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Война и снижение вреда в Украине

Украинцы, употреблящие наркотики, столкнулись з огромной проблемой доступа к программам снижения вреда из-зароссийской военной агрессии в Украине. По официальным данным, в Украине около 317 тысяч потребителей инъекционныхнаркотиков. По состоянию на январь 2022 года, 14 868 наркопотребителей получали заместительную поддерживающуютерапию методоном и бупренорфином. Украина финансировала эти программы с 2017 года. Тогда же государство значительноувеличило доступ к программам распространения стерильного инъекционного инструментария, презервативов иконсультирования равный-равному, согласно рекомендациями ВООЗ о минимальном пакете услуг снижения вреда дляпрофилактики распространения ВИЧ в Украине. (How Russia’s War Impacts Harm Reduction Programmes in Ukraine) (Talking Drugs, UK, 31.03.2022)

https://www.talkingdrugs.org/ru/voyna-i-snizhenie-vreda-v-ukaine

Message from Ukraine

What has the situation been for drug users in Ukraine since the war started? A conversation with Svitlana*, former drug user and harm reduction activist: “Everything changed overnight”. (Mainline, Niederlande, Frühjahr 2022)

https://english.mainline.nl/posts/show/14562/message-from-ukraine

NGOs call for implementation of measures to ensure continuity of HIV and opioid dependency treatment for people displaced by the war in Ukraine

On 21 April, NGOs working with and representing the interests of communities of people living with and affected by HIV, tuberculosis, viral hepatitis and drug dependence in Europe addressed a letter to governments in the EU and EU institutions. The organisations report on the great will of various partners to accommodate the needs of people escaping the war but also major obstacles, especially regarding access to opiod agonist therapy. Therefore, the NGOs call on governments in the EU and EU institutions to implement a set of urgent measures. (Correlation, Niederlande, 22.04.2022)

https://www.correlation-net.org/ngos-call-for-implementation-of-measures-to-ensure-continuity-of-hiv-and-opioid-dependency-treatment-for-people-displaced-by-the-war-in-ukraine

Ударная доза

Война в Украине оставила людей, употребляющих наркотики, без заместительной терапии. Теперь одни ищут закладки среди мин, другие — вступают в тероборону. (Real stories of opiate substitution therapy patients suffering from the Russian invasion in Ukraine) (Novaya Gazeta Europe , Lettland, 22.04.2022)

https://novayagazeta.eu/articles/2022/04/22/udarnaia-doza

Harm Reduction for Ukrainians (telegram channel)

Телеграм канал для підтримки людей, які вживають наркотики та інших уразливих груп населення України

https://t.me/HarmReductionForUkrainians

ALLIANCE FOR PUBLIC HEALTH: response to challenges caused by Russia’s aggression against Ukraine - Situational report no. 6 of 31.03.2022, special issue: Opioid Agonist Treatment (OAT)

SUMMARY

As the war threatens to interrupt treatment, OAT patients have become even more vulnerable. The Alliance for Public Health’s principal position is to preserve provision of services wherever possible.
We are transforming our activities to help war-affected people (first of all, vulnerable populations) and attempting to ensure the safety of clients, APH personnel and partner NGOs. (ALLIANCE FOR PUBLIC HEALTH, 31.03.2022)

https://aph.org.ua/wp-content/uploads/2022/03/Situation-Report_ZPT_-final_eng-1.pdf

Police abuse and care engagement of people with HIV who inject drugs in Ukraine. 

Schoenberger SF, Idrisov B, Sereda Y, Kiriazova T, Makarenko O, Bendiks S, Ahuja N, Dutta A, Flanigan T, Gillani FS, Lunze K. 

Glob Public Health. 2022 Mar 28:1-16. doi: 10.1080/17441692.2022.2049341. Epub ahead of print. PMID: 35343870.

Abstract

https://pubmed.ncbi.nlm.nih.gov/35343870/

Ukrane. Ukraine rolls out Opioid Agonist Treatment in prisons 

An important step forward in the fight against HIV/AIDS and Hepatis C: Ukraine started rolling out Opioid Agonist Treatment (OAT) in its penitentiary institutions in 2019. The Pompidou Group has supported these reforms by training Ukrainian prison staff on comprehensive drug treatment provision in prisons. Moreover, it funded renovation of a methadone dispensary within a pre-trial detention centre in the city Lviv in the Western region of Ukraine. (Council of Europe – Pompidou Group, 2.-4.02.2021)

https://www.coe.int/en/web/pompidou/-/ukraine-rolls-out-opioid-substitution-treatment-in-prisons

Extending a lifeline to people with HIV and opioid use disorder during the war in Ukraine

Altice, Frederick L et al.

