In 2019, Sebastian Kaleta, a member of the Polish parliament associated with the ruling Law and Justice party, published a report denigrating Warsaw-based organisations working in the fields of LGBTQ+ rights and harm reduction. The report alleged that these non-governmental organisations and informal groups spend public money to de facto ‘affirm’ the use of psychoactive substances and ‘promote’ non-heteronormative sexual behaviours under the guise of working to combat drug dependency and HIV/AIDS. The report used publicly available data published by local and national organisations in Poland that aim to promote sexual education, sex workers rights, safe drug use, less punitive drug laws, etc. According to Kaleta, the distribution of condoms, education about how to use psychoactive substances in a safer way, and efforts to de-stigmatize non-heteronormative sexual practices (e.g. chemsex) lead to the dissemination of ‘harmful ideologies’ with so-called “gender ideologies” at the forefront.
While the Polish press claimed that Kaleta’s report revealed a ‘hidden’ agenda to encourage certain sex- and drug-related behaviours, the document in fact reinforced a logic already present in Polish drug policy and dominant thinking about drug use: that abstinence is the right state policy, and measures to minimize harm cannot support so-called ‘social deviance.’ According to this logic, citizens should not engage in risky behaviour, and if they do, all responsibility for the outcome falls to them. One of my research participants, who works with people who inject drugs, described this logic by comparing the dominant narrative on drug use in Poland to the popular attitude towards sexuality expressed by policymakers:
I’m thinking of this kind of negation that people…, not accepting the fact that people use [drugs] and have sex. It’s such wishful thinking that everyone will stop using and they won’t use any longer. They won’t have unprotected sex – is comparable here. It’s nowhere near what most people do. This model is so drug free and also often negates pharmacology, or rather pharmacological support for treatment, to heal the addiction. The assumption here is that help and support is due to those who choose abstinence, and those who choose to use… it doesn’t really matter what happens to them, i.e. not only whether they have [drug-induced – author’s note] collapse, but also whether they become infected with HIV or HCV.
How are drugs, drug use and users talked about and thought about in a narcophobic society governed by restrictive drug laws, where harm reduction activities are still considered ‘morally controversial’ (Malinowska-Sempruch 2014)? While observing various public discussions about (il)legal drugs, I wondered what the Polish drug wars bring to the local understanding of drug addiction. What notions of risk, responsibility, and vulnerability are at play in national debates over addressing sex- and drug-related issues? Jarret Zigon (2019) writes about a certain fantasy world produced by national and international, state and non-state actors through the drug wars, a world that associates drugs with notions of addiction, transgression, crime, and immorality. In this fantasy world, drug users are socially constructed as internal enemies, as a threat to societal cohesion, or as an enslaved population, trapped in the addiction. Punishment, interestingly, can also be sometimes accompanied by concern. For instance, policies to address drug use may render a person who uses psychoactive substances a ‘victim’ of addiction who requires both punishment and care. Migration scholars coined the term “carceral care” (Abbasi 2020), to describe intertwinements of care and punitiveness in the current migration policies worldwide. However, this notion can be also applied to drug policies. Carceral care is often at the heart of policies and their concrete programs and solutions, which not only reinforce the discursive fantasy world Zigon describes, but shape drug users’ real world experiences.
While efforts to address drug use across the globe have locally different expressions, these wars produce certain universal images of what psychoactive substance use looks like, fabricating the subjectivities of drug users as irresponsible citizens, vulnerable addicts or threats to moral order (Dziuban et al. 2021). Significantly, in contemporary political discourse, narcophobia and aversion to harm reduction meets queerphobia expressed in state actions. In recent years, we have observed a clear shift in the formation of homophobic public discourse in Poland – representatives of the state often resort to homophobic arguments in order to mobilise categories of the nation, of a healthy and functioning society and of normality, and to manage society by using them (Korolczuk 2020). This shift is important because it reveals new dynamics in the relationship between the state and the citizen. A citizen who does not fit into the vision based on heteronormativity and productivity/usefulness becomes disposable for the state (Wang, 2018). Thus, there is no need to invest in harm reduction programmes.
Scholarship of harm reduction in different contexts indicates how these practices often enforce the accountability of drug users, who, by completing successive tasks, are supposed to be able to re-shape their subjectivity – as responsible, rational, and productive citizens (and thus as useful to the state) (Moore 2008; O’Malley & Valverde 2004; Race 2017). Locally, however, this logic can be shaped by a range of political, economic or social factors that alter harm reduction measures. My research with people who use drugs in Poland shows how the criminalisation of psychoactive substance possession and the abstinence-based model of drug use have together informed thinking about harm reduction among the public and policy-makers as a solution that does not so much eliminate the problem but rather exacerbates it – specifically, as a solution that ‘absolves users of responsibility’. Criminalisation thus not only limits or eliminates the possibilities of introducing some harm reduction programmes (e.g. safe injection rooms or ‘take naloxone home’ initiatives in Poland), but also forms social imaginaries about drug use and treatment methods.
