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Ukraine: Harm Reduction Activists Report Small Accomplishments

The work of the activists of the Association of Substitution Therapy Treatment of Ukraine is focused on making the lives of the patients of opiate replacement therapy more comfortable, helping them to better integrate back into society.  The major problem the substitution therapy patients face today in Ukraine is the fact that the only place where they can receive a medication are special sites where patients have to come every day personally.

Because of the efforts of the Association and other harm reduction NGOs with the support of international organizations, the situation in this area started changing for better gradually. Blogger Viktoria Lintsova reported positive changes in her city of Kirovograd where patients started receiving Methadone in regular hospital. At the middle of October Viktoria posted that the regional health care authorities adopted a new regulations allowing patients to receive opiate replacement medications in other medical establishments. Victoria was very grateful to the Association for the support it provided in this regards. She wrote:

.. сие событие стало возможным благодаря тому, что в Кировоградский облздрав было подано обращение от Ассоциации в начале июня этого года. Затем был визит технической поддержки нашего специалиста по развитию регионов Алексея Загребельного, во время которого была проведена рабочая встреча с нашим областным наркологом по вопросу беспрерывности и разработки областного приказа.

…this became possible because at the beginning of June the Association submitted a special appeal to the regional health care authorities. Then, the regional development specialist Aleksey Zagrebelnyy visited us and provided technical support, he met with the Oblast chief doctor in narcology and discussed the issues of continuity of treatment and new regulations in this regard.

 On 11/11/11/ Viktoria reported that this new regulations now work in reality. The first substitution therapy patients started receiving Methadone while staying in a Tuberculoses clinic.  She posted:

Одним из наиболее проблемных моментов было лечение ТБ, особенно в случаях с открытой  легочной формой – тогда пацинт вообще попадал в замкнутый круг – при открытой форме ТБ больным не разрещается покидать территорию больницы, поэтому необходимость ежедневного посещения сайта ЗПТ ставила человека под угрозу выписки из-за нарушения больничного режима. Кроме того, все усложнялось тем, что противотуберкулезный стационар находится за городом (около 20 км), добираться долго и сложно, и с учетом того, что туберкулезный больной с открытой легочной формой является источником инфекции для других …

 […]

  важность беспрерывности при госпитализации несомненна – …, теперь не надо выбирать между лечением и участием в ЗПТ.

One of the biggest problems in TB treatment, especially in its open form, is that the patient appears in a circle. With the open TB form the patients are not allowed to leave the territory of the hospital and the necessity to go every day to the replacement therapy site put them at risk to be kicked out of the hospital for not following the hospital’s regime. Moreover, the TB clinic is located outside of the town (20 kilometers) so it was really hard and time consuming to get there and you need to take into account that a patient with the open form of lungs’ TB is a source of infection for others …

[…]

the importance of continuity of the therapy in the hospital is obvious – …now you do not need to make a choice between a treatment or replacement therapy.

Blogger buprik from Dnipropetrovsk, who is a patient of Buprenorphine substitution therapy, reported that regional health care authorities allowed him and his wife to receive the medications via prescription. Blogger buprik and his wife had more than 20 years of drug addiction experience and a few imprisonments and became the patients of the replacement therapy in 2008. At first they were very happy about the program but later on they were disappointed with certain aspects of it.  The way the substitution therapy was provided did not allow them to live a full life, to find a job or to travel. Necessary to go to the therapy site every day for many years had become a real burden for them. 

In 2009 the regional health care authorities started a pilot project of provision of Buprenorphine though the prescriptions. At first, only four people were qualified to take part in this experiment but the situation has been gradually changing for better and now 30 our of 50 Buprenorphine patients receive their medications via prescription and the blogger buprik and his wife are among them.

Buprik posted:  

Что для нас рецептурная форма выдачи??? ВСЕ!!! Это как глоток свободы за столько лет!!!

Могла ли мечтать моя жена … что пройдет такое время??? Пройдут годы горя и страданий, годы заключения, годы жизни в подполье и постоянном страхе, появяться болезни и вот уже ей не молодой ГОСУДАРСТВО ВЫДАСТ НА РУКИ ТО РАДИ ЧЕГО ОНА СТРАДАЛА И ТЕРПЕЛА ВСЮ ЖИЗНЬ!!!!!!!!!!!!!!!!!! И теперь она хотя бы под конец жизни сможет просто поболеть дома-лежа в постели,съездить туда там где никогда не была, работать там где ей нравиться, и в конце концов стать полноценным человеком общества со свободным перемещением!!! При этом у нее в кармане будет ЖЕЛЕЗНЫЙ ДОКУМЕНТ подтверждающий хранение жизненноважного лекарства с хорошо видной печатью(для слепых мусоров)-РЕЦЕПТ!!! И походка на этот раз у нее будет уверенная …Хотя бы маленькая группа многострадального общества наркопотребителей теперь стала В ЗАКОНЕ!!! 

What is it for us the provision of medication through a prescription? Everything!!! This is a  first gulp of freedom for so many years!!!

Could my wife even dream …that there will be such time??? That after many years of sorrow and suffering, many years of imprisonment, many years of leaving in fear the government will give her, not young and healthy lady the thing for which she has been suffering  her entire life!!!!! And now at the end of her life she could just spend a few days home in a bad when she is sick and visit places she had never been before, to work where she likes and became a full member of the society with freedom of movement!!! While she has a DOCOMENT in her pocket proving the presence of the necessary medication with big visible stamp (for blind cops)- A PRESCRIPTION!!! And now even her walk will be confident…At least a small group of long-suffering community of drug users has become LEGAL!!!!

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