What is drug addiction treatment in Słupsk?
Drug addiction treatment is planned help spread over months, aimed at lasting abstinence and the patient's return to normal functioning at home and at work. It does not come down to stopping the drug alone, because the outcome is decided by changing what led to use in the first place. That is why we work with the whole patient, not only with the addiction.
Treatment is easily confused with detox, though the two are different things. Detox, the clearing of the body, breaks the action of the substance and is usually the first step, but it does not touch the cause that drove the patient to reach for the drug. Proper treatment begins only after detoxification. The course of withdrawal itself and the symptoms of the first days we describe separately, on the page about drug detox in Słupsk.
We draw up the plan individually, after a consultation and an assessment of health, and we run it entirely privately, without a contract with the National Health Fund.
Why promises are not enough
The family has been hearing this sentence for months: he did promise he would stop. Loved ones start to think it is a matter of character, that if he wanted it more strongly he would manage. Yet addiction is not weakness of will or a bad choice. The World Health Organization describes it as a disease of the brain, similar in nature to diabetes or hypertension. Nobody tells a person with hypertension to simply try harder.
In the brain there is a reward system. When we eat a good meal or sleep well, dopamine is released, a natural payment for something good for the body. A drug triggers the same mechanism, only much more strongly than food or sleep ever can. The brain learns that the substance matters more than anything else and begins to tune itself to it.
What happens in the head as time passes
Over time, ordinary pleasures stop being enjoyable. Receptors that once responded to a simple meal or a calm sleep get used to a much stronger stimulus, so the substance becomes necessary just to feel normal. The part of the brain responsible for planning and inhibiting impulses also weakens, while the urge to reach for the drug grows. That is why willpower alone is not enough, however sincere the promise may be.
The brain links use with specific signals: former company, stress, the time of day. These signals themselves trigger craving before someone can consciously think about it. That is why returning to old acquaintances or a hard day at work can undo everything, despite sincere intentions. It is not proof of ill will, only the effect of how the brain remembered situations connected with use.
It is a chronic disease, but it can be brought under control, just as with other diseases that last for years. Treatment does not consist of adding even more willpower, but of rebuilding the reward system and teaching the brain new responses to old situations. The family does not have to wait for the next promise; they can look for help that works on the cause, not only on declarations.
How can it be told that there is something more than the addiction?
Usually it cannot be told at the first appointment, and that is nobody's oversight. As long as the patient is using regularly, the substance covers the picture: it accounts for insomnia, mood swings, withdrawal from contact and the fact that nothing has been possible to plan for months. While use continues, all these symptoms have one explanation and nobody looks for a second.
The picture separates after withdrawal. A few weeks without the substance and some symptoms disappear along with it while others remain or intensify, and that is the moment when the question of a second diagnosis stops being theoretical. Sometimes it turns out that anxiety or low mood came before the drug use, only nobody named them at the time. Sometimes the reverse: they appeared after years of stimulant use.
We do not settle this over the phone or on the family's account alone, although that account is the most valuable source of information about what was happening before withdrawal. A psychiatric diagnosis is made by a psychiatrist, after their own examination, and it can take more than one appointment spread over time.
Who is responsible for the whole when two people are treating at once?
At the start almost nobody asks about this. The patient sees a psychiatrist and an addiction therapist, both do their part conscientiously, neither knows what the other has settled, and after a few months it turns out the treatment has two plans that never meet.
The division of roles at our practice looks like this:
- The psychiatrist is responsible for the psychiatric diagnosis and its treatment, including decisions on medication, which rest with them alone.
- The addiction therapist conducts psychotherapy, work on relapse and everything concerning use.
- The attending doctor at our practice is responsible for somatic condition and for making sure both routes know about each other.
- The patient decides whether to agree to information flowing between them, because without that consent coordination is impossible.
When psychiatric care is provided by someone outside the practice, we ask for consent to make contact and for information on what diagnosis was made and when. We do not take over someone else's treatment and we do not question it in absentia.
How does the plan change in Słupsk when treatment runs along two routes?
The stages stay the same: contact and diagnosis, stabilisation of health, psychotherapy proper, and then a long period of holding the change. What changes is the pace and what counts as sufficient reason to move on. With one diagnosis the marker is usually how the patient copes without the substance. With two there is a second condition, because moving to more intensive therapeutic work in a week when mental state is deteriorating tends to end with both being broken off.