Harm reduction in Poland: a history
This attitude towards harm reduction in Poland did not emerge in a social vacuum. Approaches to psychoactive substance use since the 1980s have been dominated by the belief that total abstinence is the only valid solution to the drug problem (Malinowska-Sempruch 2016). This model was pursued for years by the most influential organisation working in the drug field – MONAR (Youth Movement Against Drug Addiction). Abstinence and total rejection of psychoactive substances – ideas implemented in numerous stationary facilities across the country with a clear daily regime and community control – were supposed to teach people who use drugs responsibility for their own lives and give them the opportunity to demonstrate a strong will (Kotański 1984; Dziuban et al. 2021). Thus, they were part of the carceral care approach: they offered care to people who use drugs, while disciplining them and not accepting any form of rule transgression on their part (for some time, for example, relapse meant that MONAR patients could not be re-admitted to the facility again).
Indeed, by the late 1990s, Polish drug laws became more restrictive. However, political discussions at the time revealed ambivalence towards punishment: criminalisation, although presented as a legitimate trend in drug policy, was to some extent resisted by policymakers who saw opportunities for solving the ‘drug problem’ with treatment and harm reduction programmes, rather than through punitive action (Malinowska-Sempruch 2014; 2016). The first harm reduction programmes in Poland were implemented in the 1990s, during a period of rapid and dynamic political and economic transformation. The then-ongoing transition to democracy and a neoliberal economy reconfigured citizens primarily in terms of their economic utility and usefulness in sustaining a vision of a healthy, productive, and disciplined nation (Dunn 2015). By the late 1990s, this national vision of health, productivity and discipline was echoed in parliamentary discussions about the need for stricter drug laws. During one session of the Polish parliament, MP Henryk Kisielewski, who was in favour of criminalising possession of psychoactive substances, said:
‘And since we talk so much in this Chamber from time to time about our belonging to the leading part of Europe, in which we want to take the position of subject, and not of object, not of a second-class state, let us enter it [the European Union – author’s note] as a strong nation, with a strong identity and moral value, let us be a healthy, strong and stable, and not a contaminated [by drug use – author’s note] component of this newly shaping Europe’.
Despite ambivalence among lawmakers, criminalisation of drug possession, introduced gradually since 1997, eventually complemented the drug-free model promoted by MONAR. Over time, in the eyes of politicians, criminalisation became seen as a way to protect young people from the ‘massive and increasingly visible degradation’ of drug use, and users themselves from the risk of death. New legal regulations introduced just before and after Poland’s accession to the EU in 2004 established the drug user, previously defined in terms of a disease, as a criminal. Harm reduction, which was then in its infancy, did not fully fit into the emerging model of managing addicted bodies – such an approach was perceived by policymakers instead as a tool for ‘deepening addiction’ and weakening the chances of recovery (Dziuban et al. 2021). While since then more harm reduction programmes have been introduced slowly by nongovernmental actors, the emergence of new psychoactive substances on a large scale in Poland after 2008 has rather reinforced the punitive approach in drug policies.
As it is, Poland’s harm minimisation programmes (needle and syringe exchange programmes, substitution therapy, drop-ins) are only partially responsive to the needs of users (Bartnik & Kwiatkowska 2015). The support offered in harm reduction programmes is often conditional – substitution programmes, for example, are based on a high-threshold model and a lack of trust in drug users. Patients are not allowed to use any psychoactive substances during their treatment, they are also subjected to unannounced urine tests for the presence of these substances, and for the first 6 months of treatment they must attend the treatment centre every day to collect methadone. This last rule can be relieved after six months of treatment, provided that the patient has not violated any of the rules of the facility. One interviewee described the support model for people with drug addiction as follows:
This is part of such a systemic destruction of this population, which has been going on for decades. This systemic extermination of addicts who do not want to take advantage of the abstinence offer, i.e. they continue to use and in their use they simply take this crap [poor quality drugs – author’s note] and not the other, some switch to drinking. They do not stay in treatment because they drop out of treatment, but not because they want to drop out themselves, but because they get kicked out of treatment because they are taking substances.
People with drug dependency I interviewed during my research pointed out, for example, that substitution is still not available on prescription – in order to receive it, one has to join one of the substitution programmes located in one of the largest cities in Poland. Their functioning, however, is out of touch with the needs of patients, forcing them to travel frequently and to be regularly monitored by doctors. Quite recently, the dominant narcophobic narrative has been reinforced by the emergence of new psychoactive substances (so-called ‘legal highs’; in Polish dopalacze) on the drug market and has strengthened criminalising and punitive tendencies.
Kaleta, in the report mentioned at the beginning of this text, attacked above all those activities that go beyond the usual model of helping people who use drugs, the LGBTQ+ community and sex workers. Actions that reject seeing these groups only in terms of their vulnerabilities, that consider the agency of individuals and groups and avoid disciplining them for transgressing socially accepted norms. In the Polish drug wars, responsibility is linked to abstinence – a responsible user is someone who stops taking drugs, accepting the logic reproduced by state policy. Given the current political climate, the possibility of a shift in thinking about drug use, responsibility and users’ subjectivity, remains unclear. However, campaigns denigrating the social action of organisations, implemented by those in power, encourage social mobilisation from below, leaving hope for new and more just drug policies.
