Six regions of Ukraine have received new batches of substitute maintenance therapy

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.).

List and addresses of SMT offices in Ukraine by reference.

 

 

 

 

Viral hepatitis B and C as a threat to public health

For experts, in Ukraine, nearly 3.6% (1,517,515) of people live with chronic hepatitis C and 1.5% (632.5 thousand) of people are infected with hepatitis B. There are 82 654 individuals with a medical look at 5.4%) for hepatitis C and 23 687 patients (3.7%) for hepatitis B. However, there is a significant number of people who do not yet know about their diagnosis and can’t get access to it.

 

 

The Public Health Center of Ukraine, together with "Doctors Without Borders", has developed a booklet "Viral Hepatitis B and C as a Threat to Public Health". The publication is intended for free distribution to decision-makers, health care professionals and anyone interested in the problem of viral hepatitis and the strategy for their elimination.

 

 

The booklets will be distributed in all regions of Ukraine among departments / departments of health care of oblast state administrations. The document is available in electronic format on the site ofThe Public Health Center of Ukraine.

Note that viral hepatitis C is curable, while viral hepatitis B is an incurable disease and requires lifelong medication. Timely diagnosis of the disease helps to initiate treatment and promote either complete recovery or avoidance of such dangerous complications as cirrhosis or hepatocellular carcinoma. Thanks to the latest highly effective direct antiviral drugs that almost do not cause adverse reactions, more than 95% of patients are able to recover completely if diagnosed with hepatitis C. Treatment lasts 12 or 24 weeks.

Hepatitis C virus infection is caused by contact with infected blood while injecting drugs, dangerous injections and invasive medical manipulations, blood transfusions and its components. Acute infection with hepatitis C virus usually has an asymptomatic course

 

 

The hepatitis B virus is transmitted as a result of contact with the blood or other fluids of the infected person. The hepatitis B virus can survive outside the human body for at least seven days and remain highly virulent during this period. Hepatitis B virus infection can be prevented with a modern, safe and effective vaccine.

People living with HIV have all the same rights as other citizens

All rights of HIV-positive persons are defined in general laws and in legislation governing legal relationships related to HIV.

Thus, the Law of Ukraine "On combating the spread of diseases caused by human immunodeficiency virus (HIV) and legal and social protection of people living with HIV" regulates the availability of quality medical care, and the Civil Code of Ukraine enshrines the right to life (Art.281 ), the right to health care (Article 283), the right to medical care (Article 284), the right to information about the state of one's health (Article 285).

In addition, the Law of Ukraine "Fundamentals of Health Care Legislation" (Article 34) normalized the patient's right to choose a doctor and replace him.

Important in a person's social life is the right to privacy about health. This right is governed by several legislative acts. In particular, the Law of Ukraine "On combating the spread of diseases caused by human immunodeficiency virus (HIV) and legal and social protection of people living with HIV" (Article 13), determines that information about the results of testing a person to detect HIV, about the presence or absence of HIV infection is confidential and is a medical mystery. Healthcare providers are required to take the necessary steps to ensure that confidential information about people living with HIV is properly stored and that such information is protected from disclosure and disclosure to third parties.

In addition to the universal rights and freedoms of a person and a citizen, PLHIV are also entitled to:

  • Compensation for damages related to the limitation of their rights by disclosure or disclosure of their positive HIV status;
  • Free provision of antiretroviral drugs and medicines for the treatment of opportunistic infections in the manner prescribed by the central executive authority in the field of health.

In addition to the broad rights of HIV-infected patients, domestic law defines their responsibilities. First and foremost, it concerns the prevention of the spread of HIV.

The Law of Ukraine “On combating the spread of human immunodeficiency virus diseases and the legal and social protection of people living with HIV” (Article 12) stipulates that all PLHIV are obliged to:

  • take action to prevent the spread of HIV infection by health authorities;
  • inform persons who were their partners before the detection of the infection, about the possibility of their infection;
  • to refuse to donate blood, its components, other biological fluids, cells, organs and tissues for their use in medical practice.

Using methadone and buprenorphine may help suppress HIV / AIDS epidemic in Ukraine

Using of methadone and buprenorphine will help suppress the HIV / AIDS epidemic in Ukraine. Such conclusions were made by Yale University researchers. These drugs are used to treat opioid obesity disorders and they have proven effectiveness in preventing HIV transmission. About it writes YaleNews. Currently, only 2.7% of HIV-positive Ukrainians receive methadone and buprenorphine.

Results from a Yale study show that treatment of at least 20% of HIV-positive people with opioid-related disorders can produce positive results. In this way, new HIV infections and deaths in Ukraine can be prevented.

Methadone and buprenorphine use reduce the frequency of injections and the dose of opioids. This, in turn, lowers HIV transmission and prevents overdose deaths.

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