Methadone substitution program
| Ainura Esenamanova Coordinator of the methadone substitution therapy program in Kyrgyzstan. |
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My name is Ainura Esenamanova and I am coordinator of the methadone substitution therapy program in Kyrgyzstan.
A lot of people in Kyrgyzstan are now taking heroin. This happens because Kyrgyzstan is a transit country for the transfer of heroin from Afghanistan to Europe. Unfortunately, at present, heroin in Kyrgyzstan is easily accessible and is not expensive.
Methadone is not injected with a needle. It is taken orally in a liquid solution. It is manufactured under pharmaceutical conditions and drug users take it once a day, every day.
Today, methadone is known to be the most simple, effective and accessible drug in terms of price because it is very simple to use and its effects last from 24 to 36 hours. So the drug user takes it once a day. Unlike heroin, this dose is enough to stabilize the patient. Methadone is the cheapest drug for use in substitution therapy for heroin addicts.
The five-year experience of the methadone substitution therapy program in Kyrgyzstan has demonstrated an increase in the coverage of treatment for injecting drug users, through various services in the health care system. In the past, drugs users were inaccessible because they had no confidence in medical staff and they were afraid to be registered and regulated by law enforcement agencies. But nowadays, for the first time, they are starting to come forward to seek help.
As a result, and taking into account the fact that many drug users tend to suffer from serious illnesses, they can have consultations in our offices or receive social support and legal assistance.
Quite often the Injecting Drug Users have diseases which require medical treatment, so we are working closely with other health services to which we can refer our patients for qualified assistance.
Some of the Drug Users are also HIV positive. In order for them to start taking anti-retroviral therapy (ARVs), they have to go on a course where they prove their commitment to the program and show acceptance of the long-term therapy, for the rest of their life. Like methadone, ARVs are taken every day.
Like methadone, the ARV pills are given to the patient every morning by the program nurse. So a person comes, swallows the pills, and then takes the methadone.
In this case, of course, we control the situation; we don’t give the tablets to the patients in advance, in order to avoid their resale.
If the patient has to take additional medication in the evening, we are working with the patient’s family, to ensure the drugs are taken at home under the family’s supervision. If a person lives alone, we contact social workers and volunteers.
By the end of 2007, 444 people were involved in the methadone substitution therapy program. 54 of them were HIV-positive.
I would like to point out that in the past two years, we have seen a significant progress in the implementation of the program. |
