A new supply of substitution maintenance therapy (SMT) has already been delivered to Volyn, Zhytomyr, Kherson, Khmelnytsky, Kyiv and Sumy regions. The medicines were purchased at the expense of the State Budget of Ukraine for 2019. 366 additional treatment courses were delivered to the oblasts, with the subsequent distribution by region.
It is noted that substitution maintenance therapy is the most cost-effective treatment for people with mental and behavioral disorders due to opioid use. Methadonehydrochloride and buprenorphine hydrochloride are commonly used for SMT. However, medical heroin or a combination of buprenorphine with naloxone may be used in some countries.
The use of these drugs also plays an important role in the prevention of HIV infection. In addition, SMT reduces the risk of hepatitis C infection, increases adherence to HIV, and reduces the risk of overdose.
The effectiveness of the program is influenced by certain factors:
the correctness of the drug (diagnosis (MKH-10) "syndrome of opioid dependence");
correct dose (taking into account individual needs, adherence to the principle of low initial doses and high maintenance, adherence to the recommendations for therapeutically effective doses);
continuous and long-term treatment (no restrictions on the duration of treatment, including the possibility of life-long treatment, given the understanding of the addiction not as an acute condition but as a chronic illness);
combination of pharmacological treatment with measures of psychosocial support; availability of treatment for comorbid conditions (HIV, TB, service integration, etc.).