Tag: OST

Defending equal rights in Kazakhstan: successful patient advocacy at OAT

Post author By velyunsky
Post date August 23, 2024

The story of Alina (name changed), a patient diagnosed with trophic ulcers, demonstrates how the bias and lack of awareness of medical professionals can become a serious obstacle to quality treatment. Alina was admitted to the hospital under a government quota but encountered a problem when she told her primary care physician that she was a participant in a substitution therapy program (OAT).

Alina honestly admitted that she was on the drug treatment register and participating in OAT, asking for permission to leave the hospital in the morning to get her life-saving medication, as it was not available on hand. The doctor reacted extremely harshly, calling her a “drug addict” and threatening to discharge her, instead of showing professionalism and understanding.

Finding herself in a difficult situation, when she needed both urgent medical help and support in her addiction treatment, Alina turned to REActor for help. He quickly contacted the patient support expert at the hospital, described the situation, and asked for action. In response, the hospital promptly allocated an hour between treatments for Alina to receive the drug. Moreover, a meeting was organized with her attending physician, which was attended by the expert, the REActor, and the physician supervising the OAT program at the medical institution.

During the meeting, the doctor was informed that discrimination against patients is unacceptable. The expert reminded us that OAT is a legal and effective treatment method that has been successfully used for more than 50 years, especially important for HIV and AIDS prevention among opioid-dependent patients. Thanks to REActor’s active support, Alina was able to get help and protect her rights.

This story also underscores the importance of educating healthcare providers about programs like OAT. Awareness and respect for patients are key steps towards eliminating discrimination in medicine and creating a level playing field for all who need treatment.

Resolving сounseling сhallenges in the OST program in Montenegro

Post author By velyunsky
Post date June 20, 2024

At the begining of the year, REActors received a complaint from Luka (name changed) regarding the insufficient psychological counseling provided in the OST program. Luka’s primary concerns were the infrequent and brief sessions with the psychologist, along with the distracting environment in the overcrowded waiting area. He believed these conditions detracted from the quality of care he was entitled to.

Following up on Luka’s complaint, REActors’ team collaborated with the psychiatric clinic to evaluate the situation. The clinic’s psychiatric staff acknowledged the operational difficulties, noting the challenge of serving a large client base while ensuring personalized psychological support.

To address this issue, REActors offered Luka access to their counseling center, associated with the day center forpeople, who use psychoactive substances. This solution ensures that Luka receives the necessary psychological support in a more conducive environment, coordinated with the psychiatric clinic, thereby providing a tailored approach to meet his needs within REActors’ service framework.

Protecting your rights and dignity: supporting a client of OST in Ukraine

Post author By velyunsky
Post date June 19, 2024

Lyubov (name changed) is a woman living with HIV who used to inject drugs in the past. She is in a civil marriage with a man who is also HIV-positive and has a history of substance use. Both are patients of the OST program. On their way home from the drop-in center, where they had received self-administered medication, the couple was stopped by police officers. They began to humiliate them, treat them rudely, pick their pockets, and search them without any reason.

Although the clients informed the police that they were taking OST and showed all the necessary documents, no one listened to them, and the couple was taken to the police station. The woman called the organization. Upon hearing about such illegal actions of the police, the REActor and a social worker of the organization came to the defense of the couple. They contacted the police by phone with the doctor who had prescribed the drugs. The doctor explained that everything was legal and that the patients had no problems with taking the drugs. After that, the couple was released.

After coming to the organization with words of gratitude, the client refused to seek legal assistance because she did not believe that the police officers would be punished. She was also offered counseling by the organization’s psychologist and group training to restore her psycho-emotional state.

An assistance with recovery through OST in Azerbaijan

Post author By velyunsky
Post date May 21, 2024

The situation happened to Elmira (name changed), a 25-year-old woman from a community of people who use drugs. Her life circumstances were such that she started with light substances, but soon moved on to heavier ones, and this led to addiction. A turning point in her life was the tragic death of her lover from an overdose – this made Elmira decide to stop using. Elmira turned to a REActor. Understanding her desire to quit drugs and change her situation, he helped her access opioid substitution therapy (OST) at the Republican Narcology Center (RNC). With REActor’s support, Elmira began her treatment journey.

The initial stages of treatment were incredibly challenging for Elmira. However, with perseverance and the support of the medical professionals at RNC, she managed to stabilize her condition. Her commitment to the program and the structured support it provided were crucial in helping her navigate the difficulties of withdrawal and recovery.

