Mission Report on state-of-the-art of Opiate Substitution Treatment (OST) and necessary supportive structures for scaling-up

In Central Asia, the main driving force behind the HIV epidemic at this stage is injecting drug use, especially of opiates. In these conditions, the only possible way to stop the spread of the virus is through the rapid introduction of far reaching prevention programsme among the major risk group – injecting drug users (IDUs). Opiate substitution treatment (OST) is the most effective way of treating opiate dependency (in combination with psycho-social support), and is an inalienable part of the range of intervention measures needed to prevent the transmission of HIV infection among IDUs.

The governments of Kazakhstan, Kyrgyzstan and Tajikistan have decided to introduce substitution therapy programsme in their countries, despite the fact that the approach is new for the region and despite the position taken by the government of the Russian Federation regarding substitution therapy. Nevertheless, the main problem in all the countries of the region is the very narrow scope of opiate substitution treatment (OST) programmes.