In Ukraine, Police Can No Longer Stand Between Drug Users and Their Medication

Imagine you’ve been arrested and you have a serious medical condition. Imagine the police take away your medications, and leave you without them for days.

In Ukraine, this happens. Police can harass people who rely on methadone and buprenorphine to treat their drug addictions – arresting them, holding them for lengthy periods before trial, and denying them access to their opiate substitution therapy (OST) medications. The resulting withdrawal pains have been used to extract information and confessions, leading some human rights experts to describe denial of methadone or buprenorphine as “a form of torture.”

But now – in a huge victory for drug policy – five Ukrainian government agencies have recently adopted an inter-ministerial order that ensures access to OST by patients at police detention centers and pre-trial detention settings. The Ministry of health, Ministry of Internal Affairs, State Service on Drug Control, State Penitentiary Service, and Ministry of Justice have recognized with the force of law the rights of people who use drugs to receive their medications.

This victory is the result of three years of intense advocacy and outreach by Open Society Foundations and the International Renaissance Foundation of Ukraine. The support and partnership of multiple international and national stakeholders was indispensable. We offered testimony from patients, briefings to key government officials, and we created a special working group tasked with writing model drafts of the new order.

But this change was hard won. The lack of political will among decision-makers, frequent dismissals and appointments at relevant Ministries due to the highly unstable political situation in Ukraine, and the unfavorable attitude towards OST from many state authorities made this change anything but certain. We further recognize that there is a great deal more work to do: passage of a regulation at the national level does not ensure that it will be implemented properly locally.

Further focus is also needed to ensure that OST can be available to those who are sentenced and held in prisons. Together, and with the support and partnership of multiple international and national stakeholders (UNAIDS, UNODC, WHO, William Clinton Foundation, International HIV/AIDS Alliance, Ukrainian PLHA Network, ASTAU, the OST Patients’ Parents Network), and in cooperation with relevant Ukrainian ministries, we will continue to work so that all Ukrainians—including those vulnerable groups in police custody, pretrial detention and prisons—enjoy protection against abuses and their inalienable human right to health.

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This is an impressive victory, and a compelling example of how advocacy for policy change requires a multi-year investment and multiple strategies. In our work in Ukraine and elsewhere in the EECA region, we often struggle with the fact that policy gains can be reversed easily when government ministries change hands. In this case, political instability did not deter you and other civil society groups from working toward a more lasting change. As you say, implementation on the ground will be the next challenge, but this order is a critical step forward at a critical time in the region. Congratulations!

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