Opioid Substitution Therapy

Opioid substitution therapy (OST) is a highly effective harm reduction measure and proven treatment for dependency on heroin and other opioid drugs. Despite the strong supporting scientific evidence, availability of OST remains very limited across most countries in the region, while Russia, Turkmenistan and Uzbekistan prohibit OST.

3.7 million people who use drugs live in EECA and less than 1% receive OST. OST programs in CEECA started in 1989 and exist today in 25 out of 28 CEECA countries, the exceptions being Russia, Turkmenistan and Uzbekistan who prohibit OST. However, where programs exist, they are mostly small scale and many operate as pilots.

The lack of political commitment from governments and their subsequent failure to invest domestic funds are key barriers to the scale up of OST programs in the region. In many EECA countries, OST programs are either fully funded or at least co-financed by international donors, most significantly by the Global Fund. Only a small number of countries have taken national ownership of OST service provision.

There is also a problem with the quality and accessibility of OST services in EECA. They are extremely restrictive and inflexible and, in some cases, in conflict with human rights principles. Some people have to travel several hundred kilometers to access services. Access to OST in prison remains minimal, and thousands of people are left without any access to treatment in violation of their right to health.

EHRN encourages partners to address these problems at a number of levels:

  • By supporting advocacy with national governments in order to build political commitment for the domestic funding and scaling up of OST programs.
  • By working with networks of people who use drugs to mobilize support for OST programs and to advocate for the necessary legal environment to safely and effectively provide OST services.
  • By undertaking strategic litigation in support of people who use drugs who have been denied access to OST and thus their right to health.
  • By supporting drug user advocates and people benefiting from OST to contribute to relevant decision-making bodies at the national, regional and international level.

< 1%

of those in need receive OST in EECA

OST programs in CEECA countries: number of patients (2009-2011)

Kosovo value is for 2013. OST not available for Russia, Turkmenistan and Uzbekistan.

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