Drug Using and Harm Reduction Programme in Belarus

1
Drug Using and Harm Reduction Programme in
Belarus

• Substitution Methadone Therapy
• (pilot project)

2
Situation Analysis

• About 9400 persons are officially registered by
  the drug treatment services in Belarus on
  1.04.2003.
• The annual growth of the number of persons
  registered by the drug services constitutes
  20-40.
• the true spread of drug addiction was at least
  6-7 times higher than the official statistics,
  reaching 40 131 43 315.

3

• Absolute majority of drug users inject drugs
  (91.3)
• high degree of HIV infection
• and infectious diseases,
• above all, parenteral viral hepatitis.
• The patenteral way of HIV transmission
  through injection of drugs is dominant (75,5
  from the whole amount of PLHA)

4
Medical and Social Assistance to IDUs

• Two specialized departments for treating drug
  addicts
• in the Republics Clinic Psychiatric Hospital
  Novinki 40 beds,
• in the Minks City Narcology Outpatient Clinic
  20 beds.
• In Oblast psychiatric hospitals 3-5 beds
  (mainly for men).
• Drug addicted women are treated in psychiatric
  medical departments

5

• There are no institutions that would be really
  tackling problems of social reintegration of
  former drug users in the country.
• Today, separate attempts aimed at setting up
  such centres are undertaken, basically by
  representatives of different Christian
  confessions.
• Governmental institutions practically are not
  engaged in such activities.
• Substitution therapy is not yet in place.

6

• Methadone is included into List II Special
  hazardous narcotic drugs and psychotropic
  substances allowed for legal controlled use,
  items 45 and 46.
• The list of narcotic drugs, psychotropic
  substances and precursors to be controlled in RB
  was approved by Resolution No. 11 of the
  Government of 3 May 2000.

7
Pilot projectto introduce methadone
substitution therapy

• Four components
• Treatment
• Rehabilitation
• Provision of information to IDUs
• Education of medical staff

8
2 groupsMinsk 75 personsGomel Oblast
(Svetlogorsk) 25 p.

• the number of opiate addicts in the city of
  Svetlogorsk makes 90.1 persons per 100 000
  population, while the average national figure is
  25 persons per 100 000
• 74 of all drug users registered in city of
  Svetlogorsk are HIV-positive.

9
The selection criteria

• addiction to opiates during a number of years,
• unsuccessful treatment in the past (at least two
  attempts),
• informed consent of the patients to take part in
  the survey

10
not be eligible

• Patients with addiction to any class of
  substances, beside opiates,
• Patients with epilepsy, psychosis, organic
  amnesic disorders, oligophrenia, dementia
• Pregnant women,
• Patients under 18.