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A
t this year’s conference, opioid
substitution therapy in the form of
methadone and buprenorphine will
be available for delegates who are
unable to export medication from their own
country (see facing page), prescribed by Dr
Emilis Subata.
Dr Subata has led the Vilnius Centre for
Addictive Disorders for more than 20 years.
A psychiatrist by training, he has been an
expert consultant for the World Health
Organization (WHO), the United Nations
Office on Drugs and Crime (UNODC) and
United Nations Development Programme
(UNDP) among others, and is also an asso-
ciate professor at Vilnius University, itself a
WHO collaborating centre for harm reduction.
While Eastern Europe has struggled with a
well-documented HIV problem, it was at his
treatment centre that the very first metha-
done programme in a former Soviet country
was established, in October 1995, something
which may help to explain why Lithuania’s
HIV rates are among the lowest in the region.
‘One of the reasons for that is that we
implemented opioid substitution therapy in
the three biggest cities in Lithuania before
HIV had really appeared among injecting
drug users,’ he says. ‘It wasn’t a reaction to
HIV cases among IDUs – it was prior to the
first cases among IDUs. In those three
cities, quite a large number of IDUs with
long histories of injecting were able to
access treatment programmes, and needle
exchange programmes were introduced
quite early as well – starting around 1996 in
the sea port of Klaip
ė
da and then in Vilnius
in 1997. So we started harm reduction
programmes much earlier than in Latvia or
Estonia, for instance.’
Rates of HIV transmission through injecting
drug use have fallen substantially in recent
years, but it remains the case that HIV
testing is not always easily accessible. ‘It’s
done mostly by NGOs with external
funding, so we might not have the most
exact data,’ he acknowledges.
Most of Lithuania’s major population
centres now have needle exchange
programmes, however, and the ten largest
cities have opioid substitution therapy,
accessible free of charge. ‘In most of the
cities there are no waiting lists, although we
do have some in Vilnius,’ says Dr Subata.
His clinic also operates a mobile needle
and syringe exchange service, which
means that the service is accessible to
drug users throughout the city. ‘We used to
4 –
Daily Update
– Monday 10 June 2013
Inthevanguard
The Vilnius Centre for
Addictive Disorders
was home to the
first methadone
programme in a
former Soviet country.
The Daily Update
hears from its director,
Dr Emilis Subata
‘We hope that the
conference will
attract the
attention of
the media
and promote
discussions
among
Lithuanian
professionals,
specialists,
politicians and the
general public.’
DR EMILIS SUBATA