1. Alcohol and Drug Problem in Poland. Implications for policy Janusz Sierosławski Institute of Psychiatry i Neurology 3rd Meeting of the Expert Group on Alcohol and Substance Abuse (ASA EG) Poznan 10-11 October 2011

2. Introduction Alcohol use and alcohol related problems traditional and culturally assimilated phenomena in Poland Drug problem arisen in our country late 70’ is considered to be relatively new problem Drug problem provoke much more public concern then alcohol problem, despite much lower prevalence

3. Alcohol Problem in Poland Increasing trend in average annual alcohol consumption Increasing trend in alcohol related problems Transition into beer based drinking pattern from spirits based one Stabilization in extent of drinking by teenagers after rise in the 90’ and in the beginning of current centaury Problem of female drinking

4. Drug Problem in Poland Stabilization in extent of drug addiction after increasing trend in 90’ and first half of current centaury Change of drug use pattern on the level of addiction – increase of role of amphetamine and decrease of opiates Increasing trend in cannabis use, decreasing of amphetamine use on the occasional use level Decreasing trend in drug related health problems (HIV, deaths, mortality)

5. Alcohol and drug problem in Poland – new developments Increasing role of multi-drug use pattern including drugs and alcohol Especially youth merge alcohol and drugs mainly cannabis Increasing trend in number patients with drug and alcohol addiction The average age of drug addicts is increasing and the age of alcohol addicts is decreasing

6. Substance use – new developments New substances – so called smart drugs (highs) Legal status – more than thousand shops in Poland till 2010 Increasing trend in use and signals about health problems Not successful attempts to find solution on the basis of drug low Closing all shops in 2010 on the basis of consumers protection law

7. Response to alcohol and drug problem – concepts Evidence based policy Balanced approach demand reduction supply reduction harm reduction Decentralization – regions and local communities institutional structures funding Involvement of civil society (NGOs)

8. Response to alcohol problem – institutional structures Legal base Act of Upbringing in Sobriety and Counteracting Alcoholism National Program for Prevention of Alcohol- Related Problems 2011-2015 State Agency for Prevention of Alcohol Related Problem – coordination on the national level International cooperation WHO Alcohol policy network Alcohol research support

9. Response to drug problem – institutional structures Legal base Act on Counteracting Drug Addiction National Program for Counteracting Drug Addiction 2011-2015 Council for Counteracting Drug Addiction National Bureau for Drug Prevention – coordination on the national level International cooperation Pompidou Group National Focal Point for EMCDDA Horizontal Group UNDCP Drug research support

10. Towards an integrated policy on psychoactive substances Drug and alcohol policy - problem of coherency Despite of differences in legal status of drug and alcohol both substances produce very similar effect from the public health point of view Benefits from integrated policy Avoiding discrepancy – better coverage Public image Better planning and allocation of resources

11. Pompidou Group approach Cooperation among countries to respond drug problem political level expert level Location in the scope of Council of Europe Coherent policy towards alcohol and drugs – the current concern two publications recent project

12. Conclusions Changes on alcohol and drug scenes call for integrated approach Common fields – e.g. prevention, partially treatment Significant overlaps in target populations Integration of alcohol and drug policy should be considered to be rather long-term process than one act