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Heroin Addiction and Related Clinical Problems: 2024, 26, 60

Opioid agonist maintenance treatment in kyrgyzstan: Assessing patients’ changing medical and psychosocial needs over the course of treatment

Zhyldyz Bakirova, Ulla Pape, and Ingo Ilja Michels

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2024-60

Summary: Background The opioid agonist maintenance treatment (OAMT) programme in Kyrgyzstan has two objectives: to provide drug treatment and to prevent HIV infections among people who inject drugs (PWID). This study examines patients’ changing medical and psychosocial needs and provides recommendations for stakeholders on how best to organise collaboration to meet patients’ needs. Methods The study builds upon a retrospective analysis of 3,813 anonymised medical records (2002-2022) and 31 in-depth interviews with three groups of respondents (patients, medical staff, and NGO service providers). Interviews were conducted between December 2022 and April 2023, and focused on patients’ personal and medical history, motivation for OAMT enrolment and patients’ needs. Results Patients’ needs change during treatment. In the first phase, the focus is on treating withdrawal symptoms and adjusting the treatment dose. The second phase concentrates on stabilising patients’ health and treating comorbidities. This lays the foundations for the third phase, in which the complex tasks of adaptation and social reintegration begin. The programme fully covers patients’ medical needs but not all psychosocial needs. It represents a suitable platform for cooperation between different service providers. Conclusions An important aspect of the OAMT programme is the stabilisation of patients and the regular contact with them. This enables patients to access medical services, including antiretroviral treatment. Referral to “friendly doctors” facilitates the treatment of medical problems that have been neglected due to long-term drug dependency. Patients emphasised the non-stigmatising manner of service provision. They valued that different services are offered under one roof as a “one-stop shop”, allowing the OAMT programme to combine drug therapy, treatment of comorbidities, and general medical care for PWID. In its comprehensive treatment approach, the Kyrgyz OAMT programme can be considered a best practice model for the Central Asia region.

Keywords: Kyrgyzstan; opioid agonist maintenance treatment (OAMT); HIV/AIDS; people who inject drugs (PWID); needs