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Photo: John Feffer. Cross-posted from JohnFeffer. In those days, drugs were expensive and the supply was limited, so the Polish state could hide the problem by giving a different label to the small number of addicts. But then heroin became more readily available, in part as a byproduct of domestic poppy farming poppy seeds are a key ingredient in the Polish strudel known as makowiec. And addiction started to grow. By the mids, heroin use — along with glue-sniffing, marijuana, and speed — had grown to epidemic proportions. In the s, psychologist Marek Kotanski began a new kind of treatment for drug users that emphasized group therapy and other practices considered innovative at the time. He died in a car crash in I caught up with her on her vacation at the Polish seaside town of Rowy. Now, there are plenty of people in our society addicted to something. Some are addicted to drugs, but very few to heroin. The majority of them are addicted to so-called recreational drugs. The level of their problem is rather high. Very often they are students, good workers, managers, your friends, people you pass on the street. Now there is no distinct group of drug users. A lot of people are using different drugs at different levels. Very few use hard drugs. The majority use marijuana, amphetamines, cocaine, Xtasy, a lot of designer drugs. Also, all the doctors were very well trained, with all the new knowledge and drugs for AIDS patients. In Poland, everyone is treated for free even with all the antiretroviral drugs. Now, close to 20, people that we know are infected. There are anonymous counseling centers in every big city — free of charge. Unfortunately, the situation has changed. Everything is spent on treatment, on the medical drugs. Also, and this is happening in other countries, people stopped being afraid of HIV because it could be treated. As it did in the s, MONAR continues to employ former addicts as part of its team of psychologists and therapists. Twenty years ago, he was a like a skeleton, just bones and skin. He runs a very good center. He finished his studies and his training. He overcame hepatitis C, which was not easy. I am a clinical psychologist, and I started my training in therapy. I worked for a couple years for a good American project in Warsaw. It ended, and I was looking for work. I never dreamed of working with drug users. And Marek Kotanski said yes. I stayed for 30 years. I was full of good will. But it took a long time for me to understand what specifically this work was. A lot! With this group of clients, you have to understand when the drug user is talking to you and when a real person is talking to you. You need to be very careful and understand when the real person is in front of you. This is the real training: to understand these two personalities. The drug user will say almost anything, will promise you anything. They have a lot of hope that the treatment can be done in one day. I would never say that this part of the personality is lying. But if you believe them, if you trust the drug user personality, you cannot help this person. But if you try to build up a real relationship that is therapeutic, a good relationship full of trust but that recognizes these two different people, and if you discuss a lot of things, then maybe together you can find a solution. It takes time. Also, I myself need to be as open as I can be. When we talked in , the number of drug users and homeless people seemed liked a lot. But now when you look back 23 years —. What was different: there was a kind of border between society and homeless people or drug users. It was a different group. Yes and no. Now we have over 30 centers for drug addicts. Some of them are also for alcoholics. And there are close to live-in centers for homeless people. But they are not really homeless people like what we saw in These are new homeless people. We reached a breaking point in Poland when we moved from a Communist country to this new capitalism. With these political changes, there were a lot of social changes. Before, even if many people did not have much money, they had safety and stability. You could find work. You were sure of your work, from when you started until retirement. Now, there are plenty of people without work, or they have part-time work or occasional work. Some of these people are failures rather than homeless. We have services to visit train stations. But the people there generally prefer to stay there. The major reason is alcohol. If they want to do these things they stay on the street. Or they want to feel absolutely free. Almost anywhere. They work part-time, for instance, during the summer, and then move with the seasonal or part-time work. There are also some people from other countries — from the former Soviet countries, like Ukraine. Before , everyone had an address. Now, are you homeless if you have no address? Like in the United States, you are a free person in a free country. It used to be a couple thousand real addicts before. The majority of these addicts are in centers or in methadone programs. But no one can really count the people who use cocaine at home or on the