Drinking under control programmes: perception of alcohol-related harm reduction measures in Poland. Results of qualitative study among outpatient alcohol treatment providers

Abstract

Introduction: Harm reduction programmes for drug addicts are well documented and accepted by practitioners, whereas harm reduction programmes for alcohol addicts are under researched and encounter resistance. The article presents the results of a qualitative study focused on the perception of two case studies of drinking under control programmes (DUCPs) by outpatient treatment providers working in abstinence-focused Polish alcohol treatment system. Material and methods: The 26 alcohol addiction professionals were participants of four focus group interviews (FGI), which were audio-recorded and transcribed verbatim. Data were coded and analysed using ATLAS. ti software (version 7.5.9). Results: Three types of barriers were identified: (1) prevailing orientation towards abstinence and related images of addiction; (2) difficulties to match client profiles with the DUCPs characteristics; (3) cultural norms related to historical features and collective memories in Poland as a post-communist country. Discussion: The provision of alcohol as breaking a taboo remained the centre of critique, even when linked with work as an important societal value, and regardless of the harm reduction perspective and outcomes of DUCPs, to which there was only marginal reference. Conclusions: Treatment counsellors in an abstinence dominated treatment system, as the case of Poland shows, see no chances for the implementation of DUCPs and identify both cultural and addiction-related barriers (i.e. the lack of acceptance for providing alcohol). At the same time, they recognise the potential of DUCPs in terms of the importance of harm reduction measures and pragmatism of a bottom up perspective.