My journey towards OST took me almost 20 years

17 July 2014

My journey towards OST was very long, and it took me almost 20 years. Many times I tried different treatments, swore to quit, lied to my loved ones and to myself. Over these years I’ve accumulated a “luggage” that consisted of distrust towards doctors, multiple losses of friends, serious deterioration of my health and health of my relatives, several divorces…

Once I took this luggage to yet another doctor. It was on 13 May 2008 when I went to Simferopol, not expecting much, thinking it would be just the same old story. I’m so happy I had been wrong! OST saved me, and I’m very grateful to my doctor Andrey V. Mandybura. He convinced me that I could trust this method of therapy, unknown to me at that time. On that day, I took my first dose of buprenorphine, and six years later, on 12 May 2014, the last dose of buprenorphine was given out to a patient.

After 16 March this year, bad news struck Ukraine: reduced dosages of substitution drugs, strange people with guns… Crimea took a steady course away from Ukraine, taking 803 patients of the local OST programs towards the unknown. The doses had been reduced sharp and fast to 2 mg of buprenorphine given to patients every other day. Supplies of methadone were more plentiful, so they reduced the doses a bit slower. The body struggled to recover from a smaller dose, only to be tortured with a new reduction on the next day. In early May, Sevastopol finally surrendered: the city ran out of methadone supplies. Other cities followed the pattern. The Crimea’s in-patient clinics were barely coping with the amount of people willing to undergo detox. Hospitals lacked IV lines, medications, simple pain-killers. Officers from the Federal Drug Control Service kept their watch near drug treatment clinics, waiting for “clients”. The first OST refugees started to leave Crimea: some went to Ukraine (to continue OST or try a better detox), others – to Russia’s rehabilitation centers. 

More than a month passed since OST was discontinued in Crimea. Some patients found refuge in Ukraine or Russia, some went back to street drugs. Some are no longer with us, unfortunately.

For objective reasons, I cannot live in Crimea any more. But I can visit the region, documenting multiple violations of patient rights. Thanks to Ukrainian doctors, I am able to get buprenorphine in pharmacies by prescription and to continue my video advocacy.

In May 2014, Eurasian Harm Reduction Network held a Regional Forum on Health and Rights of People Who Use Drugs. I was there, representing the Eurasian Network of PWUD. For two days high-ranking officials, harm reduction managers, experts, doctors and drug user community representatives discussed emerging problems, giving special attention to the forced discontinuation of OST in Crimea. Such events, encouraging productive debate and bringing together various stakeholders, give us hope that there are ways to resolve conflict situations, even as complicated as that in Crimea. 

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