weekends or do amphetamines and Xtasy in club culture. I think there are many hundreds of thousands of people. Before, a good estimate of heroin users came from the number of deaths from heroin overdose. Poland is also a great market for drugs. No, the drugs come from everywhere. Poland is also a great producer of amphetamines. There are open borders. There are some statistics on the website of the National Bureau for Drug Prevention. Open borders change your work a great deal, in terms of people and drugs coming to Poland. It must be more difficult to keep track of the problem. For me, always, drug addiction is a problem, an illness or disease, and drugs were only the symptom, or the way to solve some other problems. I never agreed with any kind of punishment. But of course if some people are drug dealers or doing things that are illegal because of drugs, this should be punished. The Portuguese way is very interesting. We should try this kind of policy. But Poland in the last couple of years, mentally, is not really prepared for this kind of policy. People are not open and friendly. They are not ready to understand other people. Were you surprised by the popularity of the Palikot party and the support for marijuana decriminalization? I was not really surprised. I was happy not only with the decriminalization of marijuana but also the support for people with different sexual orientations. I work all the time in two fields: on AIDS and drug use. For me, the rights of people with sexual orientation are very important. With this I was very happy. But this party, or Palikot himself, he plays some kind of game. When we talked in , there were about AIDS patients. That obviously changed. This was before the antiretroviral medication. How serious did the AIDS crisis become here? In Poland, this problem started in the mids. When we talked in , there were a couple hundred, the majority being drug users. What happened next was that a group of people working on AIDS had a good training thanks to the Open Society Foundation, which I appreciated very much and which provided a good level of funds for prevention. We were young, full of energy and well trained. And it was well funded. Condoms as the first method of prevention became popular and easy to buy. The needle exchange programs began. Also, street services started: street work with drug users, with sex workers. Very quickly the first group of prevention activists trained the next people in even smaller towns. It was a good energetic group with good ideas. For years, Poland was seen by other countries as a good prevention policy maker. The level of new HIV-infected people was growing only by about percent a year. But now the number of HIV infected number is growing again by about 1, per year. Last year, it was 1, probably. Almost none. For 15 years at least. In , we became a member of the EU. For the next two or three years, there were some funds given. When we were waiting for membership funds, we had to change everything over to European standards. But in , we stopped getting money from European committees, from almost any international agency. We get money for drug use and prevention as a medical service. A part of it comes from local governments and local funds. Medical treatment is done in hospitals and clinics. Not so much. There are national campaigns and local campaigns. The rest are services paid from national health insurance. All medical services like counseling centers or rehabilitation and treatment centers are covered. The service is okay when you get in. But you have to wait everywhere. For some special kind of help at a particular hospital, you might to wait one or two or even four years. But you can also go privately. The emergency services are okay. If something happens, you call emergency, go to the hospital, and get good service. Not yet. Politicians struggle like little kids. Some doctors are in a good position. They have fewer patients, better pay, good working conditions. And when they finish their duty hours, they can offer private services. It happens a lot. Private clinics. Private doctors. Private hospitals. Like in other counties. For some surgeries: plastic surgery, dental work. The zloty to euro is four to one. We have really good trained doctors and nurses. And the nurses are not well paid. Doctors sometimes yes. But nurses have a lot of work and get very bad salaries. There were a lot of international and European funds coming from abroad as well as ideas and trainings. The exchange programs were very important. Treatment at the moment is okay. But prevention used to be at a much higher level. He died in He was a real strong leader, fighting as an NGO leader. This organization changed much more into a medical institution. Not everyone and everyplace: there is still a lot of energy for social work and more activities. As an NGO, we used to decide what to do and with whom. Sometimes they are stupid. Back in the good old days, I could meet with a client just anywhere, even at home or in a coffee shop to talk. People could be anonymous or give any name. But now first I have to get your proper name, your address, your personal number which everyone in Poland has , your last visit to the doctor. I have to report in the computer the time you came, your visit, your number. Can you imagine! We just want to discuss how I can help you. We are trying to find solutions. But I have to report all the clients if I want them to be paid by national health service. There are fewer and fewer NGOs, and the ones that survive are getting smaller. We have thousands of clients every year. We now have at least fulltime workers. In , there might have been about , part of them volunteers. There are also plenty of people working now part-time or short-term in different places. I am on the governing board, and we still fight for new ideas and to do the work properly with clients. When we met, the reforms had a great impact. In one day, a lot of people lost a feeling of social safety. Before, almost everyone in this country had a place to live even if it was small, plus a little or medium salary with which they could manage their monthly spending. They felt maybe not happy but safe. What happened next was like a big bomb in a little village! Some people became really rich in one or two years, and some people lose their flats, jobs, and feeling of safety. The whole society changed. Before, people were quiet and friendly, afraid of the secret police or agents. Afterwards, people had energy, good ideas to start business or get a good job. But some people are really poor, especially if there are ill or retired. Medical drugs are expensive. Only for AIDS patients. Some people get zloty per month as a pension. Some drugs could cost you or zloty per month. Then it costs zloty for a small flat. So, you have nothing left! Some medical drugs are cheaper. But some are at a very high price. Many medical industries are in Poland and keep the market at a high level in terms of prices, like in the rest of Europe. But in Poland, salaries are four times lower than the rest of Europe. Is there any resentment toward people with AIDS who get free drugs by people who have to pay a lot for their drugs? It just happened. We fought for a long time for free drugs. For people who are getting only zloty per month, they would never be able to afford the medical drugs for AIDS, which cost 4, zloty. If you are diabetic or have heart problems, you can buy some cheaper drugs, but some are really expensive. In Germany, you pay maybe 5 euro per prescription. Here you can spend all your salary at the pharmacy if you are really ill. You can find some cheaper generic versions. In the United States, more than half of personal bankruptcies are because of sickness. Do people have the same problem here? It depends what kind of illness, but yes. National health insurance in Poland is not based on personal income. I have insurance up to , zloty. But when I leave the hospital, I pay for it. In Poland, a lot of people are working just part-time or self-employed, but really all these people help big international companies to save money. These companies are not paying the proper amount of money from their employees to our government. Many people are cheating by saying that they are not working part-time. Many young people have not paid into the national health service or into retirement. They work, they are young and happy, and they are used by these big companies. Maybe only one-third of people working in Poland are officially working and paying all the taxes. This is a Polish problem. No one wants to tackle this problem. My daughter is I know all her friends and the friends of her boyfriend. And they pay very few taxes. They have these so-called junk contracts. And they give the government very little money. Everyone wants railway, transport, public services. But very few people actually pay taxes. Better regulations. They could have built good national institutions. The laws were changed a little bit here and there. We have a house now. But it could collapse with the first wind. We can survive, because my generation knows how to survive. After years, my daughter and all her friends will have no proper pensions and will make less than zloty per month. The government knows this. And nobody knows what to do! And no one really cares. This is the time to ring the bell and change everything. Poor girl, now just play and do what you want. Not from the mind. Fulltime workers like me pay a lot of taxes, and I pay my whole life. Maybe they should put money in the bank, but they are too young. Even if they have money in the bank, what does it mean for my daughter, her boyfriend? They might feel safe for some time, but not everyone. Was there a moment in the past when Poland started off on this wrong path or do you think it was inevitable? There was a moment when everyone understood the message that they were alone and had to take care of themselves. But a lot of people understood it to mean just play, drink alcohol, take drugs, work on the weekdays, play on the weekends, do what you want, like a bunch of children with no mommy or daddy. Some people were reasonable enough to build businesses, but some live just in the here and now. It was even fun. Nobody cares for you, for better or worse. Nobody keeps an eye on you. But for some people, they have a problem