The Lancet Public Health, Volume 0, Issue 0 

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00083-4/fulltext

Public Health Catastrophe Looms in Ukraine, Experts Warn

Even before the war, the country struggled with epidemics of H.I.V., tuberculosis and hepatitis. The conflict threatens to undo decades of progress. (New York Times, USA, 26.03.2022)

https://www.nytimes.com/2022/03/26/health/ukraine-health-tb-hiv.html

Ukrainians displaced by Russian invasion struggling to access HIV and drug dependency treatment

Considerable efforts are underway to support Ukrainian refugees and internally displaced people to access the HIV and drug dependency treatment they need, the European Union’s HIV/AIDS, Hepatitis and TB Civil Society Forum heard on Wednesday 16 March. (nam / aidsmap.com, UK, 21.03.2022)

https://www.aidsmap.com/news/mar-2022/ukrainians-displaced-russian-invasion-struggling-access-hiv-and-drug-dependency

Ukraine’s opiate users: Russian invasion has severely disrupted access to drug-treatment services

About 317,000 Ukrainians inject drugs like heroin regularly. As of January, 14,868 of them were receiving substitute opiates such as methadone and buprenorphine.

Ukraine has been funding these treatment services since 2017. In that year, it also rapidly expanded its services for people in need of sterile syringes, condoms and peer support or counselling – the World Health Organization-recommended minimum for harm reduction among drug users and those at risk of HIV.

The Russian invasion has severely disrupted access to these specialist drug-treatment services. Before the war, some people would collect their methadone daily, but the Ministry of Health has advised that a 15-30 days’ supply should be given. This helps to reduce the number of trips to services, which in some parts of the country are risky. Yet even at this early stage in the war, ensuring people can secure medication is proving difficult.

Of the 1,328 people registered with drug services in Kyiv, so far, most have been able to get their opiate substitution medication. But services in other parts of the country aren’t faring so well. They are either running out of supplies or contact has been lost with local drug treatment teams. (Talking Drugs, UK, 09.03.2022)

https://www.talkingdrugs.org/ukraines-opiate-users-russian-invasion-has-severely-disrupted-access-to-drug-treatment-services

War deepens suffering for Ukraine’s drug users

At a time of increased stress, withdrawal medication is hard to find while blackmarket drug prices soar. (Al Jazeera, Katar, 16.03.2022)

https://www.aljazeera.com/news/2022/3/16/war-deepens-suffering-for-ukraines-drug-users

Webinar. Harm reduction emergency response (16.03.2022, 14 Uhr)

On Wednesday 16 March, 14:00CET, C-EHRN is organising a webinar.   Eliza Kurcevic [EHRA] and other harm reduction partners and colleagues in Ukraine and bordering countries will update the Network Members on current developments, as well as emerging humanitarian and health challenges in the area. 

Members will also have the opportunity to hear about current Civil Society emergency actions that aim to ensure access to harm reduction, care and support for people who use drugs in Ukraine, and those seeking asylum in neighbouring countries.  Details on how to contribute and participate in actions will also be provided.

Veranstalterin: C-EHRN – Correlation European Harm Reduction Network, Amsterdam

Anmeldung über

https://us02web.zoom.us/meeting/register/tZIlc--hpjMoHNII9huNG3zc3J6fo1bz5dBZ

Harm Reduction During Wartime in Ukraine (Video)

An interview with Anton Basenko, chair of the Ukrainian Network of People Who Use Drugs The Russian aggression against Ukraine causes tremendous suffering for the Ukrainian people in general - and especially for vulnerable groups with special needs, such as people who use drugs. In this video interview Anton Basenko explains how their communities struggle to survive, how brave harm reduction workers save lives amid destruction of the war and how people in other countries can help them. (Drugreporter, Ungarn, 12.03.2022, Video, 30:46)

https://www.youtube.com/watch?v=VFgErPlwR-c

Ukraine’s opiate users: Russian invasion has severely disrupted access to drug-treatment services

About 317,000 Ukrainians inject drugs like heroin regularly. As of January, 14,868 of them were receiving substitute opiates such as methadone and buprenorphine. 

Ukraine has been funding these treatment services since 2017. In that year, it also rapidly expanded its services for people in need of sterile syringes, condoms and peer support or counselling – the World Health Organization-recommended minimum for harm reduction among drug users and those at risk of HIV. 

The Russian invasion has severely disrupted access to these specialist drug-treatment services. Before the war, some people would collect their methadone daily, but the Ministry of Health has advised that a 15-30 days’ supply should be given. This helps to reduce the number of trips to services, which in some parts of the country are risky. Yet even at this early stage in the war, ensuring people can secure medication is proving difficult. (Conversation, UK, 09.03.2022)

https://theconversation.com/ukraines-opiate-users-russian-invasion-has-severely-disrupted-access-to-drug-treatment-services-178624

ALLIANCE FOR PUBLIC HEALTH UKRAINE (ukrain./engl.)

https://aph.org.ua

ALLIANCE FOR PUBLIC HEALTH: response to challenges caused by the Russian aggression against
Ukraine (situational report as of 08.03.2022)

https://aph.org.ua/wp-content/uploads/2022/03/SiTRep-war-2022_1_eng.pdf

UNAIDS. Keeping harm reduction available in Ukraine (Interview)

Ten days after the start of the Russian invasion of Ukraine, UNAIDS spoke to Oleksii Kvytkovskyi, the head of the Volna Donbas Resource Center of the All-Ukrainian Association of People with Drug Addiction, a nongovernmental organization working with people who inject drugs in Ukraine. (UNAIDS, Genf, 09.03.2022)

https://www.unaids.org/en/resources/presscentre/featurestories/2022/march/20220309_oleksii-kvytkovskyi

Has resourcing of non-governmental harm-reduction organizations in Ukraine improved HIV prevention and treatment outcomes for people who inject drugs? Findings from multiple bio-behavioural surveys. 

