The official Web page of a Ukrainian community of people living with drug addiction, maintained by the Rising Voices grantee Drop-In Center, has recently published a few posts covering a war against substitution therapy programs. The feud was started by the City Council of the Ukrainian city of Sevastopol.
The introduction of substitution therapy is considered to be an important step in fighting the HIV/AIDS epidemic. The Ukrainian Parliament has adopted a special law that supports the implementation of substitution therapy programs for HIV-positive people. The Ministry of Health of Ukraine plans to introduce these programs in more than a hundred medical establishments all over the country. However, not all local communities are ready to morally accept this harm reduction approach for treating injection drug users.
According to recent reports from Ukrainian news agencies, the City Council of Sevastopol has voted to ban medical facilities that belong to the municipality from providing replacement therapy, which requires the use of methadone or buprinorphine to treat injection drug users. In addition, city council members have appealed to all state and municipal authorities of Ukraine, such as the Ministry of Health Care, the Ukrainian Parliament, the Cabinet of Ministers, and municipal councils to support their initiative and to prohibit the use of public facilities from providing methadone therapy.
In the bill banning the harm reduction programs, the city council stated:
Substituting one drug (heroin) with a cheaper synthetic drug like methadone, which has a stronger addiction effect, does not create any good. It does not help stop the growth of the number of drug addicts in Ukraine. To stop the harmful consequences of public legalization of the synthetic drug…the City Council decided to ban the introduction of substitution therapy programs on the premises, which are a part of municipal property.
The pilot substitution therapy project started in Sevastopol on March 1 of 2009. As of today, it includes 15 patients, and 15 more people are supposed to join the program on April 1. Dr. Georgiy Kadomtsev, the chief doctor of the City Psychiatric Clinic, where the program is being implemented, said that he was going to protest against the decision. He insists that the City Council's decision is based on emotions, rather than on unbiased professional arguments. Dr. Kadomtsev said:
The report of the Council member Mr. Belik [the initiator of the case] totally contradicts the definitions and criteria of diagnostics and treatment of drug addiction…The report has been very unprofessional and just contains random extracts from the Internet.
The head of the Department of Public Health of the City Administration, Mr. Viktor Pologov, called the City Council's ban absurd and said that they went beyond their authority when making this decision. Earlier, he claimed that this campaign against substitution therapy is being supported by forces involved in selling illegal drugs.
Such informational campaigns are organized by those who actually sell the drugs… The annual turnover of drug dealers in Sevastopol makes up about UAH 550 mln (approximately $70 million). Nobody wants to lose such profits. These people stuff the Internet with false information. The City Council decision is 90% based on this false data.
Mr. Pologov stated that in reality the replacement therapy programs could significantly help reduce the rate of HIV/AIDS in the city. He highlighted:
The substitution therapy program is focused on injection drug users living with HIV. Why on them? First of all, we want to reduce the spread of HIV infection in the city. Today every third injection drug user is HIV positive. Providing them with replacement therapy, we protect the ordinary people of the city. Have you seen syringes next to your front doors? Yes, you can see a lot of used syringes on streets and in parks. What if a child starts to play with one of them?…We cannot fight with drug addicts, but we can effectively fight the spread of HIV infection among them. We can reduce the number of infected syringes in the parks and next to our front doors. The City Council members have just decided to leave them there.
The news agencies also pointed out that this medical issue has a political flavor. The morning prior to the City Council's decision, a rally of certain political forces took place next to the City Council building. The protesters accused the current president of Ukraine , who is a supporter of the substitution therapy programs, in promoting drugs.
As a reaction to the political fighting about harm reduction programs, one of the readers of the www.motilek.com.ua noted:
It is very sad that Sevastopol politicians use the problem of substitution therapy just for the promotion of their political forces, and do not care at all about the people addicted to drugs and their problems.