with being grown up and responsible. In , I was for almost one year on an exchange project in California. I went half a year, stayed a little big longer, and was invited to stay in United States. My friends would have been my official sponsors. My daughter was three, staying with her father. I was thinking about my life decisions. In , I could have tried to stay and hope to bring them over to me. It was not easy to do that at that time. This training was in San Francisco, and I was thinking about a life in California. It was not a bad idea. I had a lot of friends who were going to help me, even some rich friends who were very helpful. But I decided to come back to Poland. I feel much more Polish than international, even though I traveled a lot before. It was not so common in Poland, but I had this opportunity to travel a lot. I spent more than a year in England. I traveled around Europe. But I feel more Polish than anything else. It was not a bad decision. My daughter travels a lot, has a good job, has a good flat. She will have her wedding next year in Italy. They are European now, she and her partner. There are no borders. They are a part of this world, just as we were for a long time a poor neighbor of other countries. Which decision would have been better? Maybe California would have been better. But you had some economic problems in America a couple years ago. No one knows. Now I see that these two ways were equal for her. Maybe not for me, but for her. People had time in those days for friends, real ones, not so-called friends from the Internet. There was time for meetings at home, time for theater, cinema, books. Now everyone works overtime — just to manage. Before, I started at 10 am and worked until 3 or 4 pm. I could easily go home, then later on meet friends, go to cinema, or prepare a nice supper for people at home. Now I start at 8 am and finish at 8 pm. With some breaks. I move from one place to another. I also teach. I train. I do a lot in the AIDS field. I also work on Saturday and Sunday, not every weekend, but very often. I teach in Lublin on weekends. Maybe this is a question of age and experience. But nowadays, to get by you need to work a lot of hours. This is a difference for people working on drug addiction. Almost everyone works in a lot of places. When I lived here in , there was always time to meet people. You could easily go and meet your friends. You could go to a shop and buy a new shirt. No one kept track. You had clients. But there was no registering of each minute. Each client and each hour is counted. At the beginning of s, I almost lived on the plane — Sweden, Finland, Greece, Ireland — all these exchange programs and international conferences. But there is not much interest in Poland any more. We had a great exchange program with an NGO in France. We were flying back and forth to Paris. We go to Morocco, Tunisia, Moldovia. Then one day it just ended. We thought we were friends. But we were just a market. Some people were friendly. But we were just a market, really. When you think back to the way you looked at the world in , has anything major changed in the last 23 years? I had much more hope and belief in people before. Now I still keep this hope and belief with me. People I talk to about funding, about what would be best for our clients. But also people in general. I used to believe in many social ideas. Now I see people as individuals, minding their own business. I feel like an old dinosaur. Social ideas are not so popular right now. By social I mean being a part of this world, not helping everyone but not thinking only about myself. I share some ideas and smile at them. Like I was some years ago. But they are not right in some ideas. They need time. They are fighters, not thinkers. But this is the time for young people to fight for their rights. Are there any success stories, on an individual basis, you can talk about? A lot of them had big changes in their life. One of my colleagues had been one of the clients in our movement. He was a heavy heroin drug user. Some people became our colleagues after training and working. At least three young women, former clients, received psychology degrees over the last couple years. Now, they are just ordinary happy people with their own lives. She put a special personal dedication for me not on the first page but on every page of the exam. Just before I came here to Rowy, I had a phone call from the daughter of some clients. First I treated her parents. Then she came with her partner, who had some problems with drugs. And now she just called me that her year-old son started smoking marijuana. The grandparents are okay. But her son has just started. But she might come in with him. When you look back to and everything that has changed since then, how would you evaluate that on a scale of 1 to 10 with 1 being most dissatisfied and 10 most satisfied? And when you look into the near future, how would you evaluate the prospects for Poland on a scale of 1 to 10, with 1 most pessimistic and 10 most optimistic? At the time there was no talk of drug addiction. He established a center in Glockow and from there, the movement grew. There are now twenty centers for