Writes Enrique Restoy, What’s Preventing Prevention Campaign Manager.
Working in the provision of substitution maintenance therapy (SMT) for people who use drugs in Ukraine is a difficult and dangerous task. It entails providing drug users with regular doses of opiate substitution drugs (such as methadone and buprenorphine) as a treatment for drug dependency, reaching out to a population often marginalised from, and ostracised by, the rest of society.
Physicians and other health and social workers involved in these programmes often suffer the social rejection their patients endure for working with ‘good-for nothing’ ‘drug addicts’. They work in deprived areas where delinquency and violence are rife. Often times, they are under the serious threat posed by drug mafias, who are not happy seeing their ‘market’ reduced when drug users go into therapy and stop buying their ‘products’.
At least, these professionals have the consolation that opiate substitution works and is making a significant difference for drug users. It has been endorsed by UNAIDS and the World Health Organisation (WHO), and research shows that SMT reduces deaths, crime, HIV infection and drug use and also helps generate an enabling environment to improve education, parenting and access to employment.
SMT is simply essential in countries like Ukraine, where drug users are deeply affected by the HIV epidemic. Eastern Europe and Central Asia have one of the fastest-growing HIV epidemics in the world, with a 66% rise in infection between 2001 and 2008. Ukraine is one of the most affected in the region, with a prevalence rate of 1.1% in the adult population. There is an estimated 300,000 injecting drug users in Ukraine. Up to a quarter of them in major cities are thought to be HIV positive.
On paper, the Ukrainian authorities have understood the importance of SMT in reducing the spread of HIV and AIDS. Ukraine introduced SMT programmes in 2004, being highly praised by the international community for doing so. At present over 5,000 drug users receive SMT in Ukraine with the participation or endorsement of the Ukrainian authorities; and there are plans for SMT to reach 20,000 drug users by 2014.
So you might expect that health and social workers administering SMT would be nurtured and protected by the State from violence, intimidation and social rejection. Nothing is further from the truth. It is shocking and disturbing having to call for action against a generalised pattern of police intimidation, harassment and imprisonment of SMT patients and the social and health professionals working in SMT in Ukraine.
Dr. Illya Podolyan is one of them. He has worked in SMT in Odessa for years. He was detained in May 2010 on charges related to drug trafficking when in fact he was administering SMT. His health is in poor condition and he cannot be treated properly in the detention facility where he is confined.
Please take urgent action on behalf of Dr. Podolyan and against the policy of intimidation and harassment of SMT patients and professionals in Ukraine.
Write to the Ukrainian government. Download the sample letter and contact details here.