Maryna Reshetnyak: Drop-in Center -- Ukrainian Experience in Harm Reduction

(Great program! Too bad we insist on stigmatizing, persecuting and locking them up here in the good ol' democratic US of A.)

Drop-in Center: Major Russian Paper Wrote about Ukrainian Experience in Harm Reduction
by Maryna Reshetnyak
Rising Voices

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10 AM. There is a short line next to entrance of the pharmacology clinic called “Sociotherapy”. I see a poster on the wall in Ukrainian: “Not all people are alcoholics or drug addicts, but all alcoholics and drug addicts are people”. This is “the site” – a place where patients of substitution therapy receive pills of Methadone and Buprenorphine.

There are no very young people in line. Most of them are in their 30's, but there are a few of 40's and older. Each person has a story. There is a person with crutch, a mother holding a small child …

I am entering the site together with Pavel Kutsev. He is a journalist. He is 48 and he is an opiate addict. He and his wife Yanina, the editor-in chief for a newsletter for drug addicts “Motylek” has been in the program for a year and a half.

“Sometimes I hear that substitution therapy is a legalization of drugs” says Pavel. “No, it is the legalization of drug addicts. Addiction is a snowball of problems. Starting substitution therapy you start dealing with them. Later on you can start thinking about givin drugs up completely.”

“What are the most common associations that people have about drugs?” asked Pavel “Everybody would say: death, crime, children without parents, infections, asocial lifestyle. Now let's take a person taking substitute medications. He will not die because of drug overdose. He does not participate in criminal activity. He re-establishes relations with the family. He is able to treat HIV, TB and hepatitis. Moreover, he stops taking drugs intravenously, thus reduces risks of spreading infection. Substitution therapy reduces the most dangerous consequence of the drug addiction.”

A nurse is greeting us. She has to assess the health of the patient, provide the medication, and make sure the patient has taken it (sometimes she crushes the pill with a glass) and make proper records. The nurse is taking three pills from a bottle and, with a piece of folded paper, put them directly to Pavel’s mouth. He is swallowing them up with a bit of water and showing his tongue to the nurse. There is nothing in the mouth. The nurse is nodding and the next person enters the site.

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