Keywords
drug addiction
naloxone
naltrexone
opiate antagonists
pharmacodynamics
How to Cite
Abstract
In press
Background. Opioid dependence in Ukraine is associated with high mortality, the spread of Human Immunodeficiency Virus (HIV) and hepatitis C, and a heavy burden on the health care system. Opioid Substitution Therapy (OST) is an effective evidence-based treatment, but its coverage remains low, and the full-scale war has created new barriers to access.
Aim. To conduct a comprehensive analysis of the epidemiological situation regarding opioid dependence in Ukraine, current trends in the prevalence of injecting opioid use, the socio-demographic characteristics of persons with dependence and the associated public health risks, and to assess the pharmacodynamic features and practical use of opioid antagonists as a complement to opioid substitution therapy.
Materials and Methods. Reports on the drug situation in Ukraine, integrated biobehavioral survey results and publications on opioid antagonists were analyzed. Statistical methods of time-series analysis and of growth and decline rates were applied. The study was carried out within the research topic "Scientific substantiation of strategies for preserving and restoring public health through influence on the determinants of the effectiveness of the health care system" (2024–2027), state registration No.0123U104849.
Research Ethics. The study complied with the World Medical Association Declaration of Helsinki (1964–2024), used depersonalized aggregated data without patient participation and was approved by the Bioethics Commission of Dnipro State Medical University (Protocol No.33 of January 15, 2026).
Results. Persons with opioid use disorders made up 74.5% of those treated for drug use disorders in 2023. Among people who inject drugs, HIV prevalence was 20.3% and hepatitis C prevalence was 68.4%. OST coverage was about 6% of opioid users in May 2022 and about 10% at the end of 2023; 92.5% of patients received take-home medication. Most of those treated were aged 36 years and older and lived in cities. The war interrupted OST and deepened regional disparities. Naloxone rapidly reverses overdose but acts briefly, whereas naltrexone provides prolonged receptor blockade and is used after detoxification to prevent relapse.
Conclusions. OST coverage in Ukraine remains insufficient despite growth during the war. Integrated, flexible models of care combining OST, opioid antagonists and psychosocial support are needed.
Keywords: epidemiology, drug addiction, naloxone, naltrexone, opiate antagonists, pharmacodynamics.
References
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