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Advances in Preventive Medicine
Volume 2012, Article ID 308793, 13 pages
Research Article

Evaluation of a Pilot Medication-Assisted Therapy Program in Kazakhstan: Successes, Challenges, and Opportunities for Scaleup

1ICAP, Mailman School of Public Health, Columbia University, New York, NY, USA
2Republican Applied Research Center for Medicosocial Problems of Drug Addiction, Pavlodar, Kazakhstan

Received 4 August 2012; Accepted 17 October 2012

Academic Editor: Kevin P. Mulvey

Copyright © 2012 Azizbek A. Boltaev et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. Republican AIDS Center, Report on Activities of the AIDS Service in 2011, Almaty, Kazakhstan, 2012.
  2. WHO, UNAIDS, and UNICEF, Global HIV/AIDS Response—Epidemic Update and Health Sector Progress Towards Universal Access—Progress Report, Geneva, Switzerland, 2011.
  3. WHO, Guidelines For the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence, Geneva, Switzerland, 2009.
  4. J. Marsden, D. Stewart, M. Gossop et al., “Assessing client satisfaction with treatment for substance use problems and the development of the treatment perceptions questionnaire (TPQ),” Addiction Research and Theory, vol. 8, no. 5, pp. 455–470, 2000. View at Google Scholar · View at Scopus
  5. S. Darke, W. Hall, A. Wodak, N. Heather, and J. Ward, “Development and validation of a multidimensional instrument for assessing outcome of treatment among opiate users: the Opiate Treatment Index,” British Journal of Addiction, vol. 87, no. 5, pp. 733–742, 1992. View at Google Scholar · View at Scopus
  6. M. L. Copersino, C. S. Meade, G. E. Bigelow, and R. K. Brooner, “Measurement of self-reported HIV risk behaviors in injection drug users: comparison of standard versus timeline follow-back administration procedures,” Journal of Substance Abuse Treatment, vol. 38, no. 1, pp. 60–65, 2010. View at Publisher · View at Google Scholar · View at Scopus
  7. L. C. Sobell, M. B. Sobell, G. Buchan, P. A. Cleland, I. Fedoroff, and G. I. Leo, “The reliability of the Timeline Followback method applied to drug, cigarette, and cannabis use,” in Proceedings of the 30th Annual Meeting of the Association for Advancement of Behavior Therapy, New York, NY, USA, November, 1996.
  8. L. T. Midanik, A. M. Hines, D. C. Barrett, J. P. Paul, G. M. Crosby, and R. D. Stall, “Self-reports of alcohol use, drug use and sexual behavior: expanding the timeline follow-back technique,” Journal of Studies on Alcohol, vol. 59, no. 6, pp. 681–689, 1998. View at Google Scholar · View at Scopus
  9. Z. S. Morris and M. Gannon, “Drug misuse treatment services in Scotland: predicting outcomes,” International Journal for Quality in Health Care, vol. 20, no. 4, pp. 271–276, 2008. View at Publisher · View at Google Scholar · View at Scopus
  10. A. Sharman, Acquired immunodeficiency syndrome. Monograph, part 1. 3. Injecting drug use and HIV infection, July 2012,
  11. “Harm Reduction Development 2005,” IHRD, 2012,
  12. The State Program on the Development of Health Care of the Republic of Kazakhstan for 2011–2015 “Salamatty Kazakhstan”, Endorsed by President’s Decree No. 1113 (November 2010).
  13. L. Kunekova, Physicians in Almaty Refuse to Implement Heroin-Substitution Program for Drug Addicts, KTK News Agency, Almaty, Kazakhstan, 2012,
  14. Ministry of Health, “On expansion of accessibility of opioid substitution therapy,” Order No. 333, (May 2010).
  15. Republican Applied Research Center on Medical and Social Problems of Drug Abuse, Application of Opiate Agonists Maintenance Therapy in Narcological Practice of the Republic of Kazakhstan, Methodological recommendations, Pavlodar, Kazakhstan, 2010.
  16. B. P. Smyth, J. Fagan, and K. Kernan, “Outcome of heroin-dependent adolescents presenting for opiate substitution treatment,” The Journal of Substance Abuse Treatment, vol. 42, no. 1, pp. 35–44, 2012. View at Google Scholar
  17. Law on Narcotics, Psychotropic Substances, Precursors and Counteracting Measures to Prevent Illegal Circulation and Abuse of these Substances, Law No. 279-1 adopted 10. 10. 1998 (with amendments and additions as of 07. 17. 2009). Astana, Kazakhstan.
  18. E. C. Strain, G. E. Bigelow, I. A. Liebson, and M. L. Stitzer, “Moderate- versus high-dose methadone in the treatment of opioid dependence: a randomized trial,” Journal of the American Medical Association, vol. 281, no. 11, pp. 1000–1005, 1999. View at Publisher · View at Google Scholar · View at Scopus
  19. L. Ganina, Review of the HIV Epidemiologic Situation in the Republic of Kazakhstan, Republican AIDS Center, Almaty, Kazakhstan, 2010.
  20. R. Noori, H. Narenjiha, H. Aghabakhshi, G. Habibi, and B. Khoshkrood Mansoori, “Methadone maintenance therapy outcomes in Iran,” Substance Use Misuse, vol. 47, no. 7, pp. 767–773, 2012. View at Google Scholar
