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The effects of opioid-agonist treatments on HIV risk and social stability: A mixed methods study of women with opioid use disorder in Ukraine. 

Hoff E, Marcus R, Bojko MJ, Makarenko I, Mazhnaya A, Altice FL, Meyer JP. 

J Subst Abuse Treat. 2017 Dec;83:36-44. doi: 10.1016/j.jsat.2017.10.003. Epub 2017 Oct 12. PMID: 29129194; PMCID: PMC5726590.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5726590/

Collaborative learning and response to opioid misuse and HIV prevention in Ukraine during war

Altice, Frederick L et al.

The Lancet Psychiatry, Volume 9, Issue 11, 852 - 854 

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00318-2/fulltext

Medications for opioid use disorder during war in Ukraine: Innovations in public and private clinic cooperation. 

Bromberg DJ, Madden LM, Meteliuk A, Ivasiy R, de Leon SJG, Klyucharyov K, Altice FL. 

Lancet Reg Health Eur. 2022 Aug 10;20:100490. doi: 10.1016/j.lanepe.2022.100490. PMID: 35991325; PMCID: PMC9386492.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9386492/

EMCDDA. European Web Survey on Drugs 2021: Emerging findings in Ukraine

The European Web Survey on Drugs1 collected data during March and May 2021 from people who use drugs, are aged 18 or older, and live in the 21 EU and 9 non-EU countries including Ukraine. In this period, the populations in many European and neighbouring countries were experiencing COVID-19-related lockdown or restrictions. Unless otherwise indicated, the data presented here refer to 866 respondents who reported having used at least one illicit drug in the 12 months prior to the survey (last 12 months of use) and live in Ukraine. (EMCDDA, Lissabon, 03.10.2022)

https://www.emcdda.europa.eu/publications/data-fact-sheets/european-web-survey-drugs-2021-emerging-findings-Ukraine

DESK REVIEW: Support for People with Substance Use Disorder in Ukraine During the War 

International Technology Transfer Center (ITTC) Ukraine, August 2022

https://www.issup.net/files/2022-09/ITTC%20Ukraine%20Desk%20Review_August%202022.pdf

DESK REVIEW: Support for People with Substance Use Disorder in Ukraine During the War

War in Ukraine has inevitably led to the country's health system functioning at reduced capacity. Attacks near hospitals and active military operations force people to change their place of residence and flee from the war to safer regions of the country or go abroad as refugees. As a result, vulnerable populations are unable to safely attend healthcare facilities to receive substitution treatment and specialized support services. 

The purpose of the research is to provide an insight into the current state and key issues of provision of special medical care and support services for people with substance use disorder in Ukraine during the war. The research is based on desk review involving the collection and synthesis of available information to gain an understanding of the current state of the problem, and to identify appropriate policy and operational responses. (International Technology Transfer Center (ITTC), Ukraine, 01.08.2022)

https://www.issup.net/knowledge-share/publications/2022-09/desk-review-support-people-substance-use-disorder-ukraine

UKRAINE SNAPSHOTS: Harm reduction services in action during the war in Ukraine

Introcuction

The Russian invasion of Ukraine has brought catastrophic suffering and health consequences, above all, for the civilian population. By the 20th of April 2022, the Office of the UN High Commissioner for Human Rights (OHCHR) had already recorded 2224 civilians killed (631 men, 383 women, 42 girls, and 61 boys, as well as 70 children and 1037 adults whose sex is yet unknown) and 2897 civilians injured (335 men, 271 women, 59 girls, and 64 boys, as well as 157 children and 2011 adults whose sex is yet unknown) since the beginning of the Russian invasion of Ukraine.[1] People with special needs and who need regular health services are the ones who might be affected the most. According to the UNAIDS’ latest estimates, there are 258,000 people living with HIV in Ukraine (1% of total population), and 366,000 people who use drugs, of which only 20,000 have access to OAT (Opioid Agonist Treatment). Moreover, 80,000 people are estimated to be engaging in sex work, whilst 179,000 people belong to the LGBTQ group.[2]

Since the beginning of the invasion, several organizations have been working hard to try and cater for the needs of these populations. In this snapshot, we depict the current harm reduction services being offered, as well as the needs of key populations who are caught up in the conflict. (Correlation – European Harm Reduction Network, 2022)

https://www.correlation-net.org/wp-content/uploads/2022/08/220817_UkraineSnapshots1-1.pdf

The global movement towards a public health approach to substance use disorders. 

