Table 7 Selected OAT markers for the ‘Service’ dimension for the second data point (latest data reported in the 2022–2023 national assessments)
Belarus | Moldova | Tajikistan | Ukraine | |
|---|---|---|---|---|
Population | 9.2 million (2022)[38] | 2.4 million (2023)[39] | > 10 million (2022) | 41.2 million** (2022)[40] |
Number of people with opioid dependence in state drug treatment system or registered by the system | 4,579 (2020) | 11,575 (all psychoactive substances) (2022) | 4,749 (December 31, 2021) | n/a |
Estimated number of people who use opioids (alternatively, estimated number of people who inject drugs) | 73,800 and 87,000 people (2020) | 12,920 (2020) | 22,208 (2018) | 270,800 (2022) |
Medicines used for OAT | Methadone, buprenorphine | Methadone, buprenorphine | Methadone (liquid) | Methadone, buprenorphine, start of the use of long-acting buprenorphine in January 2023 |
Availability and coverage | ||||
Coverage of the estimated number of people with opioid dependence or people injecting drugs | 4% | 5.5% (2022) | 3% | 9.4% [7.3% in February 2022, at the beginning of the Russian invasion] |
Number of OAT clients | 707 (end 2021) | 590 (September 2022) | 614 (December 2022) | 27,432 (December 2022) [20,331 in February 2022, at the beginning of the Russian invasion] |
Number of OAT sites (excluding penitentiary system) | 20 (end 2021)) | 11 sites in 10 cities (September 2022) | 15 sites (December 2022) | 207 sites (end of 2022) [224 sites in February 2022, at the beginning of the Russian invasion] |
Percent of administrative units with OAT | 100% | 29% (10 out of 34 administrative units), excluding non-government-controlled area | 100% | 100%, excluding the temporarily occupied territories |
The share of clients receiving OAT in state specialised drug treatment or mental health institutions | 100% | 100% | 100% | 51.5% |
Take-home dosages upon clinical prescription | Yes | Yes | No | Yes (provided to around 90% of all clients) |
Availability in primary care and hospitals, licensed private sector and NGOs | Hospitals | Hospitals | - | Hospitals, primary care, private sector (around 27% of all clients) |
Availability in penitentiary settings | Pre-trial detention only upon special approval | Pre-trial detention, 13 correctional facilities including for females | 2 penitentiary institutions | Pre-trial detention; 7 penitentiary institutions (including one for females and one for juvenile offenders) |
Quality and integration | ||||
Recommended dosages in accordance with national clinical guidelines | Minimum 60 mg for methadone and 12 mg for buprenorphine No restrictions on maximum dosage | Methadone: 60-120 mg; Buprenorphine: 16 mg | Minimum 60 mg for methadone and 12 mg for buprenorphine. No clinical restrictions on maximum dosage; the operational guidelines recommend a maximum of 200 mg of methadone and 16-24 mg of buprenorphine | Minimum 80 mg for methadone and 8 mg for buprenorphine |
Average dosage of methadone and buprenorphine based on clinical practice | Methadone: > = 60 mg Buprenorphine: > = 12 mg | Methadone: > = 50 mg by 87% clients in one site and 76% of clients in a study in 2021; Buprenorphine: 8 mg in one site and a study in 2021 | Methadone: ≥ 60 mg received by 46% (data from 6 out of 13 sites) | Methadone > = 80 mg in 86% of medical facilities; Buprenorphine: > = 8 mg/day or more in 93% of facilities |
Retention (% of clients on therapy for 6 months or longer) | 67% | 65% | 65%-100% in 2022 (data from 12 out of 13 sites) | 70–80% in 2022 |
Number of HIV or TB specialised services that provide OAT | 0 | 0 | 0 | 21 (and 139 multidisciplinary hospitals) |
Share of OAT sites with integrated care for HIV/TB/HCV | 30% | 27% Only 3 sites in civil sector (out of 11) integrated into a comprehensive framework and/or interacting with other services | 60% | All state funded sites are expected to provide linkages to other services; 53% of OAT clients reported the availability of additional services at OAT sites |