Drop-In Center: Will Controlling Meds Cause More Harm?


Pavel Kutsev.

Rising Voices grantee Drop-In Center continues to discuss issues that impact people living with a drug addiction. On his Web blog, the organization's leader, Pavel Kutsev, reacted to the Ukrainian government's recent decision to tighten rules concerning medications that can be used by drug users to mitigate the abstinence syndrome (also known as drug withdrawal).

The decision, made by the Ministry of Health and the Ministry of Interior, adds many more medications to the list of drugs that might lead to intoxication.

The Ukrainian drug user community has reacted very negatively to this move, because it means that it will be almost impossible to purchase these medications, which used to be sold freely. A person will now need a special prescription from a doctor before they can buy these drugs.

Pavel posted a few messages he received from the drug user community:

So, no Terpincod for me anymore…What can I get instead? Substitution therapy? Forget it! Perhaps I should start to shoot up again…

Today with Codterpin I could survive somehow. I used it as a sort of substitution therapy. I quit shots four years ago and Codterpin has helped me function and work. I just do not know what I should do now. I have consumed drugs for more than 16 years and I just cannot give up the drugs fully. There are no substitution therapy programs in my town, but it is very easy to buy an illegal drug… This is really terrible. What should I do? I do not want to go to a prison again…

The main argument the government used to justify its decision was that almost all developed European and North American countries sell these drugs only with a doctor's prescription. Pavel responded to this rationalization with the following:

I know that, for example, in France in a drugstore you can buy only condoms and toothpaste without a prescription and, in my ordinary drug addict opinion, this practice is CORRECT. However, I need to make one remark. In France the situation is different. French drug addicts have a CHOICE. Unlike in Ukraine, in France drug users can easily receive substitution therapy if they want to and are able to get the prescribed replacement therapy medications legally in any drugstore. There is a social health care establishment where a drug user can get medical assistance and there is a chance that a doctor would care.

Pavel pointed out the inconsistency in the Ukrainian government's actions concerning the regulation of substances that might lead to intoxication. He contrasted the restricted sale of these medications with the totally unrestricted sale of alcoholic beverages.

Before limiting the availability of medications, which have been sold freely in drugstores over the last 50 years, a government needs to decide what it can give in return. For example, Codterpin was used by opiate drug users for many years as a medication that can ease reactions to going cold turkey. Moreover, this medication has never led to an overdose and perhaps is not more harmful than traditional alcoholic beverages. However, the government, while limiting the sale of these medications, does not even try reducing the sales of alcoholic beverages. Here in Ukraine, you can see advertising for beer and vodka everywhere, any time of the day. By the way, the government could have mandated that alcohol producers direct a part of their profits for social programs, like rehab centers for addicts and substitution therapy programs…as I recall, this idea was actively discussed in the mid-1990s.

Pavel finished his post with a following conclusion:

Before ruining something old, we first need to build something new. Before depriving people of medications they need, we have to give them another option to show that another solution exists. We must think about these people and protect them from returning to street drugs or even committing suicide. Otherwise, lets sell other intoxication-inducing trash like gas and glue with only a doctor's prescription.

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