Johnson K, Pinchuk I, Melgar MIE, Agwogie MO, Salazar Silva F. 

Ann Med. 2022 Dec;54(1):1797-1808. doi: 10.1080/07853890.2022.2079150. PMID: 35792721; PMCID: PMC9262358.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262358/

EMCDDA. Responsiveness and preparedness in addressing drug-related needs of displaced Ukrainians in EU countries bordering Ukraine

European Monitoring Centre for Drugs and Drug Addiction (2022), EMCDDA trendspotter briefing, Publications Office of the European Union, Luxembourg, Juli 2022.

https://www.emcdda.europa.eu/system/files/publications/14753/EMCDDA%20trendspotter%20briefing-Ukraine.pdf

Situational report on access to substitute programmes maintenance therapy in Ukraine - Ситуаційний звіт про доступ до програм замісної підтримувальної терапії в Україні 

PHC (Public Health Centre of the Ministry of Health of Ukraine) (2022b), accessed on 29 June 2022

https://phc.org.ua/sites/default/files/users/user92/Ситуаційний звіт про доступ до програм ЗПТ в Україні_01.06.2022_fin.pdf

Situational report on OST in Ukraine as of 15/05/2022

PHC (Public Health Centre of the Ministry of Health of Ukraine) (2022c). 

https://phc.org.ua/sites/default/files/users/user92/Ситуаційний%20звіт_15.05.pdf

Ukraine. Table on characteristics of patients as of 01/05/2022

PHC (Public Health Centre of the Ministry of Health of Ukraine) (2022a), accessed on 29 June 2022.

https://phc.org.ua/kontrol-zakhvoryuvan/zalezhnist-vid-psikhoaktivnikh-rechovin/zamisna-pidtrimuvalna-terapiya-zpt/statistika-zpt

A qualitative exploration of daily path and daily routine among people in Ukraine who inject drugs to understand associated harms. 

Owczarzak J, Chien J, Tobin K, Mazhnaya A, Chernova O, Kiriazova T. 

Subst Abuse Treat Prev Policy. 2022 May 7;17(1):33. doi: 10.1186/s13011-022-00465-3. PMID: 35526038; PMCID: PMC9077869.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077869/

The Invisible Battle in the Ukraine War

While the Russian invasion of Ukraine has raged on for almost two months, TalkingDrugs spoke with several organisations working on the ground in Ukraine to understand the reality of the looming pain and treatment crisis brought about by the sudden lack of stable access to OST. All organisations contacted were a fantastic example of resilience in the face of adversity, and a stark reminder of how consistent access to health services is a lifeline for many. (Talking Drugs, UK, 17.05.2022)

https://www.talkingdrugs.org/the-invisible-battle-in-the-ukraine-war

Humanitarian crisis and harm reduction in Ukraine: Resources and information

On 24 February 2022, the Russian Federation launched a large-scale invasion of Ukraine. The ensuing war has entailed dramatic costs with an incalculable and growing human toll. Sustaining the health and harm reduction responses serving people who use drugs in Ukraine and those fleeing the war must be a priority for all stakeholders. Below, you will find a list of links that we will continue to update in the coming weeks to provide reliable information, analysis and support resources on this ongoing emergency. (International Drug Policy Consortium (IDPC), UK, 28.03.2022)

https://idpc.net/alerts/2022/03/humanitarian-crisis-and-harm-reduction-in-ukraine-resources-and-information

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