On February 2 Rising Voices [1]posted a story [2]about a public advocacy campaign being conducted by members of the organization Drop-In Center [3]. The campaign is focused on the needs of participants in substitution therapy [4]programs in Ukraine. The group is advocating for the use of a different type of medication for these programs. The drug currently being provided by health care authorities has an excretion time [5] that's only half as long as similar medications out there. A medication with a longer excretion time from the body would allow the patient to go for a longer period without needing the next dose of a drug.
During February and March members of harm reduction [4]programs continued this fight to receive medications that will work effectively. Pavel Kutsev, leader of the Drop-In Center, wrote a post on his Web-blog [6] that has been signed by his counterparts. The post calls for the introduction of a new medication for substitution therapy, since the one being used doesn't help patients return to a normal life.
According to our poll, 47% of patients consume a lot of alcohol. In general only 10-12% of them feel well, 8 out of 10 people use additional stimulants…Only 7-8 people out of 96 say that the dose is adequate for them…for other people this medication just does not work. It does not help them survive even till the morning…We do not really live, do not really work, we are like puppets who are only able to walk to the site, hoping for a few hours of rest from the pain.
The official Web site [7] of the association of substitution therapy patients posted open letters [8]to the tender committee of the major donor for substitution therapy programs in the Ukraine, Alliance HIV/AIDS [9]. The letters were signed by patients from two major Ukrainian cities. The participants of a substitution therapy program from Dnepropetrovsk stated that a few of them had consumed another methadone-based medication, and that the results of this therapy were much better. The patients of a Kyiv substitution therapy center, “Sociotherapia,” highlighted the following facts in their open letter to the tender committee:
According to the Ukraine's legislation, medications for substitution therapy cannot be prescribed, so it is not possible for us to consume the medication several times a day. Our request is to purchase a medication that would have a longer time of excretion from the body and less side effects, such as high tolerance, high diuretic effect, and oppression of sexual function.
The letter provides the following conclusion:
To achieve the goal of re-socialization, drug addicts should have a life…without the abstinence syndrome [10]. So there is a need for medication that would last at least 24 hours without heavy side effects … Otherwise the effect of the therapy will be reduced to a few hours of relief from the pain and there won't even be a hope for sick people to have an active and adequate life.