Drug Abuse in the Global Village
Poland
EXTENT, PATTERNS AND TRENDS IN DRUG ABUSE
Extent of Drug Abuse
Opiates obtained from locally grown poppy are the most abused drugs in Poland followed by volatile substances. Poppy straw brews ("makiwara") and poppy milk used to process heroin ("Kompot" or Polish heroin) are the two forms of opiates abused (Puzynski, S. 1983).
Treatment data figures indicate that there are up to 35,000 drug abusers in Poland (U.N. 1991).
Among 3857 drug abusers in treatment in 1991, 80% abused opiates, 7% volatile substances, 7% multiple drugs, 5% sedatives, 5% cannabis, 2% amphetamine and 1% hallucinogens (CMO 91).
Abuser Characteristics
Opiates abusers usually belong to urban areas and are single and between 20-30 years of age. About 60% are unemployed and have low education or are students. The majority have difficulties in social adaptation (U.N. 1990).
Volatile substance abuse occurs mainly in groups of primary school age children (12-15) in urban areas. The abusers are often from socially disadvantaged families (separated or alcoholic parents), and have scholastic and learning difficulties (U.N. 1990).
Among drug addicts in treatment centres in 1991, 72% were 20-34 years old, and 24% were females (CMO 1991).
Regional Variations
Drug abuse is more common in urban areas (U.N. 1990).
Trends
Volatile substance abuse among young people is increasing. A significant increase in the illicit traffick of cocaine has been reported in 1991. The increase in the demand for illicit drugs is attributed among other factors to a rise in unemployment and the deterioration in the economic situation. The abolition of travel restrictions, increased availability of illicit amphetamines and decreased control over poppy following the gradual introduction of low morphine poppy varieties greatly increased the supply of illicit drugs (U.N. 1991).
Mode of intake
About 80% of all drug addicts in Poland are intravenous drug abusers. The most frequently injected drugs are opiates (CMO 1991). Solvents are inhaled from plastic bags (U.N. 1990). The "Kompot" or Polish heroin is often mixed with barbiturates or benzodiazepines (Puzynski, S. 1983).
COSTS AND CONSEQUENCES OF ABUSE
About 70% of drug abusers are unemployed and depend on social welfare for housing and subsistence (CMO 1991).
According to a study on drug abusers who had undergone treatment, 60% of all drug addicts suffered various forms of injury, 65% overdosed, 47% attempted suicide, 33% had icterus and 24% dermatic phlegmon (CMO 1991).
A total of 130 drug related deaths were reported in 1991 (CMO 1991), compared to 19 in 1979 and 102 in 1982 (Puzynski, S. 1983). A sample survey of 212 drug abusers in treatment in Warsaw found the mortality rate as 18% between 1980 and 1984 (CMO 1991).
Drug abusers and AIDS patients have difficulties in obtaining basic medical care such as dental or gynecological services, due to rejection by both the general public and medical personnel. This has resulted in increased morbidity among drug abusers, despite a decrease in needle sharing, higher availability of needles and improved education regarding AIDS/HIV transmission. Over 10% of drug addicts in treatment are HIV positive, and in some regions it is up to 35%( CMO 1991). Out of the 149 AIDS cases reported in June 1993, 62 (41.6%) were among injecting drug abusers (AIDS 1993).
NATIONAL RESPONSES TO DRUG ABUSE
National Strategy
No information reported in Annual Reports Questionnaire by 31st December 1993.
Structure of National Drug Control Organs
The central government unit responsible for liaison and coordination of national drug control policy is the Pharmacy Department within the Ministry of Health and Social Welfare.
LEGAL, ADMINISTRATIVE AND OTHER ACTION
TAKEN TO IMPLEMENT THE INTERNATIONAL
DRUG CONTROL TREATIES**
Treaty Adherence
Poland is party to the 1961 Convention as amended by the 1972 Protocol and the 1971 Convention.
With respect to becoming a Party to the 1988 Convention, it was reported that in the course of 1990 several discussions between different drug control related government departments had taken place and initial drafts of new enforcement legislation had been prepared.
Measures taken with respect to Drug Control
Recently enacted laws and regulations:
None reported.
Licensing system for manufacture, trade and distribution:
There is a government-controlled licensing system for narcotic drugs and psychotropic substances. Codeine, dihydrocodeine, ethylmorphine, fentanyl and morphine (narcotic drugs) as well as chlordiazepoxide, clonazepam, cyclobarbital, diazepam, estazolam, oxazepam and temazepam (psychotropic substances) were manufactured in 1991.
