As the annexation of Crimea began, questions were raised last week about the future treatment of the more than 800 Methadone patients who receive treatment in the city. Sadly, today the Federal Drug Control Service Chief of Russia has in fact confirmed that the practice of prescribing Opiate Substitution Therapy (OST) as a treatment for those struggling with heroin or other opiate addictions will cease.
This news is an absolutely devastating blow to the many addicts who have been able to kick their habit with the assistance of OST. Not only is it an effective treatment for opiate dependence, it can have a huge impact on the rates of HIV and other diseases associated with IV drug use and abuse. In a statement made Wednesday, Federal Drug Control Service Chief Viktor Ivanov pushed idea that Methadone is more of a problem than a solution, having become a criminal business.
"Methadone is not a cure. Practically all methadone supplies in Ukraine were circulating on the secondary market and distributed as a narcotic drug in the absence of proper control. As a result, it spread to the shadow markers and traded there at much higher prices. It became a source of criminal incomes," Ivanov said.
How much of a Methadone supply is remaining in Crimea? Frighteningly, not much. The current stocks of Methadone and Buprenorphine in Crimean clinics "are only expected to last a matter of weeks". Other areas are already starting to feel the strain of lack of supplies, such is the case in the city of Sevastopol, where OST Clinics have "already been compelled to start decreasing patients dosage". The sudden cessation or rapid reduction in OST will lead to patients going into withdrawals, which will unfortunately lead many of these patients right back to the addictive behaviours they originally sought treatment for in an attempt to ease the physical and mental pains of opiate detox.
Not only is OST illegal, so are the needle exchange services that are imperative in reducing the spread of the disease. Suddenly having a influx in the number of addicts returning to IV drug use, and no legal means of obtaining clean syringes and other harm reduction supplies will most likely have a large impact on the rates of HIV infection and other diseases such as Hepatitis C. "Ukraine has been a regional leader in the provision of needle exchange and substitution therapy programs which prevent HIV among people who use drugs", but such a sudden and drastic change to these services "is likely to prove a disaster for health human rights and the HIV epidemic in Crimea and the region more generally".
In order to help ensure these live saving services are not effectively banned in Crimea, the International Network of People Who Use Drugs has begun advocating on behalf of the patients. The group has called on UN Organizations to "support the continuation of existing harm reduction interventions in Crimea and asked the government of the Russian Federation to cease attempts to close down these lifesaving programs". It looks as though OST patients in Crimea have a very tough road ahead.
studioL is a recovering IV drug user, methadone patient and harm reduction advocate. For more articles, rants and raves, follow her on Twitter @studiolonline