Activists stated that the state program of substitution maintenance therapy (SMT) was discredited by some private medical institutions that provide services for it, supplying such drugs beyond the need, thereby jeopardizing health and life.
The director of the All-Ukrainian Association of People with Drug Addiction (VOLNA) spoke about this at a press conference in Ukrinform. Oleg Dymaretsky.
“We conducted a social experiment when two people, voluntarily, traveled for free, accompanied by a lawyer, media representatives, with video recording of virtually the entire Ukraine in order to obtain drugs (for SMT – ed.), in order to subsequently hand over these drugs to the appropriate structures so as not to be criminally responsible. This experiment provides evidence that those providing substitution maintenance therapy services violate the law, harm the state program, and do not allow treatment. The experiment showed that almost 20 subjects provide substitution maintenance therapy services without control (SRT drugs – ed). These two people received a lot of drugs in all these institutions, even those not related to replacement therapy. At the end of this experiment, all the drugs obtained were handed over to law enforcement agencies, people wrote statements about the crime, saying that this seizure was voluntary,” said Dymaretsky.
According to him, the employees of these institutions were not interested in whether a person was undergoing SRT treatment in another medical institution, and did not enter information about the drugs received by the patient into medical information systems. As a result of this practice, according to the expert, one person could receive more drugs in this way than necessary for treatment. to the risk of overdose, directly threatening health and life. These people also risk coming to the attention of law enforcement agencies and receiving criminal proceedings.
Legislation, regulations, and government authorities correctly regulate the substitution maintenance therapy program, the speaker emphasized. Some private market entities that provide OST services earn money by selling prescriptions for narcotic drugs and potent substances.
“Many responsibilities are borne by people who have certain diagnoses and who are future or current consumers of substitution maintenance therapy services. But we will not see any criminal proceedings against people who encourage, violate the law, sites or those who protect the work of such “drug dealers”. I would like to note that a person who has a craving for drug use is not a recipient of state PMT services; he may indeed violate the law and may be held accountable (before the law – ed.). But does she violate the law when she comes to a medical institution that has a license to practice medicine or handle narcotic drugs, when the doctor must use all orders (MoH – ed.), have a registered service for socially significant diseases in the medical information system. When she is given in addition (to certain SRT drugs – ed.) a lot of drugs that a person who has a painful desire immediately uses, Dymaretsky said. At the same time, according to social activists, transferring the state program of substitution maintenance therapy exclusively to municipal or state medical institutions, and regulating this exclusively through a program of medical guarantees, could narrow access to such therapy for people who need it.
"Not all clinics abuse the law and the trust of patients. The very idea of private medical care should exist, and I would like to believe that a private drug treatment clinic can provide the patient with anonymity, choice of institution, and comfort, which in turn should contribute to the development of the quality of substitution maintenance therapy services,” the deputy director of the Charitable Foundation said at a press conference.” All-Ukrainian Association of People with Drug Addiction” Igor Kozak.
According to public activists, it is necessary to resolve the situation with the help of law enforcement agencies and compliance with existing legislation and regulatory rules in this area.
According to Dymaretsky, government agencies are aware of this problem and react to it. So on March 3 of this year, the DBR announced the exposure of a network of establishments that abused the substitution maintenance therapy program. opioids. Typically, methadone hydrochloride and buprenorphine hydrochloride are used for SRT. However, some countries may use medicinal heroin or a combination of buprenorphine and naloxone.
In 2005, the World Health Organization (WHO) added both drugs to its Core List of Essential Medicines, and in 2009 issued guidelines where all countries are recommended to make MRT the mainstay of treatment for people addicted to opioids.