rehabilitation around the country and eighteen centers for consultation. As we talked, several young people walked in and out of the room, talking, drinking tea. Wiewiora sketched in the history of MONAR and talked a little about the new range of problems that the organization has begun to address. The method they rely on in the fight against drug addiction involves not so much psychologists or therapists as ex-addicts. These are the people that predominantly staff the centers. There are on an average 30 people who live in the center, creating a sort of family atmosphere. The purpose of the method is a re-shaping of values, undertaken by the individual—not forced upon them—so that they will be able to live without narcotics. They hope, through contacts with other countries, to help establish centers in USSR, Czechoslovakia and so on. Today there are roughly people in Poland with the disease. Between percent are drug addicts. They also established contacts with Lambda, a group devoted to gay rights that was registered officially this past March. The office on Jerozolimski happens to be located near the central train station. For a fifteen-year-old homeless kid, for instance, present day Poland is incomprehensible with its joblessness and rising prices. MONAR therefore arranged to house people in the barracks surrounding the metro station which is under construction in Ursynow. A dozen or so people now live there. But, she points out, the train station is still filled with homeless people: every empty seat occupied. A movement has spontaneously begun among such people because they are, in general, young and healthy. What are the institutions that such people can fall back upon? Not many. The Ministry of Health and Labor have helped out with special funds and there are also private charitable institutions. But, she pointed out, there are no foundations for social purposes. She of course was not particularly happy about the situation. But she understood the reaction of the townspeople. After all, there just was a lack of information. In some respects, then, the severe reaction was good since it attracted news coverage and provided a lot of necessary publicity. Where do the drugs come from? Most of it is homemade heroin, she said. Many addicts prostitute themselves in order to pay for the drug. Was the use of the drug growing? Probably not. The AIDS scare was keeping the younger generation from the drug; twelve year olds seemed to prefer glue-sniffing these days. These drugs are still too expensive for the average Pole. With the large fortunes beginning to appear today in Poland, she feared that the rich might decide that drugs were fashionable and the drugs of preference from the West might take hold. Alcoholism, meanwhile, is still very strong. By John Feffer September 8, What was your feeling when you first started working there? Did you make any mistakes at the time? Can you give me any examples of these two personalities? So, the problem has become much more widespread. There are still some homeless at the train station. Are there estimates of homelessness? There are at least , people who are poor and without homes in Poland. Are they mostly in cities? Are there any estimates on drug addiction? Drugs coming from the former Soviet Union? Of course the police do their work. But you can buy any drug you wish. Are you familiar with the decriminalization and drug treatment program in Portugal? Why is that the case? Is there money from the EU for this? How would you evaluate the national health services in Poland? What if you have an urgent problem? Is there any campaign to change it? It should be, absolutely. No comment. Maybe some medical professionals should run for office. Is there a lot of medical tourism here? Someone told me that medical students get offers from Scandinavian countries… Many nurses are in England, Ireland, Germany, Scandinavia, Italy even. Was it any better at some point over the last two decades? Is he still working? These are Polish or European standards? The stupid ones are Polish. Can you give me an example? I hate it. You still have the NGO spirit. We are getting older and older. Drugs are not free? In Britain, there are long lines, but the drugs are inexpensive. Do you think anything could have been done differently with the economic reform? Do you think anything could have been done before to avoid this? You talked about the importance of security before You work for 12 hours! That computer knows where you are all the time. Have you been anywhere where the work set up is better? People you work with or people in general? Because everything has become private? What do you think about Krytyka Polityczna? Same scale, same period of time: but your own personal life? Share this: Print. John Feffer.

