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Kazakhstan to keep methadone therapy for now

Photo courtesy of people.onliner.by Photo courtesy of people.onliner.by

Kazakhstan isn’t going to give up opioid substitution therapy (OST), better known as methadone therapy. This was the government's response to the inquiry of Kazakh MP Meruert Kazbekova who called to ban methadone from Kazakhstan, Tengrinews reports.

In September this year, MP Meruert Kazbekova, member of Ak Zhol political party demanded a ban on methadone when addressing the Prime-Minister of Kazakhstan Karim Massimov. She called the drug a “threat to the national security” of Kazakhstan.

She said that the pilot project showed negative results in 2011 and an independent commission’s report to the Kazakh Ministry of Health concluded that methadone was both ineffective and dangerous for treating drug addicts.

“For unclear reasons the test results have been concealed. Now methadone lobbyists are attempting to put it on the list of essential drugs in order to get funding from the state budget within the guaranteed volume of free medical care, that is, at the expense of the taxpayers," she said.

She claimed that the use of methadone was only transitioning the drug user to a harder drug with more disastrous consequences. The deputy reminded that the government was supposed to persecute production, manufacture, distribution, sale, transit, import and export of narcotic substances.

The answer from the government has now arrived.

"In the framework of the state healthcare program "Salamatty Kazakhstan" for 2011-2015 opioid substitution therapy program has been expanded in pilot mode to cover 10 cities of Kazakhstan. Further implementation of the substitution therapy programs will be considered after the completion of the pilot project and assessment of its results," the official answer signed by Prime-Minister Karim Massimov said.

Citing the World Health Organization, the Kazakh government said that the method had a benefit of cutting expenses related to opioid dependence both for the individuals and their families and for the public through reducing consumption of heroin, the number of related deaths, the number of incidences associated with HIV infection risk and the number of instances of criminal behavior.

"Methadone has a highly predictable effectiveness. The duration of its effect is about 24-36 hours, whereas the duration of the effect of almost all the other drugs is not more than 3-6 hours," the response said.

The response also stated that Kazakhstan continued to keep the spread of HIV infection at a concentrated stage, including thanks to introduction of the OST.

The following statistics was listed in the reply: as of 1 September 2014, 200 patients received OST. Of the 46 HIV-infected patients 14 were receiving antiretroviral therapy. In total there were 13 couples, 122 people were employed. Beginning 2008, 658 individuals were registered to receive the OST. Of them, 106 had completed the therapy (after a planned reduction of the dose) and achieved remission, 61 had started a family and 2 had given birth to children.

The government's response assured that "the drug is on strict record and storage control, just as are the other drugs used in the medicine."

Methadone therapy was launched in Kazakhstan as a pilot project in 2008 in Pavlodar and Temirtau cities. The experiment was aimed at testing the opioid replacement therapy as a tool helping to stop the spread of HIV and AIDS in the Central Asian country. The therapy has generated controversy in various countries including Kazakhstan.

Those supporting the therapy insist that the program should be implemented on a wider scale. Altynay Yeskaliyeva, head of the National Scientific and Practical Center on Medical and Social Problems of Drug Abuse, declared on August 20 that the therapy showed good results and that Columbia University experts found positive results of the program being implemented in Kazakhstan.

“Thus, we are planning to make the program nationwide in 2016. The efficiency of opioid substitution program for a select number of individuals has already become evident and there is a need for it on a wider scale,” she said.

By Dinara Urazova

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