Improving access to opioid analgesics: Ukraine

1. Improving access to opioid analgesics: Ukraine March 5-6, 2013 Vienna

2. Narcotic medical substances registeredfor pain relief in Ukraine

3. Narcotic medical substances registeredfor pain relief in Ukraine

4. Registration of medical substances

6. CONTROL SYSTEM State service on drug control (SSDC) - central body of executive power in sphere of forming and implementing politics on circulation of narcotic substances (NS) Forms the list of narcotic substances, psychotropic and substances and precursors. Issues licenses for carrying out activities with narcotic substances Forms quota on NS based on MoH data Issues Permission for import, export and transit of NS on territory of Ukraine

7. CONTROL SYSTEM State service on drug control (SSDC) - central body of executive power in sphere of forming and implementing politics on circulation of narcotic substances (NS) Forms the list of narcotic substances, psychotropic and substances and precursors. Issues licenses for carrying out activities with narcotic substances Forms quota on NS based on MoH data Issues Permission for import, export and transit of NS on territory of Ukraine

8. Transportation of NS Based on license Performed by health institutions, actors which produce NS or carriers if they insure the security of cargo With escort of responsible person Within city or district without permission of MIA In quantity more than 200kg - with escort of patrol car of State automobile Inspection or state guard service of MIA

9. Import Permission for each separate operation issued by SSDC, coordinated with Security Service of Ukraine State control of quality of MS

10. Storage in health institutions Based on license In separate rooms, equipped according to requirements of MIA (Order 216)

11. Pharmacy depot • Walls – equivalent of density of 500 mm brickwall • Floor and ceiling – armored concrete slab180mm or Strengthening the inside with grid-iron • Door • Metal or wooden (covered by sheet of iron on both sides) solid with two mortise locks– 40mm • Laced metal doorsfrom inner side • Windows – screened • Multi-line security alarm system

12. Pharmacy and Medical Preventive Institution • Walls – equivalent of density of 500 mm brickwall • Floor and ceiling – armored concrete slab180mm or Strengthening the inside with grid-iron • Door • Metal or wooden (covered by sheet of iron on both sides) solid with two mortise locks– 40mm • Laced metal doorsfrom inner side • Windows – screened • Alarm system along the perimeter of the room

13. Outpatients’ departments/Posts in Medical Preventive Institution Separate room with safe or metallic cabinet fastened to floor (wall) Doors – Metal or wooden (covered by sheet of iron on both sides) solid 40mm with two mortise locks Windows – screened Autonomic alarm system with output of alarm to posts of central surveillance or local sonic or light signaling devices

14. Prescription of NS Due to absence for a long time of peroral forms of morphine there is a fix practice that doctors do not give prescriptions for strong opiods and patients receive them in Medical Preventive Institutions

15. Prescription of NS As a rule NS are prescribed by oncologists

16. Use of NS

17. Prescriptions

18. Need in morphine for population of Ukraine according to official data in 2011need: 65-75 mg per day for 3 months

19. Need in different forms of morphine With fast effect With prolonged action Injection form Syrups Sprays Candles Patches

20. Thank You