Service members in drug addiction treatment referred for medical re-evaluations – Ukraine’s Military Ombudsman’s Office

Service members undergoing opioid agonist treatment (OAT) will be referred for repeat medical assessments. So far, 163 service members have been referred to appropriate medical specialists for consultation, including 82 referred for repeat assessments by military medical commissions, according to Ukraine’s Office of the Military Ombudsman.

Photo: president.gov.ua

Under current legislation, undergoing opioid agonist treatment is grounds for being declared unfit for military service. However, people receiving treatment for opioid dependence continue to be mobilised into the military, the Office of the Military Ombudsman said.

“When treatment is forcibly interrupted, acute withdrawal syndrome develops within 72 hours. This completely undermines a service member’s combat effectiveness, increases the risk of suicide or desertion, and leads to conflicts within military units as well as additional strain on commanders and the military healthcare system.”

To address the issue, the Office of the Military Ombudsman launched an interagency initiative involving the Ministry of Defence, the Ground Forces Command, the Central Military Medical Commission (MMC) and military medical professionals. The office also submitted an appeal to the Commander-in-Chief of the Armed Forces of Ukraine.

As a result of cooperation with military units and the Ground Forces Command, 163 service members have already been referred to appropriate medical specialists for consultation, including 82 referred for repeat assessments by military medical commissions.

As the issue requires both legislative and organisational solutions, the Office of the Military Ombudsman is conducting an analytical study on how substance dependence affects military service.

“We are working in two areas: conducting in-depth interviews with military healthcare experts and confidential surveys of service members who have previously received or are currently receiving opioid agonist treatment.”

According to the preliminary findings:

• the military healthcare system currently lacks the infrastructure needed to provide opioid agonist treatment, while the supply of medication in combat conditions remains unregulated;
• military medical commissions have limited access to registries of people with substance dependence, making it difficult to properly assess their health status and medical needs;
• there are no unified diagnostic criteria for determining fitness for military service among people with substance dependence.

The Office is also developing recommendations to improve the procedures used by military medical commissions. In addition, it is working on arrangements for the medical support of service members receiving opioid agonist treatment until they are referred for specialist consultations and repeat medical evaluation.

According to the Office, the study’s findings will help develop a unified state policy: either completely excluding people with severe substance dependence from mobilisation or introducing a separate framework allowing them to serve in rear-area positions.

“To implement the second option, it is necessary to ensure uninterrupted treatment in civilian healthcare facilities, introduce rapid testing within military units and expand rehabilitation programmes,” the Office said.

Earlier, the Military Ombudsman stated that among 2,000 people mobilised into one military unit despite being unfit for service were individuals with substance dependence, including those undergoing opioid agonist treatment. She stressed that this is a widespread problem in the Armed Forces of Ukraine.

You may also want to read: Illegal detentions and broken ribs: Ukraine’s ombudsman details critical human rights violations during mobilisation in the country

ZMINA previously reported that since the start of Russia’s full-scale invasion, the number of court convictions of Ukrainian service members for drug-related offences has more than tripled. Last year, one in four convicted service members in this category was found guilty of drug trafficking.

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