We do not state in advance how many months this will take, because there is no honest figure. What is known is what lengthens that time: a co-occurring mental disorder, no support at home and a return to the same surroundings in which use was part of daily life. Two of those three factors can be moved, and work on them can begin in the first month.
We write the plan down and return to it at check-ups, rather than reconstructing it from memory. If either route changes it, the other is to learn of that in the same week, not at the next appointment a month later.
What will psychotherapy not handle on its own?
Psychotherapy deals with what leads up to reaching for a substance: recognising the situations that precede it and building a response other than the usual one. It works on a pattern, so it needs regularity and time. The course of therapy itself, the methods and the rhythm of sessions are described on the page about addiction therapy in Słupsk.
Where psychotherapy ends
It will not, however, replace psychiatric care where a psychiatric diagnosis has been made, and that boundary is worth knowing before starting. A therapist does not treat a mental disorder and does not take decisions on medication; if during the work they see the patient's state deteriorating, they refer them to a psychiatrist instead of intensifying therapy.
It works the same way in the other direction. Psychiatric care provided without work on the drug use leaves untouched the part that concerns the substance, so the patient returns with the same problem after every improvement. If the problem concerns prescription medicines rather than street drugs, the route looks different and is described on the page about treatment of medication dependence in Słupsk.
Once the patient is stable, some sessions can be held online over video, so that travelling does not become a reason to drop out. The first appointment and the work during the hardest weeks happen in person.
What to do when relapse is preceded by a drop in mood?
Contact after a relapse makes sense when it is quick. With a gap counted in days, the plan is picked up where it was broken off. With a gap counted in weeks, the rhythm of appointments usually has to be rebuilt, although the work done earlier is not lost and nobody starts from zero.
With two diagnoses there is a question that does not arise with one: what was happening in the weeks before the relapse. We check the order, that is whether sleep and mood changed before the use. If they did, packing therapy sessions more closely together is not enough and a psychiatric consultation is needed. If they did not, we improve the part of the plan that concerns trigger situations.
The fall in tolerance after a break
One warning does not depend on the diagnosis. Tolerance falls during a break faster than most people assume, so the same amount as before treatment acts far more strongly after a few weeks. With opioids the difference can be large enough that the first use after a break is the most dangerous moment of the whole episode.
How does a family in Słupsk recognise that this is no longer only drug use?
An appointment shows one day in the patient's life. The family has access to the whole week: when the sleepless nights began, whether withdrawal from contact appeared before the drug use or after it, how a bad day can be recognised before it ends in use. At an appointment these are the most useful pieces of information anyone can bring, and it is worth noting them down as they happen, because after a month every week looks the same.
The family has no legal lever, and that is a separate conversation, which we hold honestly. It does have influence over conditions: it can stop covering the consequences of use, state plainly what those consequences will be, and hold to those arrangements for longer than a week.
How many Słupsk families seek institutional support is known only approximately, and the figure says less than it appears to. In 2018 social assistance in the city granted support on grounds of drug addiction to 41 families, in 2024 to 44. On grounds of alcohol, in the same register and the same city, the figures were 651 and 398, that is two fifths lower than six years earlier. The share of drug-related cases rose over that time from about six per cent to ten, but this follows from the shrinking of the whole register rather than from a doubling of cases (Statistics Poland, Local Data Bank). Families who arrange treatment at their own cost do not appear in it at all.
What do the Słupsk registers show?
Offences recorded under the Act on Counteracting Drug Addiction numbered 178 in Słupsk in 2020, 154 in 2021, 258 in 2022, 162 in 2023 and 183 in 2024. Across the Słupsk subregion, which besides the city also covers the surrounding counties, the course is the same: 416, 418, 526, 392 and 450. Both levels peak in the same year, both fall in the next and both rise in the last (Statistics Poland, Local Data Bank, data for 2020 to 2024).
The second figure explains the first. The clear-up rate for these offences runs from 97.8 to 98.9 per cent in Słupsk, and in the subregion it stays close to 99. A register in which nearly everything entered is cleared up consists mainly of cases uncovered by the services during checks, not reported from outside. So it measures enforcement activity, and it is that activity which moves both levels at once.
These numbers therefore cannot tell how many people in the city use drugs, or whether there are more of them than five years ago. Poland has no register that counts this. The scale becomes visible only in practices and clinics, and even then with a delay, because the people who reach them have already decided to come. For someone weighing this up, the statistics offer no guidance.
