War and the resulting disruptions to medical care have created a crisis for Ukrainian patients with drug use disorder and those who treat them.
Medications to treat opioid use disorder, including methadone and buprenorphine, have been shown to save lives, cutting overdose deaths by up to 60% and reducing the transmission of HIV by offering a safe alternative to injection drug use.
Many patients take these medications, which are called opioid agonist therapies, for years or even decades, and may be at risk of overdose if they lose access to treatment.
Ukraine has the highest prevalence of HIV in Europe.
Two years after Russia’s full-scale invasion of Ukraine, which began on February 24, 2022, a new study published in Journal of Substance Abuse Treatment examines how opioid treatment programs were interrupted by Russia’s 2014 invasion of the east of Ukraine and Crimea.
Led by Anna Meteliuk, a research project manager at the Alliance for Public Health in Kyiv, Ukraine, and Danielle Ompad, vice dean for academic affairs and professor of epidemiology at the New York University School of Global Public Health, the study found that, despite efforts of local public health programs, only one-fifth of patients living in the areas occupied by Russia were successfully referred to drug treatment sites in non-conflict areas of Ukraine.
The researchers also looked at whether patients who transferred to other programs stayed in them long term. They found that less than half of the patients continued treatment through 2021, although those who received higher doses and more flexible methods of dosing were more likely to stick with their medications.
“We know from the United Nations that dozens of people in Crimea died of overdoses in the first six months after the invasion because they no longer had access to treatment under Russia’s restrictive drug laws. Our study provides further evidence of how challenging it has been to ensure access to life-saving opioid treatments in Ukraine,” says Ompad, who is also the deputy director of the Center for Drug Use and HIV/HCV Research (CDUHR) at the NYU School of Global Public Health.
Here, Ompad and Meteliuk explore the lessons their findings can teach us about improving access to drug treatment during conflicts:
The Ukraine HIV Research Training Program, which is funded by the National Institutes of Health’s Fogarty International Center and the National Institute on Drug Abuse funded the work.
Source: NYU