Description of the addiction service of the Republic of Uzbekistan

1. Description of the addiction service of the Republic of Uzbekistan Jur’at Umargaliev Ministry of Health

2. Socio-demographic structure of the Republic of Uzbekistan • Territory of the Republic 447 thousand square km. • Population 25.4 million. • 2/3 of the population- youth (< 30 years old) • Children and adolescents (<19 years old) – over 45 %

3. Since the 1980s the number of patients with addiction gradually increased 2433

4. Rates of addiction (Morbidity) (per 100 thousand population)

5. Majority of the patients were registered in connection with criminal activities 1805 or 63.1% of them were taken under the police control in 2003 . 1001 or 35% were identified by addiction organizations. 35 of them were determined as a result of preventive inspections.

6. Number of patients with addiction dropped from “D” control in 2003 • Total2730 • Imprisoned 39.5 % • Change in residency 24.3 % • Remission over 5 years 10.0 % • Death 10.2 % • Lost connection 13.6 % • Change diagnosis2.4 %

7. By the national total, the number of women with addiction did not change –1123 in 2002. At the same time, in some regions the number increased: Tashkent – 358 (351) Samarkand – 231 (205) Sukhandaria – 86 (93)

8. The number of narcotic substance users in rural areas continues to increase The number of patients with addiction increased from 7754 to 8069 in 2002 42%

9. Main age group of drug users- 18 - 40 years old. 79% of the total number of patients are in this age group

10. Main narcotic substance- Heroin 59. 4 % - Heroin consumption 728 – women Injection-67 %

11. Number of users by substance

12. The number of patients in by region

13. Government activities • In 2002, the MOH with WHO, USAID, UN organized a “Round Table” discussion • In 2002, the State commission approved program on “activities against illegal trafficking and overusing of narcotic and psychotropic substances 2002-2005” • Uzbek-Switzerland project “HR” • Project «Decreasing demand of the narcotic substances in Uzbekistan and Tadjikistan» implemented in 2003-2007 • Project F-75 «Development of the network on prevention HIV. treatment and rehabilitation of injection and other types of drug users in Kazakhstan, Kyrgizstan,Tadjikistan,Turkmenistan and Uzbekistan.» • Project «NADIN» ЕС • Information of the registered patients with addiciton.

14. Program on substitute treatment in Uzbekistan Considering the situation MOH approached State commission for narcotic control to organize a pilot project on substitute treatment (e.g. methadone) (PoST)

15. Strategic goal of PoST • Achieve reduction of use of illegal narcotics • Stabilization of the situation among the injection drug users involved in PoST • Their reintegration to society

16. Objectives of the PoST • Decrease risk of infection of HIV, hepatitis and other diseases transmitted by blood • Decrease the recurrence • Assist to reduce illegal narcotic use and decrease criminal activeness • Minimize risk of overdose • Provide possibility to receive medical-social and treatment-rehabilitation help

17. Legislative environment • Law of the Republic of Uzbekistan on «Narcotic and psychotropic substances» • Order of the State commission of the Republic of Uzbekistan of narcotics control • Order on implementation of the PoST by the Minister of Healthcare in agreement with the Ministry of Home Affairs and Supreme Court of the Republic of Uzbekistan.

18. Thank you