title: In control?: Ukrainian opiate substitution treatment patients strive for a voice in their treatment.
abstract: This article explores the burgeoning advocacy movement for methadone and buprenorphine treatment by patients, parents, and doctors in Ukraine, and their efforts to remake a system that infantilizes and controls patients into one where patients have a voice in their treatment. Through a review of gray literature and in-depth interviews with 28 patient-advocates and doctors in five Ukrainian cities between October 2009 and July 2010, this piece chronicles the emergence of opiate substitution treatment in Ukraine, describes successes toward patient-friendly treatment, and explores the institutionalized barriers that have pushed the patients to become advocates for their own treatment.
authors.affiliation: International Harm Reduction Development Program, Open Society Foundations, New York, New York 10019, USA. mgolovanevskaya@sorosny.org
authors.forename: Maria
authors.initials: M
authors.lastname: Golovanevskaya
authors.forename: Leonid
authors.initials: L
authors.lastname: Vlasenko
authors.forename: Roxanne
authors.initials: R
authors.lastname: Saucier
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002047:Buprenorphine / Q000627:therapeutic use; D055030:Drug Users; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000639:trends*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D010344:Patient Advocacy; D010358:Patient Participation; D016495:Police; D020377:Self Efficacy; D014455:Ukraine / Q000453:epidemiology; D014505:Urban Population
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D008691:Methadone