Page 25 - GHES-2-4

Global Health Economics and
Sustainability
OAT in Central Asia: Kyrgyz Republic

Table 1. (Continued)
Year Policy change Activities OAT Census Source
(Sites)
2015 Order 372 Creates a working group to revise the Approx. 1200 (Instructions on Implementation of Methadone
methadone treatment clinical protocol. (31) Maintenance Therapy and Needle and Syringe Programs
New guidelines recommend maintenance in Institutions of the State Penitentiary Service under
doses as low as 60 mg for most patients the Government of the Kyrgyz Republic, 2015; On the
and prohibit take-home dosing. Creation of a Working Group for the Revision of the
Clinical Protocol “Treatment of Opioid Dependence
Based on Maintenance Therapy with Methadone”, 2015;
Republican Narcology Center, 2015; Subata et al., 2015)
2016 Orders 161, 637 Order 637 abolishes the State Drug 1505 (31) (On Additional Measures for Counteraction of Illicit
Control Service, a law enforcement Trafficking of Narcotic Drugs, Psychotropic Substances
branch focused on trafficking and drug and Precursors, 2011; On Measures to Reform the
use through punitive measures. Order System of Law Enforcement Agencies of the Kyrgyz
161 establishes that illicit drug trafficking Republic, 2016; On the Liquidation of the State Drug
will be regulated by the Ministry of Control Service under the Government of the Kyrgyz
Internal Affairs and legal circulation of Republic, 2016; Republican Narcology Center of the
narcotic drugs including methadone will Ministry of Health of the Kyrgyz Republic, 2016)
be regulated by the Ministry of Health.
This creates a more public-health-based
approach to drug regulation.
In 2016, the government produced its
first training manual for dispensing
methadone by nurses.
2017 Orders 584, 625, Order 584 introduces a clinical protocol 1455 (29) (On Amendments to the Regulations “On the
1082, 131 for children and adolescents with Conditions and Procedure for Conducting Methadone
substance use disorders, allowing Maintenance Therapy for Persons Who Inject Drugs
treatment of OUD in minors. Order in the Kyrgyz Republic”, 2017; On the Conditions and
625 allows oversight of the methadone Procedure for Conducting Methadone Maintenance
program. Order 1082 allows methadone Therapy for People Who Use Injection Drugs in
treatment in inpatient facilities and the Kyrgyz Republic, 2017; On the Implementation
introduces take-home dosing for select of Orders of the Ministry of Health of the Kyrgyz
patients for up to five days, and Order 131 Republic No. 625 Dated July 17, 2017, and No. 1082
provides guidance on how to implement Dated November 28, 2017, 2017; Republican Narcology
Orders 625 and 1082. Center of the Ministry of Health of the Kyrgyz
Republic, 2017)
2019 Orders 542, 749 Permit PWH to seek HIV services outside 1123 (24) (On Approval of Mechanisms for Decentralization
of specialized clinics, including receiving of Medical Services for People Living with Human
antiretroviral medications at methadone Immunodeficiency Virus in the Kyrgyz Republic, 2019;
sites. These orders also provide a clinical Republican Narcology Center of the Ministry of Health
protocol for people who use opioids and of the Kyrgyz Republic, 2019)
alcohol.
2020 Order 28 Expands take-home dosing of methadone 979 (24) (On Measures to Prevent Coronavirus Infections
during the COVID-19 pandemic to (COVID-19), 2020)
mitigate community transmission of
COVID. Allows take-home dosing for up
to five days for patients whose relatives
apply on their behalf with identifying
documents.
2022 Order 1471 Updates official guidelines for OAT, 850 (24) (Ministry of Health of the Kyrgyz Republic and
incorporating input from international Republican Centre for Psychiatry and Narcology, 2022)
experts. The updated guidelines target
higher dosing, earlier transition to
take-home dosing, and faster induction
strategies. For the first time, guidelines for
buprenorphine treatment are introduced.
Abbreviations: HIV: Human immunodeficiency virus; OAT: Opioid agonist therapies; OUD: Opioid use disorder; PWH: People with HIV;
PWID: People who inject drugs.

Volume 2 Issue 4 (2024) 4 https://doi.org/10.36922/ghes.2536