Participants of substitution therapy programs for opiate drug users are using citizen media to influence the decisions of Ukrainian health care officials. In this case it's concerning the medications Ukraine purchases for harm reduction programs.

Ukrainian blogger depo3p, who leads the nonprofit organization Drop-in Center,has been raising awareness about this topic since November 2008. He began by examining various types of medications used for substitution therapy, and concluded that the one used in Ukraine is not the best choice. This is because the drug's time of excretion from the body is much shorter than the time of some other medications. Since replacement therapy patients receive the drugs only once a day, the extended time of excretion from the body helps delay the beginning of the abstinence syndrome pains.

depo3p writes:

Here is an excerpt from the description of the medication: Dosing: normally adults should take 2.5-10 mg every 4 hours during the first 3-5 days (what do they mean under ‘adults'? Can this medication be prescribed to kids? Are you kidding me?), …then the medication should be taken every 8-12 hours, depending of the reaction of the patient (and how are we supposed to live when 12 hours have passed? How are we supposed to survive 30 hours, as we receive it only once a day?)…There is another medication that is produced in the same packaging. I tried it myself. I got 75-80 grams during my first day without drugs injections and it has kept me for 2 days!!!

depo3p has suggested that substitution therapy patients consolidate their efforts in advocating for the drugs they need:

We should not just sit and wait. We should create our own patients’ movement and investigate what is going on. We need the independent expertise… let us conduct independent research, lets create a special topic on the forum and voice our concerns, complains, disappointments…We could also talk to our narcologists – progressive doctors…Anyway guys, we should do something about this, as life gets worse day after day…All the patients I have talked to are sweating a lot, have nervousness, insomnia, and fatigue…and the doctors seem to intentionally not notice the fact that we don't feel well; they have even stopped registering our claims on the medical card. Don't they see that we look worse and worse? …Even other patients see that we are changing for worst…

depo3p has recently returned to the substitution therapy medications topic again. He claims that he has received an expert opinion, which supports his conclusions:

Here is a message from an American chemist and narcologist (with a PhD). His name does not matter, as you don't need any knowledge in chemistry to realize that these facts are relevant.

According to depo3p the expert confirmed that the excretion period for the medication that is currently used in the Ukraine is 10-16 hours. At the same time, there is another drug that can be used for substitution therapy with an excretion period of 24-36 hours.

depo3p makes the conclusion that the Ukraine's choice of drug might significantly reduce the effectiveness of replacement therapy programs.

That is why people who participate in this opiates replacement program feel this bad and why up to 70 percent of them continue to consume street drugs! I am not talking about things like alcohol, tranquilizers, soporifics, antidepressants…

Rising Voices will continue to follow the development of this advocacy campaign.