Opioid substitution treatment in Ukraine: review of the published papers
Keywords:opioid substitution treatment, OST, Ukraine, buprenorphine, methadone, opioid addiction, HIV/AIDS
To review published peer-reviewed papers regarding opioid substitution treatment (OST) in Ukraine and to describe the research agenda that has been in parallel with the development of opioid substitution treatment program in Ukraine. Further, to understand research gaps and future directions of scientific efforts concerning the OST implementation in Ukraine.
Methods:Literature search using standardized research terms of PubMed, Science Direct, and Google Scholar was supplemented with consultations with relevant in-country researchers to identify any additional publications that were not found through on-line search. Original literature search has been conducted during August, 2013, two refreshment searches were conducted during October, 2013 and February, 2014. The literature search and eligible papers selection were conducted applying PRISMA guidelines.
Eight papers were published in peer reviewed journals specifically scrutinizing the features of the OST program or patients’ outcomes in Ukraine. Demonstrating the feasibility of buprenorphine and methadone maintenance treatment in Ukraine was core aim of majority of the papers. Few discussed TB and HIV treatment outcomes and health-related quality of life (QoL). Program description and cost-effectiveness of OST in Ukraine were the topic of two other papers. Decreased injection risk behavior and high retention rates were reported for Ukrainian methadone and buprenorphine patients. Other treatment indicators (TB treatment outcomes, HIV initiation, and services utilizations) have been higher among those on substitution treatment compared to those who were not. QoL besides health-related indicators have been understudied among Ukrainian OST patients.
Published papers provide evidence to conclude that OST in Ukraine is effective in terms of patients’ retention on treatment and decreasing self-reported HIV-related risk behaviors and also provides a background for wide scale-up of the program. Further research is needed to understand how the program could be improved to better meet the needs of the opioid dependent drug users accounting for Ukrainian context.
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