Drop-In Center: Continuing to be an Online Resource for Ukrainian Harm Reduction Movement

Pavel Kutsev

Pavel Kutsev

Pavel Kutsev, a leader of a Ukrainian harm reduction movement, started blogging in 2008 within the framework of the Rising Voices project the Drop-In Center. Now, nearly two years later it has become an important on-line platform where patients of substitution therapy can receive the recent news, and share their thoughts and opinions. The blog covers all important events of the live of the National Association of Substitution Therapy Patients, where Pavel is one of the leaders, where he shares live stories of the patients and follows government decisions concerning the harm reduction programs.

Pavel is not the only author of the blog. Other [ru] members [ru] of his organization and activists of the National Association posts their stories and news on challenges and successes of substitution therapy programs in other regions of Ukraine

The blog Depo3p [ru] is a strong advocacy tool. People living with a drug addiction like Pavel use this on-line journal to tell the world what problems they face being the patients of Methadone substitution therapy and to make harm reduction programs better serve their needs. Often they use the blog to report their small victories.

One of the problems Pavel has been covering for a few years was the impossibility for the substitution therapy patients to receive medical services that require a stay in a hospital. Methadone was only able be obtained at special sites, and was not available in ordinary medical establishments. The patients were supposed to personally come for a dose of medication to the site. However, if the patient was placed in a regular hospital and suffered withdrawal symptoms, then the medical personnel were not able to help. Usually the patients would just run away from a hospital. Recently the situation has changed for better. This is what Pavel wrote:

И вот оно! Опять победа!

С февраля месяца на подписи в Горздравотделе г.Киева лежит прекрасный Приказ, согласно которому всем пациентам ЗПТ при плановой или экстренной госпитализации в стационар гарантируется доставка заместительного препарата!

Конечно, без подписания этого нужного до боли документа  высоко поднявшийся в наших глазах главный врач мог бы просто   «повременить». Но и тут – победа! Нам повезло, что главврач отнесся к этой проблемище как настоящий Врач.  Отстаивающий право  своих пациентов. Нам было обещано и сдержано обещание – препарат ВОЗЯТ!


Как нам это удалось? Узнав, что среди основных препятствий, делающих невозможным процесс регулярной доставки замести/препаратов нашим лежащим «коллегам по несчастью», является такая, казалось бы, малость, как… бензин. Вернее – 5 литров  горючего – именно столько необходимо для доставки препарата  одному пациенту. Было созвано собрание… Все мы – па циенты «зэ-тэшники», старички, молодые –  прониклись тем, что с решением этой проблемы фактически у каждого из нас появляется шанс – вылечить, подлечить, излечиться! … И вот мы решаем – избираем новый совет пациентов и поручаем инициативной группе разработать Положение о кассе взаимопомощи.  … уже на третий день из общественной кассы были выданы первые суммы, благодаря которым, сегодня наши пациенты …  имеют возможность лечь в стационар

This is it! Victory again!

In February, a draft of a new regulation of Kiev Health Care Department was developed although has not been signed yet. According to this regulation, all substitution therapy patients are guaranteed provision of the substitution medications in case they are hospitalized!

Of course our chief and now much respected doctor could have waited until this very necessary regulation was signed. But there was one more victory! We were lucky that our Doctor treated this problem like a real Doctor who fights for the rights of his patients. We were promised and the doctor kept his word – the medication is DELIVERED!


How we were able to accomplish this? What we learned is that among the main obstacles making it impossible for regular delivery of the medication to our hospitalized counterparts are such a small thing as …petrol, namely 5 liters of gas necessary to deliver the medication to one patient, we called a meeting…All of us, new and old patients of the substitution therapy, we inspired the chance to have decent medical treatment… We created a patient council responsible for organizing a sort of a loan society ….In three days, the first money [we collected] we spent to deliver the medications to people who were in hospitals…

On his blog Pavel also shares sad stories about the stigma facing people living with drug addiction. This is the story Pavel posted:

Не поверил своим ушам, глазам, когда прочел эти строки:…

“Так случилось, что на выходе с сайта ЗТ Валерке стало плохо… Очередь была долгой..Он ещё стоя за дозой неважно выглядел… И вот он … получил препарат и вышел . И какой-то такой медленной походкой захромал к выходу… А прямо на выходе из сайта ЗТ Валерка – бац! И завалился… Мы перпугались. … уложили его на траву, … вызвали скорую помощь…

И вот приехала Скорая. Валере оказавают первую помощь, мы собрались в кружок, смотрим, что мол, как с нашим Валеркой. И уже когда его стали ложить на носилки … – появилась наша врач – та самя, что выдает нам препарат . Она уже шла без халата, так как уходила домой после смены. И вот, что самое поразительное – Подойдя к машине Скорой , наша врач спросила своих коллег медиков, что, мол, случилось с парнишкой? А те ей :

- А вы кто будете? Врач?