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If 15 years ago someone claimed that drug of abuse tests would be easily available in Polish pharmacists, then one would be considered to watch to many American movies. It should be noted that until Censorship regulation clearly describes that situations like alcoholism, drug addiction, prostitution or homelessness does not exist or are only minimal dregs of society in Poland. At this point we should pay tribute to Marek Kotanski who had the courage to talk publicly about the drug addiction problem, warned about its quick increase. Fortunately he brought into existence new places for drug addicts recovery. I think that even in his dreams he never presumed the range of the problem we face today. In ties a great change has occurred on narcotic market in our country. New drugs become available quickly infiltrating through teenagers community and like every western trade treated with a great dose of acceptance, without foreseeing negative effects. Big influence on increase of this situation had also a fact of coming people connected with a world of crime to drug addicts environment. Theses people did not used drugs by themselves but regarded drug trade as a very profitable business. The police describe that moment as a time of appearing so-called narcotic business in Poland. We can say that since that moment drug addiction has taken pandemic proportion. And I do not mean only people who are diagnosed as drug addicts but all who — in smaller or bigger extend use drugs. According to Addiction Clinics statistics the age of initial drug abuse among adolescents has drastically decreased. The report also informed about huge availability of all drugs as well. It is well known that drug abuse problem does not only concern big cities or pathological community. Poland is one of the bigger amphetamine and ecstasy producers, at the same time being a smuggling truck for Turkish and Afghanis heroin from the South to the North of Europe. At any place where young people gather there is always a dealer offering wide range of drugs. The myth that only rich people can afford drugs has to be exploded. Nothing more misleading! If at Warsaw club we cannot buy a bear for the price lower than 5 PLN while we can buy an ecstasy for the price of 2,5 PLN — is it expensive? And this is only one of the examples how cheap are drugs in Poland nowadays. But the trend for i. Does the word soft means more safe in this case? At this point, almost mechanically, comes a question: what should I do to keep my child away from drugs? The answer given by a therapist with a long-term experience can be surprised. There is no possibility to protect our child against drugs! At yard, school, summer trip, , disco or party with friends — our child will have a contact with drugs. He or she may even try it encouraged by somebody trusted. What is important that parents find out about the event. Of course not from a friend after several years after or — even worst — from Addiction Clinic therapist but from their own child. If that happens, we can be sure we have a good relation with our child and we can talk about the problem from every point of view. Supposing we have good knowledge to be a reliable partner in a conversation. Unfortunately, according to relations of the parents who I met in Addiction Treatment Clinic, they are the last people who find out that their child takes drugs. In past if we suspected that our coming home late daughter or son dropped in a bad company, or just explored life attractions, was enough to say… come here and breath out! And everything was clear. With drugs the situation is more complex. But one involves slowly, gradually into world of drugs; tasting variety of drugs, compare their effect, looking for harder feelings and sensations. She or he will lie, cheat, manipulate — will do anything to not being catch. Very often parents are helpless in this situation. As from one hand their child behave normal in the initial stage of drug abuse but from the other hand we have a feeling that something is wrong. Certainly we can look for a help at therapist and hoping that he will manage to diagnose that our child took drugs three days ago. But there is no such possibility. Even well trained specialist will not be able to recognize a presence of drugs in human body after few days from application. And here come the tests. Drug of abuse tests in urine or even more simple to perform — drug of abuse tests in saliva can help us a lot. They can help us to detect the presence of drugs in the body. Depending on the sort of substance it can be detected in the body from several hours to a few weeks after use. Of course we cannot presume that the test is a therapeutic mean but having it we can be sure of the real situation. In case our children know that we can use drug of abuse test and have a result only in a few minutes, they might be afraid of consequences that it will stop them against trying. It is much easier to act like this with younger children. Since teenagers taking heroin came to Addiction Treatment Clinic, every parent must be aware of the problem at early stage. Of course we can never be sure. It would be perfectly to live in a world without drugs, or without their negative effects. I think that in a real life we can feel a bit more safety with all our knowledge about drugs and having aids like drug of abuse tests. Kup produkty Diagnostic online. What are the tests for? I wish it for myself and for all Diagnosis team! Adam Nyk. Our Spring Sale Has Started.

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