Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jul:117:104062.
doi: 10.1016/j.drugpo.2023.104062. Epub 2023 May 20.

Treatment of opioid use disorder in Ukraine during the first year of the Russia-Ukraine war: Lessons learned from the crisis

Olga Morozova  1 , Iryna Ivanchuk  2 , Olga Gvozdetska  2 , Olena Nesterova  2 , Pavlo Skala  3 , Ihor Kuzin  4 , Kostyantyn Dumchev  5
Affiliations
Review

Treatment of opioid use disorder in Ukraine during the first year of the Russia-Ukraine war: Lessons learned from the crisis

Olga Morozova et al. Int J Drug Policy. 2023 Jul.

Abstract

The Russian invasion of Ukraine in February 2022 caused major disruptions of societal functions, including health care. Patients receiving medications for opioid use disorder (MOUD) depend on receiving daily treatment and face a risk of withdrawal in case of medication supply disruption. MOUD are banned in Russia, making treatment continuation impossible in temporarily occupied areas. In this paper, we review the situation with MOUD delivery in Ukraine during the first year of the Russia-Ukraine war. Legislative changes and mobilization of efforts in the time of crisis ensured treatment continuation for thousands of patients. In areas controlled by Ukraine, most patients were receiving take-home doses for up to 30 days, some experienced temporary dosing reductions. Programs in temporarily occupied regions were shut down likely leading to abrupt withdrawal among many patients. At least 10% of patients have been internally displaced. One year into the war, the number of MOUD patients in governmental clinics of Ukraine increased by 17%, and the data suggest that the coverage of private clinics has also increased. But the risks for program stability remain high as the current medication supply relies on one manufacturing facility. Using lessons learned from the crisis, we provide recommendations for future response to minimize the risks of major adverse outcomes among patients treated for opioid use disorder.

Keywords: Displacement; Medications for opioid use disorder; Methadone; Opioid use disorder; Ukraine; War.

PubMed Disclaimer

Conflict of interest statement

Declarations of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1:
Figure 1:
Number of MOUD patients in governmental clinics of Ukraine: January 2022 – January 2023.
Figure 2:
Figure 2:. Regional distribution of internally displaced MOUD patients as of September 1, 2022.
Plot A shows the number of MOUD patients who migrated out of each region. Plot B shows regional distribution of MOUD enrollment among internally displaced patients in governmental clinics (i.e. the number of displaced MOUD patients who re-enrolled in treatment in each of the regions). In both plots, the red line shows the part of Ukraine that was occupied by Russian forces as of September 2, 2022. Outline of the occupied territory is approximate (source: Soar Earth https://soar.earth/maps/13152).
Figure 3:
Figure 3:. Methadone doses in Ukraine: January 2022 – January 2023.
Proportion of inducted and stable MOUD patients in governmental clinics receiving methadone dose within a given range.
See this image and copyright information in PMC

References

    1. Altice FL, Bromberg DJ, Dvoriak S, Meteliuk A, Pykalo I, Islam Z, Azbel L, & Madden LM (2022). Extending a lifeline to people with HIV and opioid use disorder during the war in Ukraine. Lancet Public Health, 7(5), e482–e484. 10.1016/S2468-2667(22)00083-4 - DOI - PMC - PubMed
    1. Altice FL, Bromberg DJ, Klepikov A, Barzilay EJ, Islam Z, Dvoriak S, Farnum SO, & Madden LM (2022). Collaborative learning and response to opioid misuse and HIV prevention in Ukraine during war. Lancet Psychiatry, 9(11), 852–854. 10.1016/S2215-0366(22)00318-2 - DOI - PMC - PubMed
    1. Berleva H, & Sazonova Y (2017). Analytical report “Estimation of the size of populations most-at-risk for HIV infection in Ukraine”. ICF “Alliance for Public Health”. Retrieved Feb 27, 2023 from http://aph.org.ua/wp-content/uploads/2016/12/o4sn16.pdf
    1. Bromberg DJ, Madden LM, Meteliuk A, Ivasiy R, de Leon SJG, Klyucharyov K, & Altice FL (2022). Medications for opioid use disorder during war in Ukraine: Innovations in public and private clinic cooperation. Lancet Reg Health Eur, 20, 100490. 10.1016/j.lanepe.2022.100490 - DOI - PMC - PubMed
    1. Bromberg DJ, Madden LM, Meteliuk A, Ivasiy R, Galvez de Leon SJ, Klyucharyov K, & Altice FL (2023). “Medications for opioid use disorder during the war in Ukraine: a more comprehensive view on the government response-Authors’ reply”. Lancet Reg Health Eur, 26, 100583. 10.1016/j.lanepe.2023.100583 - DOI - PMC - PubMed

Publication types

LinkOut - more resources