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• W235065369 abstract "Irina Sukhoparova first became aware that her daughter was taking drugs when Tatyana was in her early twenties. the collapse of the Soviet Union in 1991, when Ukraine gained independence, small amounts of heroin started to be smuggled into the country via the Black Sea, the porous southern flank. Then, during the 1990s, an illicit industry sprang up generating large quantities of another opioid drug --a liquid made from the straw of poppies grown in Ukraine. Talking about her daughter's dependence on the highly addictive home-grown opiate, Sukhoparova says: was very hard for me, and Tatyana was very sick. It felt like very bad luck for us. We struggled with different kinds of therapy for six years, including detox and psychotherapy, but we didn't have much success. Then, in 2005, Tatyana read about an opioid substitution therapy programme in the newspaper. The programme was for 145 people, and we managed to get Tatyana on By taking the longer acting but less euphoric opioid, buprenorphine, Tatyana managed to overcome the harsh withdrawal symptoms of coming off the liquid poppy straw in a supportive clinical environment. Buprenorphine, a medicine, taken once a day (usually in tablet form under the tongue) reduces craving for opioids and blocks the effects of illicit opioid use, thus avoiding the harm associated with dirty needles and unhygienically prepared liquid poppy straw. And, in Ukraine, this treatment is free. [ILLUSTRATION OMITTED] The results were dramatic. After just two or three months on treatment, Tatyana started to look like she did before she became hooked and she was generally much healthier, Sukhoparova recalls. Tatyana was one of the first patients to participate in the country's first opioid substitution therapy programme, one that followed international treatment standards, including World Health Organization (WHO) guidelines. After that experience I wanted other parents to benefit from opioid substitution therapy, says Sukhoparova who set up Nadia i Dovira (Hope and Trust) in 2008, an association to support the parents of injecting drug users and to raise awareness that this is a treatable disease. Since 2004, when the first pilots got under way in Ukraine, opioid treatment programmes have sprung up in other parts of the former Soviet Union, including Belarus, Georgia and the Republic of Moldova, but in most of these countries there has been and still is resistance to the idea of treating opioid dependence with this therapy. Worldwide, few countries recognize dependence on illicit drugs as a health problem and even fewer provide effective treatment and care for it. We estimate that opioid substitution treatment is reaching only 10% of people who need it, says Dr Nicolas Clark, medical officer in the Management of Substance Abuse unit at WHO in Geneva. Moreover, the stigma attached to drug dependence continues to be a major barrier to seeking treatment. One of the people Sukhoparova had to thank for her daughter's recovery was Dr Sergey Dvoriak, the director of the Ukrainian Institute of Public Health Policy, and one of Ukraine's early proponents of opioid substitution therapy. A psychiatrist by training, Dvoriak became interested in drug rehabilitation while working in the United States of America in 1986. When he returned to Ukraine, he established one of the first drug rehabilitation centres in eastern Europe, the Stupeni (steps) centre in 1991. Dvoriak soon realized, however, that rehab was not enough and that providing effective treatment for people who inject illicit drugs in Ukraine was a crucial part of containing the country's HIV epidemic. In 2005, he was instrumental in setting up the Ukrainian Institute of Public Health Policy, a non-profit organization created by doctors and psychologists to design and implement evidence-based approaches to dealing with drug dependence and the rehabilitation of drug users, including those living with HIV. …" @default.
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• W235065369 date "2013-02-01" @default.
• W235065369 modified "2023-09-26" @default.
• W235065369 title "Opioid Treatment in Ukraine Risks Losing Momentum: Ukraine Has Made Progress in Introducing Opioid Substitution Therapy since 2004, but the Coverage of These Services Remains Inadequate While Injecting Drug Use Continues to Drive the Country's HIV Epidemic" @default.
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