Tashkent (Uzbekistan), 24 December 2020 — The COVID-19 pandemic and the ensuing restrictions have affected the lives of every single person around the world. However, very few realize the challenges faced by people with drug use disorders —who are among the most vulnerable and in need of ongoing care— during a global health crisis.
On the one hand, border closures during lockdowns have led to a dramatic reduction in the availability of narcotic drugs used for the treatment of substance use disorders. On the other, loss of income has become a problem for many people, but particularly for those with various forms of dependence or diseases that require ongoing treatment. Exposure to COVID-19 can also lead to additional health complications, due to their weak immune systems.
Psychotherapy practitioners at drug treatment facilities worldwide have had to adapt to the new constraints posed by COVID-19, in order to help ensure continued access to psychological and therapeutic care for patients with drug dependence. Doctor Tatyana Sobornitskaya, a psychotherapist at the Tashkent City Narcological Dispensary in Uzbekistan, shares her story.
"Since the COVID-19 pandemic outbreak, we live like on the verge of a catastrophe", admits Dr. Sobornitskaya. "Patient admissions for drug and psychotropic substance dependence sharply decreased with the introduction of a lockdown. At the same time, an increase in the number of patients admitted with alcohol dependence was observed. Later we discovered that some people with drug and psychotropic substance dependence have switched to alcohol, due to drug shortages.”
She explained that the challenges associated with the new working regime included the need to wear protective equipment (PPE) during the day and while working with patients; identifying whether patients with drug dependence admitted via emergency services had been in contact with anyone infected with COVID-19; and the need to look for symptoms of coronavirus infection in addition to the diagnosis of a narcological pathology.
In July, COVID-19 infections were detected within the facility among both patients and staff members, including Tatyana herself. "It was very hard. I stayed in my apartment for two weeks,” says Tatyana.
"In addition to psychotherapy, I also had to deal with the treatment of patients admitted to the facility, while remaining in close consultation with epidemiologists. On top of that, different kinds of information coming from the outside made patients feel scared and anxious. This led to a greater need for counseling, in addition to treatment. Thanks to the support of the Chief Clinician and the coordinated work of the staff, the necessary medication-assisted therapies were identified, which helped patients better cope with their disease.”
From July to September 2020, a total of 306 patients –including 89 with drug dependence– were admitted for in-patient treatment.
"Nevertheless, on the bright side, during these two weeks [of lockdown], patients were very receptive to information about their drug dependence; they opened up easily as they came in contact with us under such unusual circumstances," mentions Dr. Sobornitskaya.
Another positive aspect was the convenience of online communication with persons with dependence. "Online communication turned out to be convenient and simple," says Tatyana. "I run a Telegram channel for patients, and they get in touch when needed."
The UNODC Regional Office for Central Asia –under its sub-programme "Drug Prevention, Treatment and Reintegration and HIV Prevention" and UNODC Global Project GLOJ71 "Treating drug dependence and its health consequences: TREATNET II"– delivers capacity-building activities in the field of drug dependence treatment and care. The Organization aims to enhance the Member States’ capacities for drug use disorder treatment, reintegration and care.
The overall goal of the training activities is to reduce the medical, social, and economic problems associated with substance use disorders, by developing the international treatment capacity through training, enhancing skills, and expanding the global treatment workforce.
The training prepares addiction specialists for professional certification, by providing the latest information about substance use disorders and treatment. It also facilitates hands-on activities to develop their skills and confidence.