Control system:
(i) Prescription requirement: There is a prescription requirement for supply or dispensation of preparations containing narcotic drugs and psychotropic substances. However, there is one exception in the case of psychotropic substances: a product composed of barbital aminophenazone can be dispensed in small amounts (5 tablets maximum) as analgesic by a pharmacist.
(ii) Warnings on packages: The law requires warnings on packages or accompanying leaflet information to safeguard the users of preparations containing narcotic drugs and psychotropic substances.
(iii) Control of non-treaty substances, if any: None reported.
(iv) Other administrative measures: None reported.
Social Measures
Penal Sanctions related to social measures: In 1991, courts applied measures of treatment, education, after-care, rehabilitation or social reintegration for a drug-related offence both as an alternative and in addition to conviction or punishment.
Other social measures: None reported.
DEMAND REDUCTION ACTIVITIES
Primary Prevention
Education programmes for teachers and parents at primary and secondary school levels are organized by the Ministry of Education, Society and Drug Abuse Prevention and by voluntary organizations (U.N. 1990). Continuous education courses are organized for physicians and non-medical staff employed in therapeutic and rehabilitation institutes (CMO 1991).
Mass media campaigns targeted at adults have been launched. Publications on drug abuse preventive measures for the medical profession and the general public have been distributed. These include information relating to prevention of the spread of HIV infection among drug abusers (U.N. 1990).
A needle and syringe exchange scheme is in operation and syringes are readily available in pharmacies. Drug abusers have taken up their own harm reduction behaviours such as boiling fluid opiates, informing other drug abusers of their HIV status and not accepting new addicts in existing groups (CMO 1991).
Treatment and Rehabilitation
The treatment system is composed of out-patient clinics where patients are diagnosed and referred to detoxification services and to rehabilitation centres. Treatment is free of charge and based on voluntary participation (minors excepted). Treatment facilities in 1991 include 38 non-hospital residential units (run by independent health services or non-governmental organizations, or attached to psychiatric hospitals) and 15 specialized detoxification facilities (CMO 1991).
In 1991, a total of 3857 drug addicts were undergoing treatment (2919 males, 938 females). Detoxification programmes treat about 3000 opiate dependent addicts annually. Experimental Maintenance Programmes for intravenous drug abusers who have failed traditional abstinence programmes were treating approximately 60 persons in 1991 (CMO 1991).
In view of the growing AIDS problem, treatment approaches have been modified. Criteria for readmission are more liberal, more efforts are being placed in seeking addicts in their environment and substitution therapy programmes have started operating (CMO 1991).
The State encourages, supports and supervises activities of NGOs, which run more than half of the rehabilitation services (CMO 1991).
SUPPLY REDUCTION ACTIVITIES
Arrests and Convictions and types of Offences
In 1991, 421 persons (294 males) were convicted for drug related offences (231 in 1990, 591 in 1989). Of these, 28% were below 30 years of age and 41% were peasants (U.N. 1991). About 30% of drug addicts in treatment have committed non-violent crimes in connection with drug abuse (CMO 1991).
Seizures
Seizures carried out in Poland between 1989 and 1991 are detailed in table 1 (U.N. 1991).
Table 1. Seizures of illicit drugs in Poland 1989-1991.
1989 1990 1991
Cannabis herb - 11.000 kg 8.030 kg
Cocaine - - 109.800 kg
Heroin - - 13.000 kg
Opiates 0.160 kg - -
Opium (plants/ 4500.000 kg 2040.000 kg -
capsules)
Depressants 0.710 kg - -
Hallucinogens 0.015 kg - -
Stimulants 16.000 kg - 5.000 kg
Source: Reply to the UNDCP Annual Reports Questionnaire for the year 1991.
Supply Source of Drugs
Opiates are obtained from home grown poppies and amphetamine is locally made. Cocaine seized in 1991 is believed to originate from Colombia (U.N. 1991).
References and Notes
** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section was prepared by the Secretariat of the Commission on Narcotic Drugs based on Annual Reports Questionnaires for the years 1988-91.
U.N. 1990,1991. Replies to the UNDCP Annual Reports Questionnaires for the years 1990 and 1991.
CMO 1991. Reply to the questionnaire regarding the seven Targets of the Multidisciplinary Outline of Future Activities in Drug Abuse Control (CMO) for the year 1991.
Puzynski, S. 1983. Drug dependence in Poland, Current Situation. S. Puzynski, Psychoneurological Institute, Warsaw, 1983.
AIDS 1993. AIDS surveillance in Europe, Quarterly Report, 30 June 1993.