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The Ukrainian government is increasing the scope of the country’s state-funded opioid substitution therapy (OST) programme – a harm reduction tool which reduces the risk of overdose and disease transmission.
Ukraine has provided free OST to around 8,000 people since the beginning of 2017, and now authorities have made the treatment accessible for even more people. As of this year, Ukraine is now fully funding OST for over 10,000 patients at 178 healthcare facilities around the country – “a 100 fold increase in the number of OST patients in Ukraine since 2005”, according to the World Health Organisation (WHO).
OST involves people who use illicit opioids, such as heroin, being provided with prescribed opioid medicines, such as methadone or buprenorphine, for administration in supervised clinical settings. OST is a method of harm reduction for people who use opioids; due to the sterile and clinical nature of the opioid provisions, OST reduces people's risk of overdose, and cuts the transmission of infectious diseases, such as Hepatitis C and HIV. It also provides an opportunity for patients to engage with related health services – for some people, this may be their only regular interaction with a health professional. For patients who stop using illegal opioids outside of their therapy, OST means they may no longer have to engage with the illegal market altogether.
OST pilot programmes first began in Ukraine in 2004, and grew in prevalence during the following years. Prior to 2017, Ukraine’s OST programmes were primarily funded by the Global Fund to fight AIDS, Tuberculosis, and Malaria, but an increase in the country's income status in 2016 resulted in a drop in financing from the Global Fund. This change in financial contributions led to the government pledging support for this harm reduction measure by opting to fully fund the initiative, TalkingDrugs has previously reported.