third of HCV respondents knew they were positive, which increases their risk of unaware virus transmission. The results showed that HBV, HCV and HIV infections are facilitated by increased exposure to blood as well as dire socio-economic status of injecting drug users and engaging in risky behaviour such as sharing the same needles and syringes. Nationwide data on the number of HIV infections and AIDS cases reported to Sanitary and Epidemiological Stations, including those related to drugs come from the National Institute of Hygiene. The number of routinely reported new HIV infections in injecting drug users has been falling in recent years, similarly to AIDS cases, which reflect the phenomenon with considerable delay. In interpreting the above data one should pay attention to the fact that in a number of reported HIV cases there is no source of infection stated, which is likely to be using psychoactive substances. The most dramatic consequences of using drugs are fatal overdoses. The source of information on this subject is the register of the Central Statistical Office. Death cases have been extracted according to ICD-10 codes: F11-12, F14-16, F19, X42, X44, X62, X64, Y12 i Y14. In recent years in Poland we have been observing stabilization of the trend and since 2002 the number of deaths has been falling. In 2005 we recorded a slight increase in the number of drug-related deaths. In 2004 there were 231 death cases and in 2005 290, which 5 is slightly more than in 2004. The 2006 data will show whether the 2005 increase was a temporary fluctuation or a permanent reversal if the downward trend that started in 2002. Pursuant to Article 26.5 of the Act of Law of 29 July 2005 on Counteracting Drug Addiction the services of drug treatment, rehabilitation and re-adaptation are provided for a drug addict free of charge, regardless of his or her place of residence. Health care for drug addicts is based on the network of outpatient and inpatient clinics that hold the status of public or non-public health care units. Outpatient clinics (predominantly Prevention and Addiction Treatment Centres) constitute the first link of intervention and psychological assistance.
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