Drop-In Center: Building a Movement

ParticipantsUkraine needs a drug policy to truly be a European country – this was one of the ideas that emerged at a gathering of people from 25 regions of Ukraine who are living with drug addictions.

The 2nd annual conference of substitution therapy program participants took place at the beginning of October in Dnepropetrovsk, Ukraine. Pavel Kutsev, a director of the organization Drop-In Center, posted a detailed report of the event on his Web blog.

As per tradition, the conference kicked off with a visit to the methadone site so that the delegates could receive their medications. Pavel was impressed by how efficiently things worked at the site, saying:

A bus brought us to a regular municipal clinic, which had a separate entrance for patients of substitution therapy. There was no line at all. A girl with a 3-year-old child entered the methadone office and was out in 3 to 4 minutes. I was wondering whether it was always like this. When my turn came, I also received my medications very quickly and I realized that this is the norm for this site.

Pavel also posted the key points of his presentation at the conference:

Do not keep silent! The main thing for us is not to stay silent. Our voices have already helped accomplish a lot. Look, when we talk about our needs and concerns, even during our meetings, we can support each other. Nobody cares about substitution therapy as much as we do, so we also need to solve our issues ourselves…

…We realized this during our first meeting a year ago and decided to establish an association or a union. During this past year, we have actively worked to implement our plans. We disputed, discussed, negotiated, suggested. And now we have it – the Association of Substitution Therapy Participants…

Pavel also commented on the diversity of people who attended the conference:

When I realized that each region of Ukraine is represented at the conference, I was amazed. Later on I calculated that if one delegate represents hundreds of patients then potentially we have THOUSANDS of supporters. No doubt, we are strong and have a bright future!…

…Today hardly anyone would doubt the power of the association, which might have a 5 digit number of members in the near future. Thus, this association might soon have a very strong influence on the development of Ukrainian drug policy. The main question is, who will control this powerful tool? Do we fully understand our strength? Will we be able to use our consolidation in the right way? I believe the answers to these questions should define the mission of our association.

The conference was attended by a representative from Russia and a few foreign trainers and observers who, in Pavel's opinion, were very professional and knowledgeable. Here's what Pavel wrote about a trainer named Masha Golovanevskaya:

Masha Golovanevskaya not only represented Open Society Institute, but also bought us a fantastic movie, “FIX: The Story of an Addicted City.” The film is about the formation of a world-known organization VANDU, which unites drug addicts from Canada. We started the conference by watching this movie. It was extremely good! We got a copy of it and I promised Masha that I'd do my best to find a way to translate the movie into Russian and post it in our Internet resources so it will be available to everybody.

The second day of the conference was focused on advocacy issues. Pavel Skala, a facilitator of this session, is an expert in drug policy and a former Interpol staff member. Currently he heads the advocacy department of the International HIV/AIDS Alliance. He suggested that participants start creating a list of all the issues that arise in implementing substitution therapy in Ukraine, and then sort the issues based on regional and national problems. Here is what Pavel wrote about this session:

After discussing 16 issues (such as grinding our pills into powder in the hospitals, difficulty in receiving a driver's license, waiting lists for being involved in the program, etc.), we identified three main problems that urgently need our intervention on a national level. They are listed below:

- The continuous process of substitution therapy treatment. Providing the medication every day and even a few times a day when needed;

- Including methadone in the list of medications that are allowed to be purchased by prescription in a drug store. This will improve the effectiveness of substitution therapy and allow people to continue the therapy if they are staying in a hospital where replacement therapy is not provided, or when a person is sick and unable to come to the methadone site.

- Regulating the policy of registering drug addicts and providing patients the opportunity to receive a driver's license on a case by case basis.

That is it! All the other issues were tagged as “local” and solvable at the level of a methadone site or at the regional level.

One question that was discussed was that many medical establishments in Ukraine consider substitution therapy to be a recommendation, not a mandate. This situation was clarified by Dr. Tamara Tretska, deputy director of the Institute of Health Policy Research and the head of the National Substitution Therapy Project. She explained that the Ministry of Health of Ukraine is issuing a new order where substitution therapy is regarded as a “medical practice necessary for the treatment of drug addiction… and use of substitution therapy is mandatory.”

Dr. Tretskay's presentation

Dr. Tretska's presentation

The third day of the conference was focused on public relations and was facilitated by Nastia Bezverkha, one of the leaders of the youth movement “Obyektyvna realnist,” which unites intellectuals, artists and journalists. Nastia was invited as a media relations trainer and gave a fabulous and informative presentation. In the presentation, Nastia said:

Do you know what the main source of information on drug addiction is? The media

Do you know where the media gets their news? First from the police press service, then from public health workers, then from social workers and only then from drug addicts.

Our voices are only in fourth place, but they should be first!

At the end of the post, Pavel wrote about the main conference outcomes:

After the conference I was looking at my friends and realized that we have become much more confident, full of hope and have future plans.

During the conference we finalized and approved our strategy to develop the association. The conference confirmed our ability to make our own decisions and the independence of our association. The fact that the conference united people from 25 regions of Ukraine proved the unity of like-minded people living with a drug addiction. This is the main element needed to have the capacity to solve issues at the national level.

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