Walking Through Mud; History of the Polish Methadone Maintenance Treatment From Its Stakeholders’ Perspective

Abstract

This paper presents Polish methadone maintenance treatment (MMT) against the background of the dominant therapeutic community approach. The perspectives of various stakeholders—supporters and opponents—are examined as well as the barriers, facilitators, ideological conflicts, and financial interests influencing MMT policy and practice. In-depths interviews were carried out with 18 major stakeholders around 2012, almost two decades after the first MMT was launched. The interviews shed light on stakeholders’ inter- and intragroup conflicts as well as on their official and hidden agendas, but they also show the relevant wider international and national, economic, and political contexts.

Keywords :

• methadone maintenance
• stakeholders
• international influences

THE AUTHORS

Jacek Moskalewicz, PhD, Sociologist, works as the Head of the Department of Studies on Alcoholism and Drug Dependence at the Institute of Psychiatry and Neurology in Warsaw, Poland. He has been involved, for over 30 years, in alcohol and drug research as well as in psychiatric studies. His research interests cover a wide range of issues including epidemiology, policy-oriented studies, action research, social history as well as a variety of methods including conventional epidemiological approaches, population surveys as well as qualitative methods. He is a Member of the World Health Organization experts’ advisory panel on drug dependence and alcohol problems, a consultant or technical adviser to international organizations, including the World Health Organization and the United Nations Office on Drugs and Crime, and the Deputy Chairman of the Science Group of the Alcohol and Health Forum at European Commission. He is the recipient of Jellinek Memorial Award (2001).

Marta Welbel is a sociologist and psychologist, she works as an Assistant Researcher at the Department of Studies on Alcohol and Drug Dependence in the Institute of Psychiatry and Neurology in Warsaw, Poland. Her research interests cover mental health and substance use epidemiology and treatment systems, social factors in substance use and public health policy research. Currently, she is completing her PhD thesis on social inequalities in mental health and mental health care.