Consultants and experts from ENPUD work in various countries across Eastern Europe and Central Asia, collecting daily information on access to treatment and the protection of the rights of people who use drugs and people receiving opioid agonist maintenance therapy (OAMT).
In response to requests from the community of people who use drugs and OAMT patients from Ukraine, ENPUD launched activities aimed at ensuring continuity of care, upholding human rights, and finding solutions that balance state security concerns with the needs of people requiring medical assistance.
In partnership with regional consultants of the All-Ukrainian Association of People with Drug Dependence (VOLNA), ENPUD continues to document cases of rights violations affecting OAMT patients in Ukraine. Appeals from people in different regions are forming an evidence base necessary for further advocacy work and protection of the right to uninterrupted OAMT.
Preliminary analysis of the collected cases highlights several main categories of violations.
Problems with military registration after changing place of residence
There have been recorded cases when OAMT patients who moved to another region or obtained internally displaced person (IDP) status registered for military service at their new place of residence and completed required procedures. However, some local military recruitment centers did not take this information into account, which led to people being mistakenly listed as wanted and receiving administrative fines. Such situations create a risk of detention and subsequent interruption of treatment.
Ignoring medical diagnoses during military-medical commissions
In several cases patients report that diagnoses related to disorders caused by psychoactive substance use (F11–F19) are not reflected in the conclusions of military-medical commissions or do not influence the final decision on fitness for service.
Change in the practice of applying Article 15 of the Schedule of Diseases
According to information from regional consultants and patients, in 2022–2023 a significant portion of OAMT patients who underwent military-medical commission examinations received findings under clause 15-a, which provides for recognition as unfit for military service. However, since late 2023 there has been an increasing number of cases where clause 15-b has been applied, which provides for recognition as fit for service in certain units and support structures.
Risks of treatment interruption after mobilization
The most serious problems arise after mobilized individuals are sent to training centers. It is at this stage that reports most often appear about difficulties accessing OAMT medications and ART, interruptions in continuity of treatment, and deterioration of patients’ health.
Data collection and analysis are ongoing. The information obtained will be used to prepare analytical materials, develop proposals to ensure continuity of treatment, and improve mechanisms for protecting the rights of OAMT patients under martial law.
ENPUD thanks our colleagues and consultants for their important work and continues to share experience and practices for protecting the community’s rights across the region.