Даже не поднимая на нас своего взгляда, “врачиха” какбы невзначай бросила :

– Нет-нет, что вы…, я так, я прохожая…

И поспешила прочь. Мы не могли даже смотреть в её сторону, куда она удалялась.

I could not believe when I read this…

It happened that on the way out of the site Valera stared feeling bad…The line was long…He did not look well even when he stayed in the line…He received the medication and slowly moved towards the entrance…And right next to the entrance he just fell…We were very scared, we put him on the grass and called an ambulance…

The ambulance arrived and Valera was provided with first aid. We stayed around to see what was going on with him. When he was about to be put on a stretcher, a doctor who was from our site and who gives us the medication approached. She was without her medical clothes as she was going home after her duty. We were really amazed by what has happened next. She approached the ambulance and asked her colleagues what was wrong with the guy. They asked her “Who are you? Are you a doctor?” She responded, without even looking at us “No, I am just passing by” and went away. We were not able even look at her when she was walking away…

In addition, Pavel uses his blog to cover positive events from the lives of the substitution therapy community. This is what he recently wrote about the soccer competition where a team of substitution therapy patients from Poltava city participated:footbal

В конце жаркого лета в г.Полтава прошел чемпионат по минифутболу на кубок главного нарколога Мацицкого Игоря Анатольевича. Турнир проходил под девизом “От зависимости до независимости”.Этот замечательный спортивный турнир уже традиционно проводится между командами реабилитационных центров. Но в этом году в чемпионате приняла участие команда участников Заместительной поддерживающей терапии одного из сайтов г.Полтава.


В решающем поединке между игроками команды «Метадолмен» г.Полтавы и БАРЦ г.Черкасы, команда сайта «метадонщиков» заняла почетное 3 место!


Роман Полтавский, региональный представитель Всеукраинской Ассоциации ЗПТ, участник чемпионата:

- На следующий год мы собираемся занять 1 место! Только, хотелось бы, на следующий год увидеть еще команды ЗПТ с других городов. Честно говоря, я уже пытался обсуждать вопрос о провидении футбольного турнира в формате наших сайтов ЗПТ. Но пока ответы были отрицательные. Мол, кругом одни больные люди… Ведь мини футбол – не требует огромных нагрузок. …поле 25 метров длины и 12,5 ширины. Я с большим удовольствием создал и в нашей ЗТ-ешной семье пока маленький турнирчик. Ведь это так интересно и весело. Было бы желание а силы найдутся.

At the end of the hot summer, Poltava hosted a mini-football championship, which was helped organized by chief narcologist Igor Matsitskyy. The motto of the competition was “From addiction to independence”. This marvelous tournament has already become a tradition among teams of rehab centers. But this year for the first time, a team of one of Poltava substitution therapy sites participated.


In a tense battle with the BARTS team from the city of Cherkassy, the “Methadolmen” team won the honorary 3rd place….


Roman Poltavskyy, the regional representative of the All-Ukrainian Association of Substitution Therapy Patients and a participant of the tournament said “Next year we are going to win the first place. But it would be good to see next year patients’ teams from other cities. To tell the truth I have already initiated to organize a football tournament among substitution therapy sites but received only negative responses. I was told that our people are sick….But mini-football does not require much physical strength…the field is only 25 meters long by 12.5 meters wide…It was a pleasure for me to organize a very small tournament in out substitution therapy family. It was interesting and fun. If you have the desire you can always find strength!”


  • […] substitution therapy. After a few patients from our site died because it was not possible for them to receive the substitution therapy and treatment of other diseases the require a stay at a hospital…, this problem was at the top of an agenda of public health officials. A few regional health care […]

  • Ruben

    Hi, I’m from san sebastian-Spain-. I’m gonna work in Ukraine and I am taking methadone, I wanted to know who I can contact in order to go to the methadone dispensing center, otherwise I will not be able to go, and the way things are now I can not afford to leave a job. please if anyone can help me I’ll be endlessly grateful. I’ll be near kiev. if they could send me a phone number. thanks

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