Message from Ukraine

What has the situation been for drug users in Ukraine since the war started? A conversation with Svitlana*, former drug user and harm reduction activist: “Everything changed overnight”

Svitlana met the shocking news that the war had started in her home country, Ukraine, while attending an activist gathering in Tbilisi, Georgia. A former drug user and opiate substitution therapy (OST) patient herself, Svitlana is a long-time harm reduction activist and a member of the Ukrainian national network of people who use drugs “Volna”. In Tbilisi she was part of the gathering of women who use drugs from the region of Eastern Europe and Central Asia (EECA). Her family asked her to stay abroad in safety, but after a week in a hotel, Svitlana realised she belongs in her hometown of Poltava and that she must help other people from her community.

“It’s been a month since the Russians started the full-scale war against us”, — Svitlana says. — and I have been busy providing drug users who have evacuated from the Eastern regions of Ukraine, where the active military actions are underway, with shelter, food and treatment”. Harm reduction and OST programmes are available only in the big cities of Poltava region, so the refugees can only stay close by. The shelters for refugees are organised at schools, kinder gardens and even warehouses. “Today I spent 4 hours calling all of the locations, but there are no beds available for the people who are coming tomorrow. But, I will keep searching”, — Svitlana sighs. 

Just two months ago, Ukraine was among the countries of the Central and Eastern European region, where harm reduction services have been slowly but surely developing, both with the financial support of the Global Fund and with the national and local state budgets. According to the Harm reduction report 2020 Ukraine has around 317 thousand people, who inject drugs. Alliance for public health states that in 2021, there were 16,2 thousand OST patients.

Access to harm reduction services in Ukraine has been available in 2400 locations across the country with access to needle and syringe exchange, testing, counselling and outreach work as well as peer naloxone distribution. In 2019 in the city of Sumy, the first harm reduction cabinet was opened, which allowed supervised use of illicit drugs on its territory – the first ever harm reduction facility of this type, opened in the EECA region. Having regular access to harm reduction services and having access to methadone and buprenorphine by prescription, many drug users started a new life, became outreach workers, and created families. Many of them have become active members of the drug user community networks in order to advocate for wider access and better quality of harm reduction services. 

“Last year my major concern was how to register the local organisation of “Volna”, how to find a good accountant and fundraise for our community centre. I had such great plans.” — Svitlana says. – “But everything changed overnight. Now we think about our own survival.”
Svitlana and her husband are patients of the OST programme for 12 years and now together with other Ukrainian OST programme members are facing the new horrifying reality. Both Ukrainian methadone producers in Odessa and Kharkiv can no longer provide medicines and the procurement from abroad is an extremely complicated procedure, which is not within the government’s priority list.

“The supplies of methadone are running low in our city and doctors oblige all our OST patients to cut the daily dose gradually, so we can last longer. According to the Ministry of Health, the available supplies should be enough till August of 2022. After this date only God knows what kind of future waits for me and my family.” – Svitlana sums up.

*Svitlana is a fictitious name. 

Author: Anastasia Bezverkha

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