According to UNAIDS, about 30% of new cases of HIV / AIDS are among injecting drug users. Almost 32, 7% of women, who injects drugs are infected with hepatitis C. Often in HIV-positive drug addicts reveal tuberculosis.
Drug addiction – is a disease. But curable disease. In every city of Ukraine there is a narcologist’s office. This is a doctor who spend 7 years at university in order to help such people. The problem is that the system of addictions care was established in the days of the Soviet Union. Since then, despite the emergence of more effective treatments, significant changes in the work of drug services are not introduced. In Kharkov took up this issue and now at the regional level are reforming the regulatory framework that will allow narcology bring medical services to injecting drug users.
WHY WE SHOULD TREAT DRUG ADDICTS?
One of the problems that accompanies addiction – a lot of opportunistic infections. Drug users are not isolated from society. They also ride the metro, visit doctors and can personally transmit HIV or tuberculosisto you, infect tools in a beauty salon with hepatitis C.
Kharkiv Charitable Foundation “Blago” has 9 years of experience in the prevention of these diseases among vulnerable populations, including injecting drug users (IDU’s). Experience of social workers shows that addicts do not seek with issues on their own health. Once from the doctor, the patient receives information about preventive measures against possible diseases. But even if addict know, that it is likely infected, he does not refer to the AIDS center. After studying the problem Kharkiv activists developed an action plan and initiated reforms in the health care of drug addicts – since July in they are implementing a project of the UNODC, which is amed to bring health and social services for drug addicts. The project provides a number of strategic objectives that will help preserve the health of drug addicts themselves and others.
RAPID HIV TESTS AND DIAGNOSIS OF GENITAL INFECTIONS ON THE BASE OF NARCOLOGY
The first concrete step in the reforming of narcology was the training of medical personnel in procedures for the rapid HIV testing. Earlier, drug addicts can learn their HIV status in the regional AIDS-center and Mobile Ambulance clinics of charitable projects. Now at a reception at narcologist, the patient can in 15 minutes to find out if his blood antibodies, which are produced in HIV infection. Moreover, right in the office of narcologist person can find out if he is sick for hepatitis or syphilis; complete the screening questionnaire, the results of which will prompt the probability of tuberculosis. Also on the basis of drug treatment services will be introduced open access to diagnosis and treatment of sexually transmitted infections.
Rapid tests and primary diagnostics will help to illustrate to the drug addict, that it is necessary to pay attention in the first place.
INTERACTION OF DOCTORS
Next objective of the reform – to make the addict come to a physician specialty, and he was accepted. Today in the Ukrainian legislation does not provide a system that coordinated all health professionals involved in socially dangerous diseases.
To change this, the reformers are planning to sign a number of agreements between narcologist, AIDS center, Skin and Venereal Diseases and TB dispensaries and social services in Kharkov, as well as develop a monitoring system for the forwarding of the patient. UNODC project experts say that doctors are interested in these changes, because it is a kind of guide for interaction, which facilitate their work and will promptly respond to the problem of a particular patient. This kind of communication is now found only if between doctors have personal agreements, but these are isolated cases, they can not be regarded as a system.
EXPANDED OF SMT PROGRAM
Innovations also will touch and substitution maintenance therapy (SMT). Now in Ukraine 8329 persoms registered SMT program. They receive methadone – a synthetic analgesic that takes brain receptors, which previously affected opioid psychotropic substances.
Addict must come every morning to narcologist and under its supervision to take the personally calculated for him dose. Methadone prevents the effect of euphoria, and thus inhibits the desire to take a dose of street drug. Morning procedure eliminates the need to seek illegal drugs manner that reduces the criminal cases. In addition, the patient of substitution therapy had a chance to become an ordinary citizen and get a job.
Gradually, the amount of methadone that takes the patient can be reduced and he can refuse to participate in this rehabilitation program. However, because of the small number of seats thousands of drug addicts can not become the patient of methadone treatment in the region. Therefore, the UNODC project includes seeking the opportunities to expand SMT program, as well as in favor of the resolution granting SMT drugs through pharmacies for all re-socialized and stable clients not to interfere with their social growth.
PREVENTION OF COINFECTION HIV + TUBERCULOSIS
The probability that a person with HIV-positive will develop tuberculosis is 20 times higher than that of HIV-negative people in Ukraine. Taking this into account, co-infection HIV + TB is threatening problem for society, because tuberculosis can pick up anywhere – even on public transport. Experts from the World Health Organization say that registered a low incidence of HIV-associated TV in Ukraine has shown significant shortcomings of diagnosing a combination of these diseases, as evidenced by mortality.
Almost 83% of patients with HIV / tuberculosis die due to severe forms of tuberculosis identified late. That is why the special attention in the UNODC project is paid for timely diagnosis and appropriate treatment of the disease in drug-dependent patients. They are at increased risk because of their way of life provokes the appearance of both diseases. Therefore, the problem of effective prevention, early detection of these diseases within the drug treatment facilities and proper treatment of supervision phthisiologist received particular attention of the initiators of the project.
Apart from high quality of medical services, the project will also affect the social side, because addiction leads not only to physical health problems, but also entails social disadaptation. Leaving the drugs, man is obliged to completely change his lifestyle, the environment, to break most of the social networks and at the same time find the strength to forge new relationships and find a job. To address social issues project involves training for visiting nurses, which will deal with social support to drug addicts. Social workers of non-governmental organizations that have great experience in working with injecting drug users will help to them.
New methods and approaches tested in Kharkiv, Poltava and Kiev regions. Initiators of the project are hoping that this system will prove its effectiveness and success will be implemented throughout Ukraine.