Justyna Struzik, PhD, is an assistant professor at the Institute of Sociology, Jagiellonian University. She devoted her doctoral thesis to queer mobilisation in Poland. Her book Queer Solidarity was awarded as the best gender book by the Polish Gender Society in 2020, and received the Stanisław Ossowski Prize in 2021. Currently, as part of the project Crimscapes – Navigating Citizenship through European Landscapes of Criminalisation, she is looking at the criminalisation of psychoactive substance use from the perspective of users and activists. She is particularly interested in grassroots mechanisms of navigating criminalisation. Twitter: @jstruzik3
This text is a modified version of my article ‘Narcophobia Meets Queerphobia: Criminalisation, Harm Reduction and Responsibility in Polish Drug Policies’ which was published in InterAlia – A Journal of Queer Studies (2021, 16, pp. 106-111, https://doi.org/10.51897/interalia/SPUM9550). This text is based on research conducted within the project CrimScapes: Navigating citizenship through European landscapes of criminalisation, supported by a New Opportunities for Research Funding Agency Co-operation in Europe (NORFACE), Democratic Governance in a Turbulent Age (Governance) Joint Research Program, project no. 462-19-020.
 It was not the first such vote by a state authority. More on harm reduction debates in Poland: Owczarzak 2007, Struzik 2021, Dziuban et al. 2021.
 such as Social Education Foundation (FES) – working in field of sex education and STIs; Social Drug Policy Initiative (SIN) – organising screening tests of psychoactive substances and advocating for changing the public perception of drugs and drug laws in Poland; Sex Work Poland – an informal coalition of sex workers and allies advocating for sex workers’ rights; Social Policy Foundation – PREKURSOR – harm reduction organisation; and Social AIDS Committee (SKA) – an HIV/AIDS service provider.
 The term “gender ideologies, broadly applied by right-wing actors, is meant to describe harmful ideas from the West in the field of gender roles, sexuality and family values.
 I follow the understanding of the term ‘drug wars’ proposed by Jarrett Zigon (2019), who defines it as „the drug war should not be conceived as something like a singular policy issue or a totalized strategy, and neither should it be limited, as it often is in public discourse, to its localized manifestation in parts of Colombia, Mexico, or the inner cities of the United States. Rather, the drug war is best conceived as a nontotalizable and widely diffused complex phenomenon that manifests temporarily and locally as a situation”.
 The verbatim transcript of the sitting of 19.03.1997 is available here: bs.sejm.gov.pl
 In this context, words „Better children in prison, than in a cemetery” were spoken by the liberal politician Barbara Labuda, who expressed her support for the introduction of restrictive anti-drug laws. See more: Malinowska-Sempruch 2014.
Abbasi, Ghazah. 2020. “Discipline and Commoditize: How U-Visas Exploit the Pain of Gender-Based Violence”, Feminist Criminology, 15(4) 464 –491. DOI: 10.1177/1557085120923037.
Bartnik, Magdalena, & Kwiatkowska, Agata. 2015. “Iniekcyjni użytkownicy substancji psychoaktywnych” [Injecting users of psychoactive substances]. Fundacja Redukcji Szkód.
Dunn, Elizabeth. 2015. “Privatizing Poland”, Ithaca, NY: Cornell University Press. https://doi.org/10.7591/9781501702204
Dziuban, Agata, Faust, Friederike, Sekuler, Todd, Struzik, Justyna, Bonde, Lina, & Nicholls, Emily J. 2021. “HIV/AIDS and its Monsters. Negotiating Criminalisation along the Monster–Human Continuum. European Journal of Cultural Studies. https://doi.org/10.1177/13675494211017911
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Malinowska-Sempruch, Kasia. 2014. “HIV among Drug Users in Poland: The Paradoxes of an Epidemic”,[Unpublished doctoral dissertation]. Columbia University.
Malinowska-Sempruch, Kasia. 2016. “Shaping Drug Policy in Poland”. International Journal of Drug Policy, 31, 32–38. https://doi.org/10.1016/j.drugpo.2016.02.018
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Owczarzak, Jill Teresa. 2007. “Mapping HIV Prevention in Poland: Contested Citizenship and the Struggles for Health after Socialism.” University of Kentucky Doctoral Dissertations. http://uknowledge.uky.edu/gradschool_diss/515.
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———. 2017. “Thinking with Pleasure: Experimenting with Drugs and Drug Research.” International Journal of Drug Policy 49 (November): 144–49. https://doi.org/10.1016/j.drugpo.2017.07.019.
Struzik, Justyna. 2021. “Citizenship and Pleasure: a Study on Harm Reduction Assemblages in Poland”, Critical Public Health, 31:1, 30-42, DOI: 10.1080/09581596.2020.1849562
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