Reitox National Focal Point National Bureau for Drug Prevention Artur Malczewski Reitox National Focal Point National Bureau for Drug Prevention „Experiences and situation description in NPS intravenous use in Poland” 2nd European Workshop – ’Breaking the Drug Cycle’ project 19 April 2016, Budapest

Numbers of points, cities and exchanges points in 2002-2014.

Numbers of needles distributed in 2002 – 2014.

Numbers of clients in exchange programmes in 2004-2014

Numbers of needles per clients in NSP

Survey among clients of low threshold programs The study aimed to find out patterns of drug use, risky behaviours and HIV and HCV status of problem drug users. The survey included facilities which provided services for drug users such as needle and syringe exchange programmes and drop-in centres for active drug users (with needles available).

Study During a period of two weeks (from last November to first December 2008, 2010, 2012, 2014) staff members of low threshold programmes (needle and syringe exchange or drop-in centres for active drug users) held questionnaire interviews with all clients of a given programme (full sample). Contacts were made through drug users in order to exchange the injecting equipment, give advice, support or simply have a talk. The study was launched at the same time as in France. The respondents’ identities were coded in order to prevent double counting and guarantee anonymity. In the presentation there are results of the person who inject last month - 581 from 733 persons in 2008 and 246 persons from 366

Sources of the income – in 2014 r. more than one answer possible (%) N= 581 (2008); N=246 (2014)

Place of living (%) N= 581 (2008); N=246 (2014)

Percentage of clients broken down by kind of program (%) N= 581 (2008); N=246 (2014)

Level of education (%) N= 581 (2008); N=246 (2014)

Risk behaviours (%) N= 581 (2008); N=246 (2014)

HIV and HCV According to the responses of respondents 49% of respondents (48% of men and 45% women) were infected with HIV in 2008 .; In 2014. while this percentage was 47% of the respondents (52% of men and 42% women). In the case of hepatitis C percentages were much higher. In 2014. 70% were infected with HCV (69% of men and 71% women). In 2008. The percentage was higher and remained at 82% (82% of men and 80% women). N= 581 (2008); N=246 (2014)

LMP of drugs Any NPS: 60% (2014) Any opiates: 2008: 80% 2014: 48% The most problematic: Opioids: 68% (2008), 34% (2014) Amphetamine: 18% (2008) 7% (2014) Alcohol: 6% (2008), 18% (2014) NPS: 28% (2014)

Needs and recommendation for HR: More financial support for NSP to be able to provide more different service; Cooperation between all institutions; Adapting the offer to the needs of clients: not only needle exchange and syringes, drop-in should offer a wide range of intervention: (educational groups, support group, innovative ways of working, psychiatric support, therapeutic support, prevention) Shelter for current drug users or for clients of OST Taking into account changing on the drug scene: NPS

Discussion The above data on harm reduction programmes indicate that since 2002 the number of needle and syringe exchange programmes and exchange points has been falling. This situation might be caused by the following factors: opening new methadone maintenance facilities where beneficiaries of the exchange programmes enter treatment; likely fall in popularity of injecting drug use; disappearance of so-called open drug scenes (“bajzle”) e.g. in Poznań, Szczecin or Gdańsk where street workers operate; no interest in opening new exchange programmes on the part of the implementers. lack of financial resources or not willing from the cities to support harm reduction programs

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Thank you very much! artur.malczewski@kbpn.gov.pl