In Poland, people struggling with opioid use disorder can benefit from substitution treatment for almost 20 years now. Treatment and dispensing of drugs take place in special programs, where the staff often oblige patients to continuous visits, even every day. This prevents them from stabilizing their family and working life and increases the risk of spreading COVID-19. The Polish Drug Policy Network appeals to the Speakers of the Sejm and the Senate to introduce legal solutions that will make it possible for people to obtain their medicine at a regular pharmacy.
At the end of September 2020, the Polish Drug Policy Network (PDPN) sent an appeal to the Speaker of the Sejm, Elżbieta Witek and the Speaker of the Senate, Tomasz Grodzki, for the immediate resumption of work on the draft amendment to the Act on Counteracting Drug Addiction prepared by the National Bureau for Drug Prevention (NBDP). In the opinion of PDPN experts, this is a greatly needed project and its adoption would help to treat people with opioid use disorder to a wider scale and thus contribute to the improvement of public health in Poland.
People struggling with opioids use disorder (eg heroin) can benefit from substitution treatment in Poland since 1992. It involves administering substances with properties and effects similar to the drug they have been using but excluding those intoxicating. Most importantly, the administration of substitution drugs prevents the occurrence of withdrawal symptoms. Such substitution treatment helps to maintain abstinence, significantly improves the quality of life and extends it significantly. It also allows you to fulfil social roles, such as taking up a job.
In most cases, patients need long term treatment. They must use their medication constantly, as do people with depression, diabetes and heart disease. There is, however, an important difference. Treatment and dispensing of drugs take place in special programs, where the staff often oblige patients to continual visits, even every day. Forcing these visits brings financial gain to programs but can jeopardize the purposes of patient treatment and social readaptation. This causes many complications for their lives, is often tied to constant, long journeys and does not allow to fully stabilize their family and professional life.
“The enactment of the bill by the NBDP is particularly important in times of a pandemic, as it extends the current model of substitution treatment to include the possibility of using drugs prescribed by doctors without the need to gather patients in stationary programs. Remember that addiction is a disease and patients suffering from this disease should be entitled to a prescription medication – just like patients suffering from any other medical condition that requires pharmacological support, such as diabetes. “
Agnieszka Sieniawska, Chairwoman of Polish Drug Policy Network
According to the report conducted by the NBDP, in 2019 there were only 25 substitution treatment programs in Poland. Their distribution is uneven. In some voivodships, there are none at all. For this reason, Poland is struggling with overloaded substitution programs, which is a crucial factor reducing their effectiveness. It is especially noticeable in Warsaw, where people from all over Poland migrate to gain access to treatment.
“Due to the frequent attendance requirement, substitution programs serve too many people every day. Daily appearance maintains environmental risk factors, hampers progress in therapy and social reintegration. “
Jacek Charmast, Chairman of Jump 93 Association
In the circumstances of the COVID-19 pandemic, people with substance use disorders using substitution programs face even greater inconveniences. The centralization of treatment in the biggest of Polish cities means that patients from smaller towns have to travel tens of kilometers to their substitution programs. Sometimes several times a week. They are therefore particularly vulnerable to infection.
During the COVID-19 pandemic, due to special conditions, a number of attempts were made in Poland to issue substitution medication to patients for periods longer than usual (for a week or two). This solution proved successful – no increase in overdoses was recorded, and patients were able to dispose of the drug according to their needs and medical recommendations. This is a positive signal confirming the correctness of the proposed solutions in the amendment.
PDPN experts indicate that in the current situation of the COVID-19 pandemic, the possibility of purchasing a prescription substitute drug will not only reduce the risk of coronavirus infection, but also allow patients to receive treatment in their place of residence without the need to move to another city or province. There are also economic reasons for this – the availability of prescription drugs would free up the funds needed to maintain substitution programs in Poland.