Opioid prescriptions under scrutiny in Poland prompted by fentanyl fears [Advocacy Lab Content]

The Polish Ministry of Health has implemented a daily system for monitoring the prescription and dispensing of opioids following increasing reports of fentanyl use in the country.

To counter this potential threat, since only toxicology tests can confirm if a person has indeed taken fentanyl, the Ministry of Health is tightening the prescription system for opioid medications, including those containing fentanyl.

“Starting Monday 17 June a daily system for monitoring the issuance and dispensing of opioid prescriptions will be operational,” said Health Minister Izabela Leszczyna to “Wydarzenia” Polsat News.

What is Fentanyl

The use of fentanyl, a potent synthetic opioid, has become a major public health crisis in the United States, leading to hundreds of thousands of deaths from overdoses. Initially introduced as a pain management medication in clinical settings, its misuse escalated dramatically after 2013.

Fentanyl is approximately 100 times more potent than morphine and 50 times stronger than heroin, with as little as 2 milligrams (0.002 grams) being potentially lethal.

Its high potency, ease of production, and the small quantity required for smuggling make it an attractive option for drug traffickers. The drug often gets mixed with heroin, methamphetamine, or cocaine, frequently without the users’ knowledge, leading to a surge in overdose deaths.

According to data from 2015 to 2022, overdose deaths in the U.S. doubled, with synthetic opioids like fentanyl being a major contributor. The crisis is so severe that it now represents the leading cause of death for Americans aged 18-45.

While Europe and Poland are yet to experience the full brunt of this crisis, there are increasing signs that fentanyl is making its way into these regions.

The Mazovian Police Headquarters in Radom is investigating fentanyl-related cases. “We are looking into 30 deaths from years ago, some even over a decade ago. We are analysing these cases and looking for common denominators. Maybe these cases are connected, and we will find a link to fentanyl,” said police spokesperson Katarzyna Kucharska.

Regional authorities have even called a crisis management meeting on Tuesday, 18 June, to address the issue of youth using fentanyl ahead of the holidays. However, the threat of fentanyl in Poland remains minimal.

Data from the General Police Headquarters indicates that from January 2022 to April 2024, Polish police seized 252.2 grams of fentanyl, a minuscule amount compared to the 21 tons of other narcotics confiscated in 2023 alone. Additionally, there have been no cases of fentanyl production in Poland, nor have other substances used to manufacture it been seized.

Polish prescription problem

Fentanyl usually enters Poland through illegal circulation using forged prescriptions or through theft of medication containing the substance, although the police also note that powder or tablets may come from smuggling.

At the forefront of this is the unethical online prescribing services, where it is possible to receive a prescription even without physical contact between the patient and the doctor.

The Patient Rights Ombudsman’s Office has been actively involved in combating prescription machines. In early June, it successfully led to a ruling by the Provincial Administrative Court that prescriptions for psychotropic drugs, opioids, and medical marijuana cannot be issued without examining the patient.

There are increasing calls for the Ministry of Health to address this matter, and the situation is expected to change from Monday, 17 June.

Health Minister Izabela Leszczyna noted that during the pandemic when telemedicine was introduced into the legal system, prescription machines also came into effect.

“Unfortunately, they were not introduced in a way that is tight enough, so we now have to correct it,” she stated.

The Minister also addressed concerns about the new system: “I want to emphasise that this monitoring will be conducted at the level of doctors and medical entities, but patient data will not be transmitted anywhere,” she said, adding that patient data is sensitive and completely secure.

Safeguard access for patients in pain

Tightening the prescription system is necessary, but we cannot allow fear of opioids, which may be the only way for many patients to alleviate pain, to prevail. Data shows that approximately 20% of Poland’s population is affected by chronic pain and more than 5% experience severe pain.

“These individuals require appropriately selected painkillers prescribed by a doctor,” Prof. Jarosław Woroń, secretary of the Polish Society for the Study of Pain told Euractiv.

Untreated pain can damage the structures of the central nervous system, and untreated acute pain can turn into chronic pain, which is much harder to treat. “This can lead to a vicious cycle of intersecting ailments: pain, insomnia, anxiety, depression,” warns Prof. Woroń.

Pain treatment is not only focused on reducing physical suffering but also on improving quality of life and reducing the risk of having to increase medication doses.

“A patient suffering from untreated pain generates healthcare system costs 5-6 times higher than a treated person,” notes Prof. Woroń. The Polish Society for the Study of Pain fully supports the decision to launch the monitoring.

[By Paulina Mozolewska, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]

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