Polish Prisons: Improving Access to Substitution Treatment

Recommendations for improving access to substitution treatment in Polish prisons have been signed. This step forward was made in early December at a conference co-hosted by the Penitentiary Service, the Social AIDS Committee and Open Society Institute’s Global Drug Policy program. The recommendations are a follow-up to a round table which took place in May, attended by Poland’s Minister of Justice, past and present Penitentiary Service directors, politicians, physicians, and NGO representatives.

Experts state that each opioid-dependent person should have the choice of drug-free or substitution treatment; that everyone receiving substitution treatment outside of prison should continue to receive it in prison; and that each region should create at least one substitution treatment programme for people in all types of penitentiary institutions.
Identifying the barriers which hinder universal access to substitution treatment in Poland, Col. Dubiel, Penitentiary Service director, stated that the problem lies in the fact that many believe that methadone treatment is equal to ‘giving free drugs to drug users’. He also stressed that increasing access to substitution therapy in prisons is hard when outside access is so poor.

On civil society’s behalf, the recommendations were signed by Kasia Malinowska-Sempruch, who directs the Global Drug Policy program, and Artur Lutarewicz of the Social AIDS Committee. Lutarewicz, a psychologist,underlined that incarcerating an opioid-dependent person with no access to methadone is comparable to torture. ‘Half a year ago, a roundtable took place which was emotional, yet, unlike many conferences, led to a concrete outcome: the recommendations. We now need to work out appropriate procedures to make sure the recommendations are followed up with real changes.’

Presenting the international perspective, Kasia Malinowska-Sempruch drew attention to the UN Special Rapporteur on the Right to Health’s visit to Poland in May. Mr. Grover later emphasized the need to improve access to substitution treatment. Similar recommendations for Poland were made last month by ECOSOC. ‘I am very glad that the Penitentiary Service in Poland treated these recommendations seriously and that the document, which will be signed today, aims at their implementation’, said Ms. Malinowska-Sempruch.

Director of the Health Service Office, Leszek Markuszewski, discussed future spending plans: ‘The cost of substitution therapy in the penitentiary system amounts to 87,000 PLN [€21,000] per year. An increase of up to 400,000 PLN [€95,000] is required if the number of programmes is to grow from 5 to 30, or even 40.’ Summing up, Marek Balicki MP, former Minister of Health, reflected: ‘Today’s situation is not due to a lack of financial resources, but to the attitude towards dependent persons. The current drug law is excessively restrictive not only in relation to drug users or dependent persons, but also to centres which want to provide substitution therapy. I am glad that prisoners will have the same conditions of treatment as people who are free’.

Contact:
Magdalena Dabkowska, Global Drug Policy program, Open Society Institute
tel. + 48 511 966 107; email: m.dabkowska@hfhrpol.waw.pl
Agata Kwiatkowska, Social AIDS Committee
tel. + 48 602 246 324; email: agata.kwiatkowska@skaids.org