In Poland, the responsibility for the field of prevention has been entrusted for years to local governments and non-profit organisations. According to Piotr Jablonski, Poland’s National Anti-Drug Coordinator, the main actors in this area are non-profit organisations, which fund 80 per cent of treatment activities and more than 90 per cent of prevention activities. At the 2nd Annual International Panel of the Permanent Conference on Healthcare in Prague, he stressed that funding is essential, but how individual actors use it is also important.
For alcohol and drugs, Poland is at the average level of the European Union in terms of the ratio of consumers to population. The prevalence of alcohol use in the population of 15 to 64 year olds was 79.9 per cent last year. In terms of drug use, the prevalence is 5.4 per cent. „In this respect, we belong to the group of countries that have managed to reduce the prevalence of drug use,“ says Jablonski.
The government there considers addiction to be one of the most serious public health problems. Therefore, it does not want to focus only on people who have already succumbed to addiction, but also on others. „Addictions in the general definition include not only people who are clinically dependent, but also people such as neighbours, workers, colleagues, children, family members and so on,“ the coordinator explained.
Non-profit organisations are important
Instead of focusing on each addiction separately, the Polish authorities have created (as in the Czech Republic) a national drug programme that includes alcohol, illegal drugs or so-called behavioural addictions such as gambling, problematic online gambling or addiction to the internet itself. Jablonský said that thanks to the tightening of drug policy, the prevalence of drug use has decreased.
Although the Ministry of Health is still the primary institution in the fight against addiction, this year the Polish Parliament approved the creation of the National Centre for Addiction Prevention, whose budget is the responsibility of the Ministry of Health. In addition to covering prevention programmes for all types of addiction, it will also focus on domestic violence.
This is not common in other countries. Jablonski justified the aforementioned at the conference by saying that they wanted to put the issue of addiction in a broader context when setting the strategy. „We have included actions that should lead to a reduction in domestic violence because it is linked to alcohol consumption,“ he explained, adding that this is not only true for Poland, but probably for all countries in the world.
According to the national coordinator it has also been true for years that local governments and non-profit organisations have been important actors in prevention. „The actors in the implementation are mainly non-profit organisations, which represent 80 per cent of the activities in treatment and more than 90 per cent in prevention. Local governments use their resources for various activities such as training and prevention,“ Jablonski explained.
Higher taxes on alcohol and tobacco
The Polish government has also introduced a system whereby prevention is implemented at the local and regional level. Funding mainly comes from increased taxation on alcohol. „Since drinking alcohol cannot be completely eliminated from life, at least thanks to this mechanism we have enough money to implement prevention programmes. Each of the 2,500 Polish municipalities is obliged to implement its own prevention activities,“ said the anti-drug coordinator.
In the future, these funds should be even higher. In fact, over the next five years, Polish excise duties on alcohol and tobacco will increase by five to ten per cent each year. „The availability of alcohol in Poland is quite high. We will also try to create new economic principles that will prevent easy access to alcohol,“ Jablonski justified the tax measures.
State authorities also cooperate with non-profit organisations or universities at other levels. For example, the referral system in the health promotion programme is up and running. This is the joint initiative of several institutions and this is how evidence-based lists of prevention programmes should reach local governments. According to the Polish anti-drug coordinator, a lot of money also goes into public education.
The National Prevention Centre also closes more than 200 contracts on prevention and treatment each year. Most of them are managed by NGOs. „Now we will be looking at how to expand programmes in future years, such as harm reduction programmes. We believe that changes in the composition of addiction policies will improve the situation with the prevalence of alcohol and drug use and other addictions,“ Jablonski said at the conference.