Trickey A, Semchuk N, Saliuk T, Sazonova Y, Varetska O, Walker JG, Lim AG, Stone J, Vickerman P. 

J Int AIDS Soc. 2020 Aug;23(8):e25608. doi: 10.1002/jia2.25608. PMID: 32851812; PMCID: PMC7450208.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450208/

Engaging people who inject drugs and their peers in HIV testing and harm reduction in Ukraine: do they make a difference? 

Kravchenko N, Denisiuk O, Kuznetsova J, Jayaraj J, Zachariah R, Smyrnov P. 

J Infect Dev Ctries. 2019 Jul 31;13(7.1):118S-125S. doi: 10.3855/jidc.11293. PMID: 32065814.

https://jidc.org/index.php/journal/article/view/32065814/2094

Methadone maintenance for HIV positive and HIV negative patients in Kyiv: acceptability and treatment response. 

Dvoriak S, Karachevsky A, Chhatre S, Booth R, Metzger D, Schumacher J, Chychula N, Pecoraro A, Woody G. 

Drug Alcohol Depend. 2014 Apr 1;137:62-7. doi: 10.1016/j.drugalcdep.2014.01.008. Epub 2014 Jan 30. PMID: 24548802; PMCID: PMC3985084.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3985084/

Opioid Agonist Treatment and Improved Outcomes at Each Stage of the HIV Treatment Cascade in People Who Inject Drugs in Ukraine. 

Mazhnaya A, Marcus R, Bojko MJ, Zelenev A, Makarenko I, Pykalo I, Filippovych S, Dvoriak S, Altice FL. 

J Acquir Immune Defic Syndr. 2018 Nov 1;79(3):288-295. doi: 10.1097/QAI.0000000000001827. PMID: 30312275; PMCID: PMC8215524.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215524/

МІНІСТЕРСТВО ОХОРОНИ ЗДОРОВ’Я УКРАЇНИ

Міністерство охорони здоров’я України у зв’язку з введенням з 24 лютого 2022 року воєнного стану в Україні відповідно до Указу Президента України від
24.02.2022 No 64/2022, з метою забезпечення безперервності надання медичної допомоги особам із психічними та поведінковими розладами внаслідок вживання опіоїдної залежності в умовах військової агресії Російської Федерації, повідомляє. (МІНІСТЕРСТВО ОХОРОНИ ЗДОРОВ’Я УКРАЇНИ. 25.02.2022)

Ukraine_OST_in_emergency_situations-ukrain

Ukraine. Opioidsubstitution in Notsituationen

Gesundheitsministerium der Ukraine zur Sicherstellung der Kontinuität der medizinischen Hilfe für Personen mit psychischen und Verhaltensstörungen infolge der Opioidabhängigkeit, 25.02.2022 (Deutsche Übersetzung: DeepL-Übersetzer)

Ukraine_OST in emergency situations-de

The Global State of Harm Reduction 2020

Ukraine und Opioidabhängigkeit: Tabelle auf Seite 82 und Kapitel zur TBC-Prävalenz, Seite 56-57

HRI – Harm Reduction International, 2021

https://www.hri.global/files/2021/03/04/Global_State_HRI_2020_BOOK_FA_Web.pdf

Injection Drug Use Trajectories among Migrant Populations: A Narrative Review. 

Melo JS, Mittal ML, Horyniak D, Strathdee SA, Werb D. 

Subst Use Misuse. 2018;53(9):1558-1570. doi:10.1080/10826084.2017.1416404

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033671/

Russia's ban on methadone for drug users in Crimea will worsen the HIV/AIDS epidemic and risk public health. 

Kazatchkine M. 

BMJ. 2014 May 8;348:g3118. doi: 10.1136/bmj.g3118. PMID: 24812004.

No abstract available

https://pubmed.ncbi.nlm.nih.gov/24812004/

Association of patterns of methadone use with antiretroviral therapy discontinuation: a prospective cohort study. 

Bach P, Wood E, Dong H, et al.

BMC Infect Dis. 2015;15:537. Published 2015 Nov 19. doi:10.1186/s12879-015-1255-7

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653887/

Sovereign Rules and Rearrangements: Banning Methadone in Occupied Crimea. 

Carroll JJ. 

Med Anthropol. 2019;38(6):508-522. doi:10.1080/01459740.2018.1532422

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6536354/