  21. I. I. Michels, H. Stöver, and R. Gerlach, “Substitution treatment for opioid addicts in Germany,” Harm Reduction Journal, vol. 4, article 5, 2007. View at Publisher · View at Google Scholar · View at Scopus
  22. N. M. Noordin, M. I. Merican, H. A. Rahman, S. S. Lee, and R. Ramly, “Substitution treatment in Malaysia,” The Lancet, vol. 372, no. 9644, pp. 1149–1150, 2008. View at Publisher · View at Google Scholar · View at Scopus
  23. S. B. Sells and D. D. Simpson, Eds., The Effectiveness of Drug Abuse Treatment, Ballinger, Cambridge, Mass, USA, 1976.
  24. R. L. Hubbard, M. E. Marsden, J. V. Rachal, H. J. Harwood, E. R. Cavanaugh, and H. M. Ginzburg, Drug Abuse Treatment: A National Study of Effectiveness, University of North Carolina Press, Chapel Hill, NC, USA, 1989.
  25. J. C. Ball and A. Ross, The Effectiveness of Methadone Maintenance Treatment: Patients, Programs, Services, and Outcomes, Springer, New York, NY, USA, 1991.
  26. L. E. Sullivan, D. Barry, B. A. Moore et al., “A trial of integrated buprenorphine/naloxone and HIV clinical care,” Clinical Infectious Diseases, vol. 43, supplement 4, pp. S184–S190, 2006. View at Publisher · View at Google Scholar · View at Scopus
  27. B. Spire, G. M. Lucas, and M. P. Carrieri, “Adherence to HIV treatment among IDUs and the role of opioid substitution treatment (OST),” International Journal of Drug Policy, vol. 18, no. 4, pp. 262–270, 2007. View at Publisher · View at Google Scholar · View at Scopus
  28. A. Latypov, D. Otiashvilli, O. Aizberg, and A. Boltaev, Opioid Substitution Therapy in Central Asia: Towards Diverse and Effective Treatment, Eurasian Harm Reduction Network, Vilnius, Lithuania, 2010.
  29. T. Burki, “Russia's drug policy fuels infectious disease epidemics,” The Lancet Infectious Diseases, vol. 12, no. 4, pp. 275–276, 2012. View at Google Scholar
  30. R. Elovich and E. Drucker, “On drug treatment and social control: Russian narcology's great leap backwards,” Harm Reduction Journal, vol. 5, article 23, 2008. View at Publisher · View at Google Scholar · View at Scopus
  31. L. M. Sanders, C. Trinh, B. R. Sherman, and S. M. Banks, “Assessment of client satisfaction in a peer counseling substance abuse treatment program for pregnant and postpartum women,” Evaluation and Program Planning, vol. 21, no. 3, pp. 287–296, 1998. View at Google Scholar · View at Scopus
  32. Z. S. Morris and N. McKeganey, “Client perceptions of drug treatment services in Scotland,” Drugs, vol. 14, no. 1, pp. 49–60, 2007. View at Publisher · View at Google Scholar · View at Scopus
  33. E. Peles, S. Schreiber, A. Sason, and M. Adelson, “Earning, “take-home” privileges and long-term outcome in a methadone maintenance treatment program,” Journal of Addiction Medicine, vol. 5, no. 2, pp. 92–98, 2011. View at Publisher · View at Google Scholar
  34. H. M. Rhoades, D. Creson, R. Elk, J. Schmitz, and J. Grabowski, “Retention, HIV risk, and illicit drug use during treatment: methadone dose and visit frequency,” American Journal of Public Health, vol. 88, no. 1, pp. 34–39, 1998. View at Google Scholar · View at Scopus
  35. H. Dagmar, A. Paula, F. Michael, S. Heino, M. Lars, and M. Soraya, “The effectiveness of opioid maintenance treatment in prison settings: a systematic review,” Addiction, vol. 107, no. 3, pp. 501–517, 2012. View at Google Scholar
  36. UNODC, Drug Dependence Treatment: Interventions for Drug Users in Prison, Vienna, Austria, 2012,
  37. WHO, UNODC, and UNAIDS, Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users, 2009.
  38. WHO, Operational Principles for Good Pharmaceutical Procurement, Geneva, Switzerland, 1999.
  39. UNDP, Opioid Substitution Therapy from the Viewpoint of Specialists and Former Injecting Drug Users, Kiev, Russia, 2007.
  40. R. P. Mattick, C. Breen, J. Kimber, and M. Davoli, “Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence,” Cochrane Database of Systematic Reviews, no. 3, p. CD002209, 2009. View at Google Scholar · View at Scopus
  41. S. Minozzi, L. Amato, S. Vecchi, and M. Davoli, “Maintenance agonist treatments for opiate dependent pregnant women,” Cochrane Database of Systematic Reviews, no. 2, p. CD006318, 2008. View at Google Scholar · View at Scopus
  42. M. Connock, A. Juarez-Garcia, S. Jowett et al., “Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation,” Health Technology Assessment, vol. 11, no. 9, pp. 1–171, 2007. View at Google Scholar · View at Scopus
  43. Ministry of Health, Minutes of the Meeting on Results of Evaluation of Opioid Substitution Therapy in Kazakhstan, Astana, Kazakhstan, 2012.
  44. Ministry of Health, Roadmap for Execution of the Decision Made at the Meeting on Results of Evaluation of Opioid Substitution Therapy in Kazakhstan, Astana, Kazakhstan, 2012.