Article title Experience of Using Substitution Maintenance Therapy in Penitentiary Facilities

Professor of Psychiatry, University of California San Diego, Department of Psychiatry Director, Center for Criminality & Addiction Research, Training & Application Director, International Addiction Technology Transfer Center - Ukraine and Central Asia Co-Director, International Addiction Technology Transfer Center - South East Asia (San Diego, California (USA)


PhD, Associate Professor (Kyiv, Ukraine)

Name of magazine Legal journal «Law of Ukraine» (Ukrainian version)
Issue 7/2019
Сторінки [140-151]

The author notes that drug abuse is one of the major problems faced by the penitentiary system; it threatens national security and is a dominant factor in the relations of convicts and staff, it leads to violence, bullying and arbitrariness against convicts, and often against members of their families and friends on the outside. Drug abuse and bloodtransmitted viral infections (including HIV/AIDS and viral hepatitis) are serious problems in penitentiary facilities and the criminal justice system on the whole.

The purpose of the article is to analyze the international experience of using substitution maintenance therapy medications in convicts and prisoners.

The article emphasizes the need for using the best European and world experience of combating drug crime and drug addiction. One of these priorities may be substitution maintenance therapy for drug addicts in penitentiary facilities of Ukraine, drawing upon positive international experience. Besides, over the past 20 years, harm reduction measures have been successfully implemented in correctional facilities and in society throughout Europe as an add-on strategy of existing drug-free treatment programs. The author notes that the joint position paper of the World Health Organization, United Nations (UN) Office on Drugs and Crime and the joint United Nations HIV/AIDS program “Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention” emphasizes that substitution maintenance therapy of opioid dependence is an efficient strategy for the prevention of HIV/AIDS and criminal behavior of convicts and thus should be implemented as soon as possible in communities with high HIV-infection risk.

The author comes to the conclusion that the main advantage of the substitution maintenance therapy program in penitentiary facilities is primarily that it offers opioid drug users a chance to abandon illegal opiates, thereby significantly reducing the probability of being infected with socially dangerous diseases (HIV, hepatitis “B”, “C”, etc.), to reduce the rate of criminal activity and behavior, and to get the chance for resocialization, and thus to improve considerably the quality and standard of living.


Keywords substitution maintenance therapy; methadone; buprenorphine; HIV/AIDS; drug situation; imprisonment; detention; enforcement of sentence; penal and correctional facility; convicts; inmates; staff of penal and correctional facilities


Authored books

1. Shirley-Beavan S, The State of Harm Reduction in Western Europe 2018 (Harm Reduction International 2019) (in English).

2. Dvoriak S ta inshi, Intehrovane likuvannia khvorykh na opioidnu zalezhnist v umovakh tsentriv pervynnoi medyko-sanitarnoi dopomohy: navchalno-metodychnyi posibnyk [Integrated Treatment of Opioid Dependence Patients in Primary Health Care Facilities: Study and Methodology Guide] (Drukarskyi dvir Oleha Fedorova 2016) (in Ukrainian).

3. Dvoriak S ta inshi, Likuvannia opioidnoi zalezhnosti ahonistamy opioidiv: navchalnometodychnyi posibnyk [Treatment of Opioid Dependence by Opioid Agonists: Study and Methodology Guide] (K.I.S. 2012) (in Ukrainian).


Edited books

4. Natsionalnyi zvit za 2017 rik shchodo narkotychnoi sytuatsii v Ukraini (za danymy 2016 roku) Pohlyblenyi ohliad narkosytuatsii v Ukraini dlia Yevropeiskoho monitorynhovoho tsentru z narkotykiv ta narkotychnoi zalezhnosti [2017 National Report (2016 data) to the European Monitoring Center for Drugs and Drug Addiction. In-Depth Information on Drug Situation in Ukraine] (Derzhavna ustanova “Ukrainskyi monitorynhovyi ta medychnyi tsentr z narkotykiv ta alkoholiu Ministerstva okhorony zdorov’ia Ukrainy” 2017) (in Ukrainian).

5. Zamisna terapiia. Analitychnyi ohliad [Substitution Therapy. An Analytical Overview] (MBF “Mizhnarodnyi Alians z VIL/SNID v Ukraini” 2005) (in Ukrainian). 6. Zdorove v ispravitelnyih uchrezhdeniyah [Health in Correctional Facilities] (Vsemirnaya organizatsiya zdravoohraneniya 2015 (in Russian).


Journal articles

7. Grinstead О and others, ‘Reducing post-release HIV risk among male prison inmates: a peer-led intervention’ (1999) 26 Criminal Justice and Behavior 453-65 (in English).



8. ‘Problema narkomanyy v tiurmakh y merы po snyzhenyiu vreda: doklad o polozhenyy del’ [‘Drug Abuse Problem in Prisons and Harm Reduction Measures: Status Report’] (Vsemyrnaia orhanyzatsyia zdravookhranenyia, 2005) < data/assets/pdf_file/0007/78550/E85877R.pdf> (accessed: 24.05.2019) (in Ukrainian).

9. ‘V Ukraini rozshyriat prohramu zamisnoi pidtrymuvalnoi terapii (ZPT) dlia narkozalezhnykh liudei’ [‘Ukraine To Expand the Substitution Maintenance Therapy (SMT) Program for Drug Addicts’] (Ukrinform, 18.08.2018) <https://www.ukrinform. ua/rubric-society/2520290-v-ukraini-rozsirat-programu-zamisnoi-terapii-dlanarkozaleznihmoz.html> (accessed: 02.06.2019) (in Ukrainian).

10. Loon, ‘Zamisna pidtrymuvalna terapiia: shliakhy vprovadzhennia v ustanovakh vykonannia pokaran’ [‘Substitution Maintenance Therapy: Towards Implementation in Penal and Correctional Facilities’] (, 06.04.2018) < zamisna-pidtrymuvalna-terapiia-shliakh.html> (accessed: 02.06.2019) (in Ukrainian).

11. Ringis A, ‘Metadozy: pljusy i minusy zamestitel’noj terapii dlja narkomanov’ [‘Methadoses: Pros and Cons of Substitution Therapy for Drug Addicts’] (Fokus, 14.12.2009) <> (accessed: 02.06.2019) (in Russian).