Journalists and experts conducted a discussion on the topic “Is substitution therapy needed in Ukraine?”

October 23, 2009, a press lunch with participation of journalists of printed periodical publications and television channels and experts on substitution therapy took place at the International Renaissance Foundation.

Journalists of leading television channels and publications provided for viewing video materials, which were shot during press tours that had taken place during one year.

In particular, Inter television channel publicized one video from Lithuania, where substitution therapy has been used as an effective method for decreasing harm and treatment of drug addiction for 15 years. Leading experts from Lithuania and clinic patients themselves spoke for the expediency of the substitution therapy and also shared their work experience in this area.

Some patients, who met with journalists in Lithuania, confirmed the fact that methadone is a preparation, with the help of which it is quite realistic to get rid of drug addiction and protect oneself and surrounding people from dangerous infectious diseases.

In one of the videos, Deputy Mayor of the city of Klaipeda and Head of Commission for City’s Drug Control Audra Dauyotyene commented the situation with the substitution therapy in such a way: “City authorities also care for such issues on the city level. At first, people used to ask us – don’t you have many problems, why do you also need drug addicts? But if we don’t care for problems of drug addicts, health and life of healthy people will be endangered. These issues have to be approved on the political level since public vision of the problem depends on that and for that, politicians need to refuse from gaining their political points on acute social problems, in particular, on treatment methods, such as substitution therapy.”

Also journalists stated a real vision of the situation regarding what is really going on with substitution therapy in Ukraine. The audience was offered to view a video from Simferopol and video clips, edited from journalists’ videos: “Waiting List”, “Methadone in Crimea”, “First Day” and others, which are already laid out on the Internet resource http://www.zpt.in.ua/.

The participants of the event also proposed to view a film “Cоming Hоme”.

An open discussion between journalists, patients of substitution therapy and experts took place during the press lunch. Experts, in particular, Tamara Tretska, Deputy Director on Substitution Maintenance Therapy of the Ukrainian Institute for Public Health Policy, shared information regarding real problems that occur in the regions in terms of organization of assistance to drug addicts. In particular, according to Tretska, still there are no opportunities to open full-fledged substitution therapy sites in some regions and officials hinder operation of SMT centers by making provocative accusations, addressed to the employees.

“SMT programs in the world already have 20-year history. For the first time, one started to implement them in 1964, at first in the U.S.A., then in Canada and Great Britain. Long-term research, conducted in the U.S.A., Western Europe and Australia, confirmed that SMT is the most effective method in a complex of treatment and rehabilitation people with opioid dependence. The WHO insists that it is especially important to use this type of treatment right in those countries where the most common way for spreading of HIV infection is injections and IDUs are the most vulnerable group”, emphasized Tretska.

According to Pavlo Scala, International Expert on Drug Policy of the ICF “International HIV/AIDS Alliance in Ukraine”, already a long time ago substitution therapy proved itself as an effective method of treatment and only those, who cover the market of street drugs, hinder substitution therapy. “A well-known statement “Drug business against ST” has once again been confirmed in Ukraine recently. A known group of drug dealers was uncovered in Kharkiv and it included heads of subdivisions of Kharkiv police. So, it is no surprise that as of today, Kharkiv Oblast is one of the regions where there is no SMT. The detained turncoat policemen were causing trouble to a pharmaceutical company, which officially supplies methadone and buprenorphine to Ukraine within the framework of a general state program, thereby undermining profitability of illegal drug business”, emphasized Pavlo Scala during the press lunch.

Currently, more than 1 million drug-addicted people receive SMT with usage of methadone and buprenorphine in 65 countries, including all countries of the European Union. On the post-Soviet space, SMT programs are being implemented in Lithuania, Latvia, Georgia, Azerbaijan, Kyrgyzstan, Belarus, Ukraine etc.

In Ukraine, first SMT pilot projects with limited number of patients were started in 2004 on the basis of drug rehabilitation facilities in Kherson and Kyiv under the support of the representative office of United Nations Development Program (UNDP) in Ukraine. Further financing of implementation of the SMT program in Ukraine is being provided at the expense of the funds of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

As of October 15, 2009, in Ukraine, 4,719 patients get substitution maintenance therapy, among them 844 people – SMT with application of Addnok preparation (buprenorphine hydrochloride), and 3,875 people – with application of Methadol preparation (methadone hydrochloride). SMT program is being carried out in 26 regions of Ukraine, in 100 healthcare facilities, including both on the basis of narcological dispensaries and on the basis of multi-field hospitals, anti-tuberculosis dispensaries and centers for prevention and fighting AIDS.

SMT is one of the types of narcological assistance to people with opioid dependence. More information on substitution maintenance therapy can be found here.

The following people participated in the press lunch:

• Pavlo Scala – International Expert on Drug Policy, ICF “International HIV/AIDS Alliance in Ukraine”
• Tamara Tretska – Deputy Director on Substitution Maintenance Therapy, Ukrainian Institute for Public Health Policy
• Dmytro Sherembei – All-Ukrainian Network of PLWHA
• Iryna Sukhoparova – a mother of a drug-addicted woman
• Victoria Tymoshevska — Public Health Initiatives Program Director 
• Halyna Skipalska – Director, Representative Office of HealthRight International in Ukraine
• Sviatoslav Shunko — a patient of substitution therapy
• Kateryna Malanchuk — a patient of substitution therapy
• Lyudmyla Rudak — a patient of substitution therapy
• Vitaliy Shandrak — a patient of substitution therapy

Journalists:

• Olesya Vakulyuk – Inter television channel
• Natalya Plakhotnyuk – Molod’ Ukrainy newspaper
• Taras Ratushnyi – Belsat television channel, expert on drug policy
• Angelina Karyakina – Gazeta po-ukrainsky, Kraina magazine

Journalist-moderator — Mariya Lebedeva

			Olena Kucheruk, tel: +380 (44) 461 97 09 | fax: +380 (44) 486 76 29 email: kucheruk@irf.kiev.ua office: Kyiv, Artema Street, 44, room 4