Today, Elmira stands on the threshold of a better life. She has found employment and has mended her relationship with her parents, rebuilding the connections that had frayed during her years of addiction. Elmira’s journey to recovery highlights the profound impact of access to effective treatment and support systems. Her story is a beacon of hope for others struggling with similar challenges, demonstrating that with the right help, it is possible to overcome addiction. Her story is a powerful testament to the transformative impact of OST and the comprehensive support offered by REActor and the NGO Struggle Against AIDS (SAAPU).

Entitlement or preference? The world celebrates Health Day

Post author By velyunsky
Post date April 7, 2024

April 7 marks World Health Day, founded by the World Health Organization (WHO) in 1950. This day recalls the importance of health for all people in the world and emphasizes the need for access to skilled health care as a fundamental human right. In this context, providing life-saving services such as opioid substitution therapy (OST) to people from key populations is critical. This approach enables patients to manage physical dependence, reduce the risk of transmission of infectious diseases (e.g. HIV or hepatitis), and improve quality of life.

However, despite the proven effectiveness of OST, many people around the world (including in the Eastern Europe and Central Asia region) face barriers to accessing this treatment due to stigmatization, lack of access to health services, or legal restrictions. This creates serious obstacles for those in need of assistance.

For example, recent changes to the Ministry of Health’s January 24 Order to the opioid substitution therapy program in Georgia have made significant adjustments. Under the previous rules, patients participating in the program had the opportunity to receive a two-day dose of medication if they were unable to visit a healthcare facility, and this dose could be picked up for them by a family member or other authorized person. However, under the changes made, this right has been limited and patients or their authorized representatives must now visit the service center daily.

The changes also affected the ability to provide patients with pharmaceuticals in special cases. Previously, there was an option to receive a five-day supply of medication when long-term home treatment exceeding two months was required, or a seven-day supply for those with a pronounced disability or active tuberculosis. However, the amendments have completely abolished this exceptional regulation. Under the previous regulation, patients could also be given a dose if they had to move around the country (the principle of business travel). The innovations have abolished this regulation and now, even in cases of exceptional need such as business travel or ill health, patients can only be given a one-day dose.

Kazakhstan also has a serious problem with violations of the rights to health care and health maintenance for people who use psychoactive substances. These problems have been identified, including through the REAct, on appeals related to obstacles in accessing medical services for clients. This situation covers several aspects:

– Lack of access to free medical care, including tests and abortions, for persons without compulsory social health insurance.

– Limited access to a guaranteed amount of free medical care for people who use psychoactive substances.

– Insufficient drug supply and diagnosis of diseases among persons in detention centers.

According to the Order of the Minister of Health of the Republic of Kazakhstan from September 23, 2020, № KR DSM-108/2020, treatment of people who use psychoactive substances is carried out within the guaranteed volume of free medical care in regional Mental Health Centers (MHC). Anonymous treatment is available only on a paid basis. However free medical care does not provide the necessary range of services for social, psychological, pedagogical, labor, cultural, economic, and legal support for people from the community.

The theme of this year’s World Health Day is “My Health, My Right” and aims to support and recognize the right of everyone, wherever they are, to access high-quality health care, education and health information, and freedom from discrimination. This means that it is worth taking another opportunity to draw public attention to such violations of people’s rights to quality and timely health care and the need to develop a model that complies with human rights principles and international standards while taking into account the needs of patients, their families and the interests of organizations providing addiction treatment services. And legislate to guarantee the provision of a full range of assistance for the treatment and rehabilitation of everyone who needs it.

Health is everyone’s right, as is equal access for all people to qualified care.

Georgia’s new legislation on substitution therapy program raises public concerns

Post author By velyunsky
Post date March 1, 2024

On February 15, a press conference organized by the Georgian Harm Reduction Network was held in Tbilisi, Georgia, on the problem of access to treatment for people who use drugs. The main issue was changes in legislation regulating opioid substitution therapy (OST).

Drug policy organizations, health experts, and public associations expressed their concern about the changes made to the legislation on OST. They believe that such changes will not adequately protect the rights of patients participating in the program.

It was noted at the event that the innovation will significantly worsen the situation of people with disabilities and other patients with severe chronic diseases. According to the new rules, doses will no longer be provided in case of the need to move within the country (the principle of a business trip). Even in cases of justified and objective reasons (including travel or health problems), only a one-day dose will be available to patients.

Nongovernmental organizations call on representatives of the Ministry of Health of Georgia to open a dialogue on this issue. They propose to create an inclusive platform where public and professional organizations, as well as health experts, could discuss the problems of OST programs and jointly develop a model based on human rights principles, and international standards and taking into account the interests of patients, their families and medical institutions.

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